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Sushruta Samhita Uttaratantra Chapter 50 Hikkā Pratiședha (Therapy of Hiccup)

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AIAPGET Factors

        In HIKKA, the particular person feels as if YAKRIT, PLIHA and ANTRANI are popping out of their mouth.

        The 5 sorts of HIKKA are – Annaja, Yamala, Kshudra, Gambhira and Mahati.

        Kshudra Hikka arises from JATRUMULA.

        Gambhira Hikka begins from NABHI.

        GAMBHIRA & MAHATI Hikka are incurable. (Su.Ut.50/15)

        HIKKA may be cured by VAMANA in sufferers who will not be very emaciated.

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The fiftieth chapter of Uttaratantra of Sushruta Samhita is known as as Hikkā Pratiședha. This chapter offers with Therapy of Hiccup.

अथातो हिक्काप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We’ll now expound Hikkā pratiṣedha- remedy of hiccups: as revealed by the venerable Dhanvantari.

Nidāna – causes

विदाहिगुरुविष्टम्भिरूक्षाभिष्यन्दिभोजनैः |
शीतपानासनस्थानरजोधूमानिलानलैः ||३||
व्यायामकर्मभाराध्ववेगाघातापतर्पणैः |
आमादोषाभिघातस्त्रीक्षयदोषप्रपीडनैः ||४||
विषमाशनाध्यनशनैस्तथा समशनैरपि |
हिक्का श्वासश्च कासश्च नृणां समुपजायते ||५||

Under talked about are the causes for hiccup, dyspnoea and cough in human beings –

        consumption of meals which trigger heartburn,

        meals that are arduous / tough for digestion,

        meals which are likely to trigger constipation, that are dry and create extra moisture contained in the physique tissues,

        extreme ingesting of chilly water,

        sitting on chilly surfaces and staying in chilly locations,

        publicity to mud, smoke, breeze and hearth,

        extreme indulgence in bodily workout routines,

        lifting heavy weights in extra,

        strolling for lengthy period,

        suppression of naturally manifested physique urges,

        malnutrition,

        ama dosha i.e. extreme accumulation of undigested meals within the physique,

        damage,

        extreme indulgence in copulation,

        lower / depletion of physique tissues,

        aggravation of doshas within the physique,

        indulgence in consumption of meals in fallacious methods together with – visamasana (consuming meals at improper time), adhyasana (consuming extreme amount of meals usually), anasana (not taking meals in any respect or consuming meals in very much less amount) and samasana (consuming combination of wholesome and unhealthy meals)

Nirukti – definition

मुहुर्मुहुर्वायरुदेति सस्वनो यकृत्प्लिहान्त्राणि मुखादिवाक्षिपन् |
स घोषवानाशु हिनस्त्यसून् यतस्ततस्तु हिक्केति भिषग्भिरुच्यते ||६||

Vayu – primarily udana and prana vata would abnormally transfer in upward course accompanied with sound. Whereas in upward motion, this aggravated vata causes shaking of liver, spleen and intestines and the particular person would really feel as if these organs are popping out of the mouth with a loud sound. This situation would trigger troubles to life. Resulting from these occasions taking place, this illness is known as hikka – hiccup by the physicians.

Vidha – sorts

अन्नजां यमलां क्षुद्रां गम्भीरां महतीं तथा |
वायुः कफेनानुगतः पञ्च हिक्काः करोति हि ||७||

Vata (aggravation) adopted by kapha (getting aggravated) produces 5 sorts of Hikka by names –

        Annaja Hikka,

        Yamala Hikka,

        Ksudra Hikka,

        Gambhira Hikka and

        Mahati Hikka

Pūrvarūpa – premonitory signs

मुखं कषायमरतिर्गौरवं कण्ठवक्षसोः |
पूर्वरूपाणि हिक्कानामाटोपो जठरस्य च ||८||

Under talked about are the premonitory signs of hiccup –

        experiencing astringent style within the mouth,

        restlessness,

        feeling of heaviness within the throat and chest and

        gurgling noise within the stomach

Rūpa – medical options

Annaja hikkā

त्वरमाणस्य चाहारं भुञ्जानस्याथवा घनम् |
वायुरन्नैरवस्तीर्णः कटुकैरर्दितो भृशम् ||९||
हिक्कयत्यूर्ध्वगो भूत्वा तां विद्यादन्नजां भिषक् |१०|
Causes –

        gulping meals in hurry,

        consuming stable / arduous meals in extra and

        consuming pungent meals in extra

As a result of above mentioned causes, vata would get blocked by meals and produce hiccups. This hikka is called Annaja Hikka i.e. hiccup produced by meals, by physicians.

Yamala hikka

चिरेण यमलैर्वेगैर्या हिक्का सम्प्रवर्तते ||१०||
कम्पयन्ती शिरोग्रीवं यमलां तां विनिर्दिशेत् |११|

Yamala means two or twin or pair. Hiccup which is available in pairs after lengthy intervals of time is known as Yamala Hikka. This hikka causes shaking of head and neck.

Kṣudra hikka

विकृष्टकालैर्या वेगैर्मन्दैः समभिवर्तते ||११||
क्षुद्रिका नाम सा हिक्का जत्रुमूलात् प्रधाविता |१२|

Under talked about are the options of Ksudra Hikka –

        hiccup seems at any time,

        it has delicate bouts and

        arises from the bottom of the shoulders / neck

Gambhīrā hikkā

नाभिप्रवृत्ता या हिक्का घोरा गम्भीरनादिनी ||१२||
शुष्कौष्ठकण्ठजिह्वास्यश्वासपार्श्वरुजाकरी |
अनेकोपद्रवयुता गम्भीरा नाम सा स्मृता ||१३||

Under talked about are the options / signs of Gambhira Hikka –

        begins from umbilicus, deep inside,

        accompanied with loud sounds,

        causes dryness of lips, throat, tongue and mouth,

        dyspnoea,

        ache in flanks and

        has many related problems

Mahati hikka

मर्माण्यापीडयन्तीव सततं या प्रवर्तते |
देहमायम्य वेगेन घोषयत्यतितृष्यतः |
महाहिक्केति सा ज्ञेया सर्वगात्रप्रकम्पिनी ||१४||

Under talked about are the options of Mahati Hikka –

        it hurts the marmas – important organs / deadly spots

        bouts come up consistently,

        bouts trigger bending of the physique,

        hiccup is related to loud sounds,

        particular person has profound thirst and

        shaking of complete physique

आयम्यते हिक्काऽतोङ्गानि यस्य दृष्टिश्चोर्ध्वं ताम्यते यस्य गाढम् |
क्षीणोऽन्नद्विट् कासते यश्च हिक्की तौ द्वावन्त्यौ वर्जयेद्धिक्कमानौ ||१५||

The particular person affected by Hikka must be refused (to not be handled) when hikka presents with the under talked about options –

        the particular person expands / stretches his physique throughout the bouts of hiccup,

        gaze of the particular person is fastened upward,

        particular person turns into deeply unconscious and

        is emaciated,

        dislikes meals and

        coughs regularly and

        when he suffers from the final two sorts of hikka i.e. gambhira hikka and mahati hikka

Hikka cikitsā – remedy of hiccup

प्राणायामोद्वेजनत्रासनानि सूचीतोदैः सम्भ्रमश्चात्र शस्तः |१६|

Under talked about are helpful measures –

        doing pranayama – controlling respiration patterns,

        utilizing harsh phrases and abusing the affected person,

        threatening the affected person,

        pricking the affected person with needles and

        inflicting agitation within the thoughts of the affected person

यष्ट्याह्वं वा माक्षिकेणावपीडे पिप्पल्यो वा शर्कराचूर्णयुक्ताः ||१६||
सर्पिः कोष्णं क्षीरमिक्षो रसो वा नातिक्षीणे छर्दनं शान्तिहेतोः [१] |१७|

Avapida means nasal drops. In hiccups, the under talked about recipes shall be used (instilled into the nostril) as avapida –

        yastimadhu combined with honey or

        pippali combined with sugar powder, heat ghee, milk or sugarcane juice

In individuals who will not be very emaciated, hiccups may be cured by producing vomiting.

नारीपयःपिष्टमशुक्लचन्दनं घृतं सुखोष्णं च ससैन्धवं तथा ||१७||
चूर्णीकृतं सैन्धवमम्भसाऽथवा निहन्ति हिक्कां च हितं च नस्यतः |१८|

Under talked about recipes put into the nostril are additionally helpful (in curing hikka) –

        girl’s milk (breastmilk), paste of rakta candana, ghrta and saindhava lavana or

        powder of saindhava lavana dissolved in water

युञ्ज्याद्धूमं शालनिर्यासजातं नैपालं वा गोविषाणोद्भवं वा ||१८||
सर्पिःस्निग्धैश्चर्मबालैः कृतं वा हिक्कास्थाने स्वेदनं चापि कार्यम् |१९|

Smoke of one of many under talked about shall be inhaled by the affected person –

        sala niryasa – gum / resin of sala tree,

        naipala – manassila or

        horn, leather-based and hairs of cow combined with ghee

On the web site of origin of hiccup, fomentation must also be performed.

क्षौद्रोपेतं गैरिकं काञ्चनाह्वं लिह्याद्भस्म ग्राम्यसत्त्वास्थिजं वा ||१९||
तद्वच्छ्वाविन्मेषगोशल्य(ल्ल)कानां रोमाण्यन्तर्धूमदग्धानि चात्र |
मध्वाज्याक्तं बर्हिपत्रप्रसूतमेवं भस्मौदुम्बरं तैल्वकं वा ||२०||
स्वर्जिक्षारं बीजपूराद्रसेन क्षौद्रोपेतं हन्ति लीढ्वाऽऽशु हिक्काम् |२१|

Under talked about recipes must be combined with honey and given to the affected person for licking –

        Svarna Gairika or

        Ash of bones of home animals or

        ash of hairs (thorns) of porcupine, ram, cow and hedgehog burnt in a closed pot

        ash of feather of peacock licked with honey and ghee or

        ash of udumbara licked with honey and ghee or

        ash of tilvaka timber licked with honey and ghee or

        sarji kshara combined with juice of bijapura and honey

All these recipes would rapidly treatment hiccups.

सर्पिःस्निग्धा घ्नन्ति हिक्कां यवाग्वः कोष्णग्रासाः पायसो वा सुखोष्णः ||२१||

Yavagu – thick gruel or Payasa – milk pudding must be consumed comfortably heat, added with ghee. This might treatment hiccups. 

शुण्ठीतोये साधितं क्षीरमाजं तद्वत् पीतं शर्करासंयुतं वा |
आतृप्तेर्वा सेव्यमानं निहन्याद् घ्रातं हिक्कामाशु मूत्रं त्वजाव्योः ||२२||
सपूतिकीटं लशुनोग्रगन्धाहिङ्ग्वब्जमाचूर्ण्य सुभावितं तत् |२३|

Under talked about recipes would rapidly treatment hikka –

        goat’s milk boiled with decoction of sunthi, added with sugar and consumed,

        inhaling odor of urine of goat or sheep for some minutes, until satisfaction,

        powder of putikita (an insect emitting unhealthy odor), lasuna, ugragandha, hingu and abja (kamala) soaked for a lot of instances within the urine of goat or sheep and inhaled

क्षौद्रं सितां वारणकेशरं च पिबेद्रसेनेक्षुमधूकजेन ||२३||
पिबेत् पलं वा लवणोत्तमस्य द्वाभ्यां पलाभ्यां हविषः समग्रम् |२४|

Varanakesara (Nagakesara) must be combined with honey, sugar and juice of sugarcane and madhuka. It must be licked by the affected person.

Likewise, the affected person ought to eat one pala (40gm) of saindhava lavana combined with two pala (80gm) ghee.

हरीतकीं कोष्णजलानुपानां पिबेद्घृतं क्षारमधूपपन्नम् ||२४||
रसं कपित्थान्मधुपिप्पलीभ्यां शुक्तिप्रमाणं प्रपिबेत् सुखाय ||२५||

For acquiring consolation from hikka, the affected person ought to eat the under talked about recipes –

        Haritaki added with Yava Ksara and honey, adopted by ingesting heat water,

        juice of Kapittha combined with honey and pippali must be consumed in a amount of 1 sukti (20gm)

कृष्णां सितां चामलकं च लीढं सशृङ्गवेरं मधुनाऽथवाऽपि |
कोलास्थिमज्जाञ्जनलाजचूर्णं हिक्का निहन्यान्मधुनाऽवलीढम् ||२६||

Under talked about recipes are additionally helpful –

        powder of krishna, sita (sugar), amalaka and srngavera must be licked with honey or

        powder of kernel of kola seeds, anjana (sauvira anjana) and laja (fried paddy) must be licked with honey

पाटलायाः फलं पुष्पं गैरिकं कटुरोहिणी |
खर्जूरमध्यं मागध्यः काशीशं दधिनाम च ||२७||
चत्वार एते योगाः स्युः प्रतिपादप्रदर्शिताः |
मधुद्वितीयाः कर्तव्यास्ते हिक्कासु विजानता ||२८||

Powder of under talked about 4 formulae said in quarter verses, would treatment hiccup, if they’re licked, added and combined with honey –

        fruits and flowers of patala or

        gairika and katurohini or

        seeds of kharjura and magadha or

        kasisa and dadhinama (kapittha)

कपोतपारावतलावश(ल्ल)कश्वदंष्ट्रगोधावृषदंशजान् रसान् |
पिबेत् फलाम्लानहिमान् ससैन्धवान् स्निग्धांस्तथैवर्ष्यमृगद्विजोद्भवान् ||२९||

Soup of meat of the under talked about animals and birds must be consumed heat, added with juice of bitter fruits and saindhava lavana –

        kapota – pigeon,

        paravata – dove,

        lava fowl,

        sallaik – porcupine,

        svadamstra – mouse deer,

        godha – iguana lizard,

        vrsadamsa – jungle cat,

        rsyamrga – black deer,

        two sorts of animals i.e. jangala and viskira

विरेचनं पथ्यतमं ससैन्धवं घृतं सुखोष्णं च सितोपलायुतम् |
सदागतावूर्ध्वगतेऽनुवासनं वदन्ति केचिच्च हिताय हिक्किनाम् ||३०||

Under talked about interventions are helpful in individuals having hiccup –

        virecana – purgation,

        ghee added with saindhava lavana and sitopala and consumed comfortably heat,

        anuvasana basti – oil / unctuous enema – is the very best for vata which has began transferring upwards in sufferers of hikka (in keeping with opinion of some others)

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे हिक्काप्रतिषेधो नाम (द्वादशो-ऽध्यायः, आदितः) पञ्चाशत्तमोऽध्यायः।।५०।।

Thus ends the fiftieth chapter by title Hikka pratişedha in Uttarasthana of Suśruta Samhita.

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