पञ्चाशत्तमोऽध्यायः अथातो हिक्काप्रतिषेधं व्याख्यास्यामः यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the chapter which deals with the ( symptoms and) medical treatment of hiccough (Hikka- Pratisedha). 1
Hiccough Causes
विदाहिगुरुविष्टम्भि रुक्षाभिष्यन्दिभोजनैः । शीतपानासनस्थान- रजोधूमानिलानलैः ॥२॥ । व्यायामकर्मभाराध्व-वेगाघातापतर्पणैः आमदोषाभिघातस्त्री – क्षयदोषप्रपीडनैः ॥३॥ विषमाशनाध्यशनैस्तथासमशनैरपि । हिक्का श्वासश्च कासश्च नृणां समुपजायते ॥ ४॥
Causes – Hiccough, cough and asthma are the result of using those articles of fare which are heavy, dry, or secreting ( Abhisyandi ) or which are followed by an acid reaction or which remain long in an undigested state (in the stomach) as well as of cold drinks, residence in cold places, exposure to cold or dust or smoke or fire or wind, loadcarrying, toils of journey, voluntary repression of (physical urgings), fasting (Apatarpana), accumulation of Ama-dosa (mucus in the intestines), blow or hurt, emaciation (weakness) due to sexual excess, concomitant distress or agony of any existing or continuing physical ailment, irregular diet, eating, before the digestion of a previous meal or of a wrong application of Samsamana remedies.2-4.
Hiccough Derivation
मुहुर्मुहुर्वायुरुदेति सस्वनो यकृत् प्लिहान्त्राणि मुखादिवाक्षिपन् । स घोषवानाशु हिनस्त्यसून् यतस्ततस्तु हिक्केति भिषग्भिरुच्यते ॥ ५ ॥
Derivation — The Vayu (wind) constantly belches out of the mouth with a feeling, as it, the spleen, the liver and the intestines are being thrown out of the oral cavity. The physicians have bestowed the name Hikka on the disease owing to fact of its speedily extinguishing the vital spark in man ( from Sanskrit root – Hins to kill). 5.
Hiccough Classification
अन्नजां यमलां क्षुद्रां गम्भीरां महतीं तथा । वायुः कफेनानुगतः पञ्च हिक्काः करोति हि ॥ ६ ॥
Classification- Hikka is divided into five kinds which are styled Annaja, Yamala, Ksudra, Gambhira and Mahati all of which are the effects of the derangement of the bodily Vayu action in unison with the deanged Kapha. 6.
Hiccough Premonitory Symptoms
मुखं कषायमरतिर्गौरवं कण्ठवक्षसोः । पूर्वरूपाणि हिक्कानामाटोपो जठरस्य च ॥ ७ ॥
Premonitory Symptoms- An astrigent taste in the mouth, an aversion to all sorts of pursuits, heaviness about the throat and cardiac region and a rumbling sound in the abdomen (Jathara) are the premonitory symptoms which usher in a fit of hiccough. 7.
Hiccough Symptoms
त्वरमाणस्य चाहारं भुञ्जानस्याथवा घनम् । वायुरन्नैरवस्तीर्णः कटुकैरर्दितो भृशम् ॥ ८॥ हिक्कयत्यूर्ध्वगो भूत्वा तां विद्यादन्नजां भिषक् ॥ ९॥ चिरेण यमलैर्वेगैर्या हिक्का सम्प्रवर्तते । कम्पयन्ती शिरोग्रीवं यमलां तां विनिर्दिशेत् ॥ १० ॥ विकृष्टकालैर्या वेगैर्मन्दैः वेगैर्मन्दैः समभिवर्तते । क्षुद्रिका नाम सा हिक्का जत्रुमूलात् प्रधाविता ॥ ११ ॥ नाभिप्रवृत्ता या हिक्का घोरा गम्भीरनादिनी । शुष्कौष्ठकण्ठजिह्वास्य – श्वासपार्श्वरुजाकरी । अनेकोपद्रववती गम्भीरा नाम सा स्मृता ॥ १२ ॥ मर्माण्यापीडयन्तीव सततं या प्रवर्तते । देहमायम्य वेगेन घोषयत्यतितृष्यतः ॥ १३ ॥ महाहिक्केति सा ज्ञेया सर्वगात्रप्रकम्पिनी ॥ १४ ॥
Symptoms – The bodily Vayu being suddenly deranged by taking too much food and drink, which are of Katu taste and very harmful, is pushed upward and belched out in gusts which are known as Annaja Hikka. The hiccough which occurs in double strokes and at long intervals shaking the head and the neck is called Yamala. The hic-cough which rises with a mild force and at long intervals from the root¹ of the clavicles (Jatru) is called Ksudrika. The violent hiccough which rises from the region of the umbilicus accompained by a deep sound and interfering with free respiration, causing dryness of the lips, throat, tongue and of the mouth and producing pain at the sides and complicated with many other distressing symptoms, is called Gambhira. The hiccough which produces a feeling of crushing pain, at the vulnerable parts (Marmans) and stretches out the body in full, shaking all the limbs and which occurs continuously and with a considerable force accompained by a report, and produces a severe thirst is called Maha-Hikka. 8-14.
Hiccough Prognosis
आयम्यते हिक्कतो यस्य देहो दृष्टिश्चोर्ध्वं ताम्यते यस्य गाढम् । क्षीणोऽन्नद्विट् क्षौति यश्चातिमात्रं तौ द्वावन्त्यौ वर्जयेद्धिक्कमानौ ॥ १५ ॥
Prognosis – A hiccough-patient whose body is stretched out in full during a fit, with his eyes turned upward and fixed in a gaze as well as the one suffering from weakness, excess sneezing (D.R.— cough) or an aversion to food as well as those suffering from the last two cases of Hikka viz., Gambhira and Mahati should be given up as inourable. 15.
प्राणायामोद्वेजनत्रासनानि सूचीतोदैः सम्भ्रमश्चात्र शस्तः । यष्ट्याहं वा माक्षिकेणावपीडे पिप्पल्यो वा शर्कराचूर्णयुक्ताः ॥ १६ ॥ सर्पिः कोष्णं क्षीरमिक्षो रसो वा नातिक्षीणे छर्दनं शान्तिहेतोः । नारीपयः पिष्टमशुक्लचन्दनं घृतं सुखोष्णञ्च ससैन्धवं तथा ॥ १७ ॥ चूर्णीकृतं सैन्धवमम्भसाऽथवा निहन्ति हिक्काञ्च हितञ्च नस्यतः ॥ १८ ॥
Treatment Practice of Pranayama (control of breath-wind), tickling, frightening and producing confusion by pricking with needles may be effectively resorted to in a case of (simple) hiccough. Yastimadhu mixed with honey, or Pippali mixed with sugar, or warm compund of milk, clarified butter and the expressed jiice of sugarcane¹ should be employed in the manner of an Avapida-Nasya. Vomiting and purging may be induced in patient not extremely weak. Red sandal-wood made into a paste with the breast-milk or lukewarm clarified butter mixed with Saindhava salt, or powdered Saindhava dissolved in water is beneficial, if administered as a medicinal snuff 16-18.
1. By the word “Mula” (i.e. root) of the Jatru (clavicles) Gayadasa understands the regions of the heart, Kloma, throat, etc.-Dalhana.
युञ्ज्याद् धूमं शालनिर्यासजातं नैपालं वा गोविषाणोद्भवं वा ॥ १९ ॥ सर्पिः स्निग्धैश्चर्मबालैः कृतं वा हिक्कास्थाने स्वेदनं वापि कुर्यात् । क्षौद्रोपेतं गैरिकं काञ्चनाहं लिह्याद् भस्म ग्राम्यसत्त्वास्थिजं वा ॥ २० ॥ तद्वच्छ्छ्राविन्मेषगोशल्लकानां रोमाण्यन्तर्धूमदग्धानि चात्र | वा ॥ २१ ॥ मध्वाज्याक्तं बर्हिपत्रप्रसूतमेवं भस्मौदुम्बरं तैल्वकं स्वर्जिक्षारं बीजपूराद्रसेन क्षौद्रोपेतं हन्ति लीढ्वाऽऽशु हिक्काम् ॥ २२ ॥
Gummy exudation of Sala tree, Manah -sila, or cow’s horn, or cow’s hairs and skin, charged with clarified butter, should be used in fumigation (Dhupana ). As an alternative, the seats of hiccough (viz., umbilical region etc.) should be duly fomented. The patient should be advised to use a lambative composed of Svarna-Gairika or the ashes of the bones of any domestic animal pasted with honey. Hairs of Savidha² a sheep, a cow or of Sallaki should be burnt in a covered pot and given to be licked with honey. Plumes of a peacock or the fruit of Udumbara or (the bark of) Lodhra should be similarly burnt and the ashes thus prepared should be licked by the patient in combination with honey and clarified butter. Sarjika-Kshara licked with the expressed juice of Bijapura and with honey would also instaneous relief in a paroxysm of hiccough. 19-22.
सर्पिः स्निग्धा घ्नन्ति हिक्कां यवाग्वः कोष्णग्रासा: पायसो वा सुखोष्णः । शुण्ठीतोये साधितं क्षीरमाजं तद्वत् पीतं शर्करासंयुतं वा । आतृप्तेर्वा सेव्यमानं निहन्याद् घ्रातं हिक्कामाशु मूत्रं त्वजाव्योः ॥ २३ ॥ सपूतिकीटं लशुनोग्रगन्धाहिङ्ग्ग्वम्बुनाऽऽचूर्ण्य सुभावितं तत् ॥ २४॥
1. Tepid milk, tepid clarified butter and expressed juice of sugar-cane are also seprately used as snuff. 2. svavidh and sallaki are the two different kinds of porcupine.
Lukewarm gruels (Yavagu) saturated with clarified butter as well as lukewarm Payasa prove curative in a case of hiccough. The milk of a she-goat duly cooked with Sunthi and water¹ (in the manner of Ksira-paka) and mixed with sugar could be as well taken to satiety with benefit. The smell of urine of a she-goat and of a ewe would readily cure a fit of hiccough. Similarly the smell of Puti-keeta² duly soaked in the infi of radish, Vaca and Hingu³ in the manner of Bhavana saturation would have the same result. 23-24.
सितां पिबेद्रसेनेक्षुमधूकजेन ॥ २५ ॥ क्षौद्रं वारणकेशरञ्च पिबेत् पलं वा लवणोत्तमस्य द्वाभ्यां पलाभ्यां हविष: समग्रम् | हरीतकीं कोष्णजलानुपानां पिबेद् घृतं क्षारमधूपपन्नम् ॥ २६ ॥ रसं कपित्थान्मधुपिप्पलीभ्यां शुक्तिप्रमाणं प्रपिबेत् सुखाय ॥२७॥ कृष्णां सिताञ्चामलकञ्च लीढं सशृङ्गवेरं मधुनाऽथवाऽपि । कोलास्थिमज्जाञ्जनलाजचूर्णं हिक्कां निहन्यान्मधुनाऽवलीढम् ॥ २८ ॥
Naga-kesara mixed with sugar and honey should be taken with a copious quantity of) the expressed juice of sugar-cane and of Madhuka flowers. A Pala weight of Saindhava salt should be used with twoPala weight of clarified butter. Haritaki should be first taken and then a draught of tepid water. Clarified butter shuld be taken with milk and honey. A Picu (two Tolas) weight of the expressed juice of Kapittha should be taken with honey and powdered Pippali for the relief (of hiccough). A lambative prepared with Pippali, Amalaka, Sunthi, Sugar and honey or one prepared with Anjana (Souviranjana), powdered fried paddy, and the kernel (of the stone of) Vadara-fruit should be licked as a remedy for an attack of Hikka. 25-28.
पाटलाया: फलं पुष्पं गैरिकं कटुरोहिणी । खर्जूरमध्यं मागध्यः काशीशं दधिनाम च ॥ २९ ॥ चत्वार एते योगाः स्युः प्रतिपादप्रदर्शिताः । मधुद्वितीयाः कर्तव्यास्ते हिक्कासु विजानता ॥ ३० ॥
1. Some rendervas the decoction of Sunthi.
2. Puti-keeta is a kind of bad-smelling worm appearing generally during the rainy season.
3. Some read ‘हिङ्गुल’ (Hingu and lotus) in place of‘हिङ्ग्वम्बु’ । In both cases, however ‘भावित’ means simply ‘mixed.’ 4
The four different liquid compounds¹ prepared with the drugs mentioned in the four quarts of the present verse, viz., (1) The fruit and flower of Patala, (2) Gairika and Katu-rohini (3) the kernel ( inner pulp) of Kharjura and Pippali and ( 4 ) Kasisa ( sulphate of iron) and Kapittha (D.R. Dadhi), should be mixed with honey and administered by an experienced physician in cases of Hikka. 29-30.
श्वदंष्ट्रगोधावृषदंशजान् कपोतपारावतलावशल्लक रसान्। पिबेत् फलाम्लानहिमान् ससैन्धवान् स्निग्धांस्तथैवर्ष्यमृगद्विजोद्भवान् ॥ ३१ ॥
Meat as diet The soup prepared with the meat of Sallaka (porcupine), Svadamstra, Godha, Vrsa-darmsa (wild cat), Rsya (D.R. Riksa-a bear) and Mrga (different kinds of deer as well as of Kapota and Paravata (different kinds of pigeon), Lava and other birds should be taken lukewarm with the expressed juice of acid fruits and with Saindhava and a Sneha (clarified butter etc.) 31.
विरेचनं पथ्यतमं ससैन्धवं घृतं सुखोष्णञ्च सितोपलायुतम् । सदागतावूर्ध्वगतेऽनुवासनं वदन्ति केचिच्च हिताय हिक्किनाम् ॥ ३२ ॥
Purgatives as well as potions of tepid clarified butter mixed with Saindhava-salt and sugar should be regarded as highly beneficial in an up-coursing of the bodily Vayu in case of Hikka. Some authorities are of opinion that the application of an Anuvasana-vasti would be also beneficial in such cases. 32.
इति सुश्रुत संहितायामुत्तरतन्त्रे हिक्काप्रतिषेधव्याख्यानाम पञ्चाशत्तमोऽध्यायः ॥ ५० ॥
Thus ends the fiftieth chapter in the Uttara-Tantra of the Susruta Samhita which deals with the ( symptoms and) treatment of hiccough.
1. According to Vrnda and Cakrapani lambatives should be prepared with these drugs. According to some, the decoction should be used.
