Chapter L - Symptoms and Treatment of Hiccough (Hicca)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of hic cough (Hicca-Pratishedha). 1.

Causes:—

Hiccough, cough and asthma are the result of using those articles of fare which are heavy, dry, or secreting (Abhishyandi) 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, over-fatiguing physical exercises, physical exertion, load-carrying, toils of journey, voluntary repression of (physical urgings), fasting (Apatarpana), accumulation of Ama-dosha (mucus in the intestines), blow or hurt, emaciation (weakness) due to sexual excesse, 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 Samshamana remedies. 2.

Derivation:—

The Vayu (wind) constantly belches out of the mouth with a report shaking, as it were, the spleen, the liver and the intestines. The physicians have bestowed the name Hicca on the disease owing to fact,of its speedily extinguishing the vital spark in man (from Sanskrit root—Hins to kill). 3.

Classification:—

Hicca is divided into five kinds which arc styled Annaja, Yamala, Kshudra Gambhira and Mahati, all of which arc the effects of the derangement of the bodily Vayu acting in unison with the deranged Kapha. 4.

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) arc the premonitory symptoms which usher in a fit of hiccough. 5.

Symptoms:—

The bodily Vayu being suddenly deranged by taking too much food and drink, is pushed upward and belched out in gusts which are known as Annaja Hicca. 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 root^[1] of the clavicles (Jatru) is called Kshudrika. 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 as it were, at the vulnerable parts (Marmans) and stretches out the body in full, shaking all the limbs and which occurs frequently and with a considerable force accompanied by a report, and produces a severe thirst is called Maha-Hicca. 6 —10.

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, frequent sneezing (D. R.—cough) or an aversion to food as well as those suffering from the last two cases of Hicca vis., Gambhira and Mahati should be given up as incurable. 11

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. Yashti-madhu mixed with honey, or Pippali mixed with sugar, or a lukewarm compound of milk, clarified butter and the expressed juice of sugar-cane^[2] should be employed after the manner of an Avapida-Nasya. Vomiting and purging may be induced in a 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 Saindhaiva dissolved in water is beneficial, if administered as a medicinal snuff. 12.

Gummy exudation of Shala trees, Manah-shila, 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 Shvavidh^[3], a sheep, a cow or of Shallaki should be burnt in a covered pot and given to be licked with honey. Plumes of a peacock or the fruit of Udumvara 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 Vijapura and with honey would also give instataneous relief in a paraxysm of hiccough. 13.

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 Shunthi and water^[4] (in the manner of Kshira-paka) and mixed with sugar could be as well taken with benefit. The urine of a she-goat and of a ew^re taken to satiety would readily cure a fit of hiccough. Similarly the smell of Puti-kīta^[5] duly soaked in the infusion of radish, Vaca and Hingu^[6] after the manner of Bhavana saturation would have the same result. 14.

Naga-keshara 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 two-Pala weight of clarified butter. Haritaki should be first taken and then a draught of tepid water. Clarified butter should be taken with milk and honey. A Pichu (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, Shunthi, 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 Hicca. 15.

The four different liquid compounds^[7] 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
4. and Kasisa (sulphate of iron) and Kapìttha (D. R.—Dadhi),

should be mixed with honey and administered by an experienced physician in cases of Hicca. 16.

Meat as diet:—

The soup prepared with the meat of Shallaka (porcupine), Shvadamshtra, Godha, Vrisha-damsha (wild cat), Rishya (D. R. Riksha—a bear) and Mriga (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.). 17.

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 cases of Hicca. Some authorities are of opinion that the application of an Anuvasana-vasti would be also beneficial in such cases. 18.

 

Thus ends the fiftieth chapter in the Uttara-Tantra of the Sushruta Samhita which deals with the (symptoms and) treatment of hiccough.

Footnotes and references:

[1]:

By the word “Mula” (i.e., root) of the Jatru (clavicles) Gayadāśa understands the regions of the heart, Kloma, throat, etc.—Dallana.

[2]:

Tepid milk, tepid clarified butter and expressed juice of sugar-cane are also separately used as snuff.

[3]:

Śvāvidh and Śallaki are the two different kinds of porcupine.

[4]:

Some render “śuṇṭhītoya” as the decoction of Śunthi.

[5]:

Puti-kīta is a kind of bad-smelling worm appearing generally during the rainy season.

[6]:

Some read “hiṅgvañca”(?) (Hingu and lotus) in place of “hiṅgvambu” | In both cases, however, “bhāvita” means simply ‘mixed’.

[7]:

According to Vrinda and Cakrapāni lambatives should be prepared with these drugs. According to some, the decoction should be used.