Chapter CLI - The Nidanam of Hic Cough

Dhanvantari said:—Now I shall discourse on the Nidanam of Hiccough. Hiccough and dyspnœa result from similar causes, and its preliminary symptoms, as well as the number of types in which it is ordinarily divided by pathologists, are same as those mentioned under dyspnœa. The several types of hiccough are named as Vakshyodbhava, Kshudra, Yamala, Mahati, and Gambhira. The wind in the stomach, enraged and aggravated by hasty and injudicious eating, partaking of sharp, unwholesome and parchifying substances and such like causes, produces a kind of hiccough which is never loud, and which abates with the eating of the evening meal. This type of hiccough is called Vakshyodbhava or Annaja. The low and mild hiccough, which is caused by the wind enraged by fatiguing physical exercises, is called Kshudra. It rises from the root of the throat, becomes aggravated through labour, and abates with the partaking of food. The type in which hiccoughs rise in couples, and which, though mild at the outset, becomes violent in course of time, and in which the head and the neck are simultaneously shaken, is called Yamala. Delirium, vomiting, dysentery, yawning, and distortion of the eyes are the symptoms that are found to supervene with the advancement of this type of hiccough. In the Mahahicca-type the eye. brows droop down, the temples are sunk, consciousness vanishes, a peculiar pain is felt in all the sense-organs, the spinal bone is arched down, and an aching pain is felt about the heart. This kind of hiccough violently rises from the bottom of the abdomen, or from the region of the umbilicus, in quick succession and accompanied by a loud report and an excruciating pain. Yawning and spasmodic jerks of the limbs, are its characteristics. This type of hiccough proceeds only from fatal and deep-seated organic disorders, and the remedies administered to subdue the same, must be likewise deep-acting in their potency. The two last-named types should be abandoned as incurable, while the one, which is not ordinarily fatal, should be regarded as indicating an unfavourable prognosis as soon as it develops all the afore, said grave symptoms. Any of the types of hiccough, afflicting an old man, or one of impaired digestion, or one that is extremely run down from sexual excesses, may have a fatal termination. Any disease of whatsoever type and denomination, may prove fatal, but the only two maladies, that portend An impending danger, are hiccough and dyspnœa.