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{{#seo:
|title=Hikka Shwasa Chikitsa
|titlemode=append
|keywords=Shwasa, hikka, dyspnea, hiccups, tamaka shwasa, bronchial asthma, respiratory disorders, vamana, therapeutic emesis, virechana, therapeutic purgation, swedana, sudation
|description=Chikitsa Sthana Chapter 17. Management of Hikka (Hiccups) and Shwasa (Dyspnea)
}}
<big>'''[[Chikitsa Sthana]] Chapter 17. Management of Hikka (Hiccups) and Shwasa (Dyspnea)</big>'''
<big>'''[[Chikitsa Sthana]] Chapter 17. Management of Hikka (Hiccups) and Shwasa (Dyspnea)</big>'''
=== Sanskrit Text, Transliteration and English Translation ===
=== Sanskrit Text, Transliteration and English Translation ===
<div class="mw-collapsible mw-collapsed">
अथातो हिक्काश्वासचिकित्सितं व्याख्यास्यामः ||१||
अथातो हिक्काश्वासचिकित्सितं व्याख्यास्यामः ||१||
इति ह स्माह भगवानात्रेयः ||२||
इति ह स्माह भगवानात्रेयः ||२||
<div class="mw-collapsible-content">
athātō hikkāśvāsacikitsitaṁ vyākhyāsyāmaḥ||1||
athātō hikkāśvāsacikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smAha bhagavAnAtreyaH ||2||
iti ha smAha bhagavAnAtreyaH ||2||
</div></div>
Now we shall expound the chapter on the management of ''Hikka''(hiccups) and ''Shwasa''(dyspnoea). Thus said Lord Atreya. [1-2]
Now we shall expound the chapter on the management of ''Hikka''(hiccups) and ''Shwasa''(dyspnoea). Thus said Lord Atreya. [1-2]
==== Agnivesha’s query ====
==== Agnivesha’s query ====
<div class="mw-collapsible mw-collapsed">
वेदलोकार्थतत्त्वज्ञमात्रेयमृषिमुत्तमम् |
वेदलोकार्थतत्त्वज्ञमात्रेयमृषिमुत्तमम् |
रोगा नानात्मकास्तेषां कस्को भवति दुर्जयः ||४||
रोगा नानात्मकास्तेषां कस्को भवति दुर्जयः ||४||
<div class="mw-collapsible-content">
vēdalōkārthatattvajñamātrēyamr̥ṣimuttamam|
vēdalōkārthatattvajñamātrēyamr̥ṣimuttamam|
rogA nAnAtmakAsteShAM kasko bhavati durjayaH ||4||
rogA nAnAtmakAsteShAM kasko bhavati durjayaH ||4||
</div></div>
Agnivesha , an intelligent disciple, asked his doubt with modest salute of folded hands to Lord Atreya, who has the knowledge about the subject and principles of the Vedas “The diseases are categorized under two categories (''samanyaja'' and ''nanatmaja'') of three ''dosha'' (''vata, pitta'' and ''kapha'') aggravated due to three factors (like unwholesome utilization of sense organs (''asatmendriyartha samyoga''), intellectual errors (''pajnaparadha'') and advent of maturity of time (''parinama'')). Which among these diseases is most difficult to cure?” [3-4]
Agnivesha , an intelligent disciple, asked his doubt with modest salute of folded hands to Lord Atreya, who has the knowledge about the subject and principles of the Vedas “The diseases are categorized under two categories (''samanyaja'' and ''nanatmaja'') of three ''dosha'' (''vata, pitta'' and ''kapha'') aggravated due to three factors (like unwholesome utilization of sense organs (''asatmendriyartha samyoga''), intellectual errors (''pajnaparadha'') and advent of maturity of time (''parinama'')). Which among these diseases is most difficult to cure?” [3-4]
==== Atreya’s reply and nature of disease of ''shwasa'' and ''hikka'' ====
==== Atreya’s reply and nature of disease of ''shwasa'' and ''hikka'' ====
<div class="mw-collapsible mw-collapsed">
अग्निवेशस्य तद्वाक्यं श्रुत्वा मतिमतां वरः |
अग्निवेशस्य तद्वाक्यं श्रुत्वा मतिमतां वरः |
अन्ते सञ्जायते हिक्का श्वासो वा तीव्रवेदनः ||७||
अन्ते सञ्जायते हिक्का श्वासो वा तीव्रवेदनः ||७||
<div class="mw-collapsible-content">
agnivēśasya tadvākyaṁ śrutvā matimatāṁ varaḥ|
agnivēśasya tadvākyaṁ śrutvā matimatāṁ varaḥ|
ante sa~jjAyate hikkA shvAso vA tIvravedanaH ||7||
ante sa~jjAyate hikkA shvAso vA tIvravedanaH ||7||
</div></div>
After listening to Agnivesha, Lord Punarvasu, the most prudent among the sages was very delighted and made ultimate and conclusive statement. “In fact there are many diseases which can kill a patient. But none of the diseases is as lethal as ''shwasa'' and ''hikka'' as they can cause immediate death. The person suffering from any other disease can also get eventually afflicted with enormously painful ''hikka'' and ''shwasa'' at the time of death.”[3-7]
After listening to Agnivesha, Lord Punarvasu, the most prudent among the sages was very delighted and made ultimate and conclusive statement. “In fact there are many diseases which can kill a patient. But none of the diseases is as lethal as ''shwasa'' and ''hikka'' as they can cause immediate death. The person suffering from any other disease can also get eventually afflicted with enormously painful ''hikka'' and ''shwasa'' at the time of death.”[3-7]
==== Predominance of ''dosha'' and affliction of ''dhatu'' ====
==== Predominance of ''dosha'' and affliction of ''dhatu'' ====
<div class="mw-collapsible mw-collapsed">
कफवातात्मकावेतौ पित्तस्थानसमुद्भवौ |
कफवातात्मकावेतौ पित्तस्थानसमुद्भवौ |
मिथ्योपचरितौ क्रुद्धौ हत आशीविषाविव ||९||
मिथ्योपचरितौ क्रुद्धौ हत आशीविषाविव ||९||
<div class="mw-collapsible-content">
kaphavātātmakāvētau pittasthānasamudbhavau|
kaphavātātmakāvētau pittasthānasamudbhavau|
mithyopacaritau kruddhau hata AshIviShAviva ||9||
mithyopacaritau kruddhau hata AshIviShAviva ||9||
</div></div>
''Hikka'' and ''shwasa'' are mainly ''kapha'' and ''vata'' dominant in nature. They originate at the site of ''pitta'' (upper part of stomach). This results in further depletion of ''dhatus'' like ''rasa'' situated in heart. Hence generally they are extremely difficult to treat. After getting afflicted with this disease, if one indulges in unwholesome regimens, then disease gets aggravated and results in death just as from fatal snake venom. [8-9]
''Hikka'' and ''shwasa'' are mainly ''kapha'' and ''vata'' dominant in nature. They originate at the site of ''pitta'' (upper part of stomach). This results in further depletion of ''dhatus'' like ''rasa'' situated in heart. Hence generally they are extremely difficult to treat. After getting afflicted with this disease, if one indulges in unwholesome regimens, then disease gets aggravated and results in death just as from fatal snake venom. [8-9]
==== Etiological factors ====
==== Etiological factors ====
<div class="mw-collapsible mw-collapsed">
पृथक् पञ्चविधावेतौ निर्दिष्टौ रोगसङ्ग्रहे |
पृथक् पञ्चविधावेतौ निर्दिष्टौ रोगसङ्ग्रहे |
कण्ठोरसः प्रतीघाताद्विबन्धैश्च पृथग्विधैः ||१६||
कण्ठोरसः प्रतीघाताद्विबन्धैश्च पृथग्विधैः ||१६||
<div class="mw-collapsible-content">
pr̥thak pañcavidhāvētau nirdiṣṭau rōgasaṅgrahē|
pr̥thak pañcavidhāvētau nirdiṣṭau rōgasaṅgrahē|
kaNThorasaH pratIghAtAdvibandhaishca pRuthagvidhaiH ||16||
kaNThorasaH pratIghAtAdvibandhaishca pRuthagvidhaiH ||16||
</div></div>
Five types of ''hikka'' and ''shwasa'', based on etiology, signs, symptoms and treatment are being elaborated here, listen to them carefully:
Five types of ''hikka'' and ''shwasa'', based on etiology, signs, symptoms and treatment are being elaborated here, listen to them carefully:
==== General ''Samprapti'' (pathogenesis) ====
==== General ''Samprapti'' (pathogenesis) ====
<div class="mw-collapsible mw-collapsed">
मारुतः प्राणवाहीनि स्रोतांस्याविश्य कुप्यति |
मारुतः प्राणवाहीनि स्रोतांस्याविश्य कुप्यति |
घोरान् प्राणोपरोधाय प्राणिनां पञ्च पञ्च च |१८|
घोरान् प्राणोपरोधाय प्राणिनां पञ्च पञ्च च |१८|
<div class="mw-collapsible-content">
mārutaḥ prāṇavāhīni srōtāṁsyāviśya kupyati|
mārutaḥ prāṇavāhīni srōtāṁsyāviśya kupyati|
ghorAn prANoparodhAya prANinAM pa~jca pa~jca ca |18|
ghorAn prANoparodhAya prANinAM pa~jca pa~jca ca |18|
</div></div>
By the above mentioned etiological factors the ''vata'' gets aggravated in the ''pranavahasrotas'' ( channels carrying ''prana'') and deranges the ''kapha'' situated in the chest region producing lethal blockage of ''pranavayu'' and five types of dreadful ''hikka'' and ''shwasa''. [17-18]
By the above mentioned etiological factors the ''vata'' gets aggravated in the ''pranavahasrotas'' ( channels carrying ''prana'') and deranges the ''kapha'' situated in the chest region producing lethal blockage of ''pranavayu'' and five types of dreadful ''hikka'' and ''shwasa''. [17-18]
==== Premonitory symptoms ====
==== Premonitory symptoms ====
<div class="mw-collapsible mw-collapsed">
उभयोः पूर्वरूपाणि शृणु वक्ष्याम्यतः परम् ||१८||
उभयोः पूर्वरूपाणि शृणु वक्ष्याम्यतः परम् ||१८||
आनाहः पार्श्वशूलं च पीडनं हृदयस्य च |
आनाहः पार्श्वशूलं च पीडनं हृदयस्य च |
प्राणस्य च विलोमत्वं श्वासानां पूर्वलक्षणम् ||२०||
प्राणस्य च विलोमत्वं श्वासानां पूर्वलक्षणम् ||२०||
<div class="mw-collapsible-content">
ubhayōḥ pūrvarūpāṇi śr̥ṇu vakṣyāmyataḥ param||18||
ubhayōḥ pūrvarūpāṇi śr̥ṇu vakṣyāmyataḥ param||18||
AnAhaH pArshvashUlaM ca pIDanaM hRudayasya ca |
AnAhaH pArshvashUlaM ca pIDanaM hRudayasya ca |
prANasya ca vilomatvaM shvAsAnAM pUrvalakShaNam ||20||
prANasya ca vilomatvaM shvAsAnAM pUrvalakShaNam ||20||
</div></div>
Following are the premonitory symptoms of both the diseases:
Following are the premonitory symptoms of both the diseases:
==== Specific pathogenesis of ''hikka'' ====
==== Specific pathogenesis of ''hikka'' ====
<div class="mw-collapsible mw-collapsed">
प्राणोदकान्नवाहीनि स्रोतांसि सकफोऽनिलः |
प्राणोदकान्नवाहीनि स्रोतांसि सकफोऽनिलः |
इति महाहिक्का |
इति महाहिक्का |
<div class="mw-collapsible-content">
prāṇōdakānnavāhīni srōtāṁsi sakaphō'nilaḥ|
prāṇōdakānnavāhīni srōtāṁsi sakaphō'nilaḥ|
iti mahAhikkA |
iti mahAhikkA |
</div></div>
*''Vishesha samprapti'': ''Vata'' along with ''kapha'' blocks the channels carrying ''prana, udaka'' and ''anna'' and produces ''hikka''.
*''Vishesha samprapti'': ''Vata'' along with ''kapha'' blocks the channels carrying ''prana, udaka'' and ''anna'' and produces ''hikka''.
==== ''Gambhira hikka'' ====
==== ''Gambhira hikka'' ====
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हिक्कते यः प्रवृद्धस्तु कृशो दीनमना नरः |
हिक्कते यः प्रवृद्धस्तु कृशो दीनमना नरः |
इति गम्भीरा हिक्का |
इति गम्भीरा हिक्का |
<div class="mw-collapsible-content">
hikkatē yaḥ pravr̥ddhastu kr̥śō dīnamanā naraḥ|
hikkatē yaḥ pravr̥ddhastu kr̥śō dīnamanā naraḥ|
iti gambhIrA hikkA |
iti gambhIrA hikkA |
</div></div>
Excessive aggravation of ''kapha'' and ''vayu'' in an aged, emaciated and mentally depressed individual leads to ''hikka''. This ''hikka'' is characterised by deep and resonant sound, and affliction of the chest. He yawns, contracts and expands his body, and while respiring he contracts both the flanks making murmuring sounds, and suffers from stiffness and pain. In such a patient the ''hikka'' arises from the umbilicus or ''pakvashaya'' (intestines) with pain all over the body. During this time his body bends and he suffers from black outs, obstruction in the respiratory tract and loss of strength and unconsciousness. Such ''hikka'' is known as ''gambhira hikka'' which ultimately results in death. [27-30]
Excessive aggravation of ''kapha'' and ''vayu'' in an aged, emaciated and mentally depressed individual leads to ''hikka''. This ''hikka'' is characterised by deep and resonant sound, and affliction of the chest. He yawns, contracts and expands his body, and while respiring he contracts both the flanks making murmuring sounds, and suffers from stiffness and pain. In such a patient the ''hikka'' arises from the umbilicus or ''pakvashaya'' (intestines) with pain all over the body. During this time his body bends and he suffers from black outs, obstruction in the respiratory tract and loss of strength and unconsciousness. Such ''hikka'' is known as ''gambhira hikka'' which ultimately results in death. [27-30]
==== ''Vyapeta hikka'' ====
==== ''Vyapeta hikka'' ====
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व्यपेता जायते हिक्का याऽन्नपाने चतुर्विधे |
व्यपेता जायते हिक्का याऽन्नपाने चतुर्विधे |
इति व्यपेता हिक्का |
इति व्यपेता हिक्का |
<div class="mw-collapsible-content">
vyapētā jāyatē hikkā yā'nnapānē caturvidhē|
vyapētā jāyatē hikkā yā'nnapānē caturvidhē|
iti vyapetA hikkA |
iti vyapetA hikkA |
</div></div>
The ''vyapeta hikka'' produced after the intake of four types of food (i.e. eatable, chewable, drinkable, lickable) and gets aggravated after food gets digested. He suffers from delirium, vomiting, diarrhea, thirst and unconsciousness. There is yawning, watering of eyes, dryness of mouth and bending of the body, and ''adhmana'' (distension of the abdomen). This ''hikka'' originates from the root of the clavicle and attack is not continuous. ''Hikka'' is injurious to life. [31-33]
The ''vyapeta hikka'' produced after the intake of four types of food (i.e. eatable, chewable, drinkable, lickable) and gets aggravated after food gets digested. He suffers from delirium, vomiting, diarrhea, thirst and unconsciousness. There is yawning, watering of eyes, dryness of mouth and bending of the body, and ''adhmana'' (distension of the abdomen). This ''hikka'' originates from the root of the clavicle and attack is not continuous. ''Hikka'' is injurious to life. [31-33]
==== ''Kshudra hikka'' ====
==== ''Kshudra hikka'' ====
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क्षुद्रवातो यदा कोष्ठाद्व्यायामपरिघट्टितः |
क्षुद्रवातो यदा कोष्ठाद्व्यायामपरिघट्टितः |
इति क्षुद्रहिक्का |
इति क्षुद्रहिक्का |
<div class="mw-collapsible-content">
kṣudravātō yadā kōṣṭhādvyāyāmaparighaṭṭitaḥ|
kṣudravātō yadā kōṣṭhādvyāyāmaparighaṭṭitaḥ|
iti kShudrahikkA |
iti kShudrahikkA |
</div></div>
The ''vayu'' gets slightly aggravated in the ''koshtha'' (alimentary tract), due to the physical exercises and reaches the throat and produces ''kshudra hikka''. This does not produce much pain and does not afflict the head and vital parts (''hridaya marma''). In this type of ''hikka'', the ''doshas'' do not reside or get lodged in the channels of respiration, food and drinks. This gets aggravated on exertion and subsides on taking food. ''Hikka'' gets subsided by itself also. The ''doshas'' are situated in cardiac region, ''kloma'', throat and palate. This mild form of ''hikka'' is curable and known as ''kshudra hikka''. [35-37]
The ''vayu'' gets slightly aggravated in the ''koshtha'' (alimentary tract), due to the physical exercises and reaches the throat and produces ''kshudra hikka''. This does not produce much pain and does not afflict the head and vital parts (''hridaya marma''). In this type of ''hikka'', the ''doshas'' do not reside or get lodged in the channels of respiration, food and drinks. This gets aggravated on exertion and subsides on taking food. ''Hikka'' gets subsided by itself also. The ''doshas'' are situated in cardiac region, ''kloma'', throat and palate. This mild form of ''hikka'' is curable and known as ''kshudra hikka''. [35-37]
==== ''Annaja Hikka'' ====
==== ''Annaja Hikka'' ====
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सहसाऽत्यभ्यवहृतैः पानान्नैः पीडितोऽनिलः |
सहसाऽत्यभ्यवहृतैः पानान्नैः पीडितोऽनिलः |
इत्यन्नजा हिक्का |
इत्यन्नजा हिक्का |
<div class="mw-collapsible-content">
Sahas ā'tyabhyavahr̥taiḥ pānānnaiḥ pīḍitō'nilaḥ|
Sahas ā'tyabhyavahr̥taiḥ pānānnaiḥ pīḍitō'nilaḥ|
ityannajA hikkA |
ityannajA hikkA |
</div></div>
The ''vayu'' gets aggravated and moves in the upward direction due to the intake of excess food or drinks in hurry or excess of alcohol, anger, talking, laughing, weightlifting etc. factors aggravate ''vayu'' in ''koshtha'' (alimentary tract) gets afflicted by food and drinks and move in the upward direction and get lodged in channels of chest and produce ''annaja hikka''. This ''hikka'' occurs slowly and intermittently along with sneezing. The ''hikka'' that does not afflict vital points (''marma'') and organs and it subsides after drinking water or taking food is known as ''annaja hikka''.[38-41]
The ''vayu'' gets aggravated and moves in the upward direction due to the intake of excess food or drinks in hurry or excess of alcohol, anger, talking, laughing, weightlifting etc. factors aggravate ''vayu'' in ''koshtha'' (alimentary tract) gets afflicted by food and drinks and move in the upward direction and get lodged in channels of chest and produce ''annaja hikka''. This ''hikka'' occurs slowly and intermittently along with sneezing. The ''hikka'' that does not afflict vital points (''marma'') and organs and it subsides after drinking water or taking food is known as ''annaja hikka''.[38-41]
==== Prognosis of ''hikka'' ====
==== Prognosis of ''hikka'' ====
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अतिसञ्चितदोषस्य भक्तच्छेदकृशस्य च |
अतिसञ्चितदोषस्य भक्तच्छेदकृशस्य च |
अक्षीणश्चाप्यदीनश्च स्थिरधात्विन्द्रियश्च यः |
अक्षीणश्चाप्यदीनश्च स्थिरधात्विन्द्रियश्च यः |
तस्य साधयितुं शक्या यमिका हन्त्यतोऽन्यथा ||४४||
तस्य साधयितुं शक्या यमिका हन्त्यतोऽन्यथा ||४४||
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atisañcitadōṣasya bhaktacchēdakr̥śasya ca|
atisañcitadōṣasya bhaktacchēdakr̥śasya ca|
akShINashcApyadInashca sthiradhAtvindriyashca yaH |
akShINashcApyadInashca sthiradhAtvindriyashca yaH |
tasya sAdhayituM shakyA yamikA hantyato~anyathA ||44||
tasya sAdhayituM shakyA yamikA hantyato~anyathA ||44||
</div></div>
The ''hikka'' destroys a person suffering from excessive accumulation of ''doshas'', emaciated due to fasting, emaciated due to disease, weak due to ageing or excessive indulgence in sex. The symptoms of delirium, pain, excess thirst and stupor in ''yamika hikka'' patient make it incurable for treatment.
The ''hikka'' destroys a person suffering from excessive accumulation of ''doshas'', emaciated due to fasting, emaciated due to disease, weak due to ageing or excessive indulgence in sex. The symptoms of delirium, pain, excess thirst and stupor in ''yamika hikka'' patient make it incurable for treatment.
==== Specific pathogenesis of ''Shwasa'' ====
==== Specific pathogenesis of ''Shwasa'' ====
<div class="mw-collapsible mw-collapsed">
यदा स्रोतांसि संरुध्य मारुतः कफपूर्वकः |
यदा स्रोतांसि संरुध्य मारुतः कफपूर्वकः |
विष्वग्व्रजति संरुद्धस्तदा श्वासान्करोति सः ||४५||
विष्वग्व्रजति संरुद्धस्तदा श्वासान्करोति सः ||४५||
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yadā srōtāṁsi saṁrudhya mārutaḥ kaphapūrvakaḥ|
yadā srōtāṁsi saṁrudhya mārutaḥ kaphapūrvakaḥ|
yadA srotAMsi saMrudhya mArutaH kaphapUrvakaH |
yadA srotAMsi saMrudhya mArutaH kaphapUrvakaH |
viShvagvrajati saMruddhastadA shvAsAnkaroti saH ||45||
viShvagvrajati saMruddhastadA shvAsAnkaroti saH ||45||
</div></div>
The aggravated ''vayu'' along with vitiated ''kapha'' obstructs the channels (of ''prana, udaka'' and ''annavaha'') and spreads throughout the body and produces ''shwasa''. [45]
The aggravated ''vayu'' along with vitiated ''kapha'' obstructs the channels (of ''prana, udaka'' and ''annavaha'') and spreads throughout the body and produces ''shwasa''. [45]
==== ''Mahashwasa'' ====
==== ''Mahashwasa'' ====
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उद्धूयमानवातो यः शब्दवद्दुखितो नरः |
उद्धूयमानवातो यः शब्दवद्दुखितो नरः |
इति महाश्वासः |
इति महाश्वासः |
<div class="mw-collapsible-content">
uddhūyamānavātō yaḥ śabdavadduḥkhitō naraḥ|
uddhūyamānavātō yaḥ śabdavadduḥkhitō naraḥ|
iti mahAshvAsaH |
iti mahAshvAsaH |
</div></div>
The patient breathes with a loud noise during the night due to the upward movement of aggravated ''vayu'' like intoxicated bull. The ''vayu'' gets obstructed and the person becomes unconscious. The eyes get distorted and he cannot visualize properly. The eyes and face become abnormal and the elimination of urine and feces is obstructed and the voice becomes feeble and the person looks tired and respiration could be heard from distance, such person suffering from ''mahashwasa'' succumbs to death very fast. [46-48]
The patient breathes with a loud noise during the night due to the upward movement of aggravated ''vayu'' like intoxicated bull. The ''vayu'' gets obstructed and the person becomes unconscious. The eyes get distorted and he cannot visualize properly. The eyes and face become abnormal and the elimination of urine and feces is obstructed and the voice becomes feeble and the person looks tired and respiration could be heard from distance, such person suffering from ''mahashwasa'' succumbs to death very fast. [46-48]
==== ''Urdhva Shwasa'' ====
==== ''Urdhva Shwasa'' ====
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दीर्घं श्वसिति यस्तूर्ध्वं न च प्रत्याहरत्यधः |
दीर्घं श्वसिति यस्तूर्ध्वं न च प्रत्याहरत्यधः |
इत्यूर्ध्वश्वासः |
इत्यूर्ध्वश्वासः |
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dīrghaṁ śvasiti yastūrdhvaṁ na ca pratyāharatyadhaḥ|
dīrghaṁ śvasiti yastūrdhvaṁ na ca pratyāharatyadhaḥ|
ityUrdhvashvAsaH |
ityUrdhvashvAsaH |
</div></div>
The vitiated ''kapha'' obstructs channels of respiration leading to aggravation of ''vata'' resulting in prolonged expiration and shallow inspiration (breath doesn’t get deeply inspired). The patient looks up with moving eye balls as if he is scared of something. When he gets afflicted with this type of ''shwasa'' he suffers from unconsciousness, dryness of mouth, restlessness. The upward movement of ''vayu'' is aggravated resulting in obstruction of downward movement and unconsciousness, black outs and he succumbs to death quickly. [49-51]
The vitiated ''kapha'' obstructs channels of respiration leading to aggravation of ''vata'' resulting in prolonged expiration and shallow inspiration (breath doesn’t get deeply inspired). The patient looks up with moving eye balls as if he is scared of something. When he gets afflicted with this type of ''shwasa'' he suffers from unconsciousness, dryness of mouth, restlessness. The upward movement of ''vayu'' is aggravated resulting in obstruction of downward movement and unconsciousness, black outs and he succumbs to death quickly. [49-51]
==== ''Chhinna Shwasa'' ====
==== ''Chhinna Shwasa'' ====
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यस्तु श्वसिति विच्छिन्नं सर्वप्राणेन पीडितः |
यस्तु श्वसिति विच्छिन्नं सर्वप्राणेन पीडितः |
इति छिन्नश्वासः |
इति छिन्नश्वासः |
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yastu śvasiti vicchinnaṁ sarvaprāṇēna pīḍitaḥ|
yastu śvasiti vicchinnaṁ sarvaprāṇēna pīḍitaḥ|
iti chinnashvAsaH |
iti chinnashvAsaH |
</div></div>
The patient suffering from ''chhinna shwasa'' has interrupted breath as the prana(vital centers referred in [[Sutra Sthana]] Chapter 29) is afflicted. There is complete stoppage of breath, such individual suffers from intense pain as if cutting of the ''marma'' (vital parts), constipation with abdominal distension, sweating, unconsciousness, burning sensation in ''basti'' (bladder and urinary system), excessive tears in the eyes, emaciation of the body, the eyes become red when patient struggles to breath, mental disorientation, dryness of mouth, discoloration of skin, delirium, looseness of joints. An individual suffering from above said features of ''chhinna shwasa'' succumbs to death very quickly. [52-54]
The patient suffering from ''chhinna shwasa'' has interrupted breath as the prana(vital centers referred in [[Sutra Sthana]] Chapter 29) is afflicted. There is complete stoppage of breath, such individual suffers from intense pain as if cutting of the ''marma'' (vital parts), constipation with abdominal distension, sweating, unconsciousness, burning sensation in ''basti'' (bladder and urinary system), excessive tears in the eyes, emaciation of the body, the eyes become red when patient struggles to breath, mental disorientation, dryness of mouth, discoloration of skin, delirium, looseness of joints. An individual suffering from above said features of ''chhinna shwasa'' succumbs to death very quickly. [52-54]
==== ''Tamaka Shwasa'' ====
==== ''Tamaka Shwasa'' ====
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प्रतिलोमं यदा वायुः स्रोतांसि प्रतिपद्यते |
प्रतिलोमं यदा वायुः स्रोतांसि प्रतिपद्यते |
इति तमकश्वासः |
इति तमकश्वासः |
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pratilōmaṁ yadā vāyuḥ srōtāṁsi pratipadyatē|
pratilōmaṁ yadā vāyuḥ srōtāṁsi pratipadyatē|
iti tamakashvAsaH |
iti tamakashvAsaH |
</div></div>
The ''vayu'' moves in the opposite direction due to the obstruction in the respiratory tract, stiffness in the neck, head aggravates the ''kapha'' and produces rhinorrhoea, and ''gurghuraka'' sound (rhonchi). Exceedingly severe attack afflicts the ''prana'' and enhances severity. During severe attack, the patient faints repeatedly, has severe cough and becomes unconscious. The patient finds it difficult to expectorate the phlegm and feels relieved for period of 1 ''muhurta'' (3 hours) after expectoration of phlegm. There is hoarseness of voice and patient speaks with difficulty, even he does not get proper sleep, and on lying down he suffers from dyspnea as his flanks are afflicted by ''vayu''. He feels comfortable in the sitting position. He likes hot things. His eye balls are always prominent, there is sweat on the forehead, dryness of the mouth, gets repeated attacks of dyspnea, and it increases and subsides repeatedly. In gets aggravated when appearance of clouds in the sky, rains, cold weather, easterly winds and ''kapha'' enhancing food and behavior. The ''tamaka shwasa'' having above mentioned features is ''yapya'' (palliable) and in the initial stages it is curable disease. [55-62]
The ''vayu'' moves in the opposite direction due to the obstruction in the respiratory tract, stiffness in the neck, head aggravates the ''kapha'' and produces rhinorrhoea, and ''gurghuraka'' sound (rhonchi). Exceedingly severe attack afflicts the ''prana'' and enhances severity. During severe attack, the patient faints repeatedly, has severe cough and becomes unconscious. The patient finds it difficult to expectorate the phlegm and feels relieved for period of 1 ''muhurta'' (3 hours) after expectoration of phlegm. There is hoarseness of voice and patient speaks with difficulty, even he does not get proper sleep, and on lying down he suffers from dyspnea as his flanks are afflicted by ''vayu''. He feels comfortable in the sitting position. He likes hot things. His eye balls are always prominent, there is sweat on the forehead, dryness of the mouth, gets repeated attacks of dyspnea, and it increases and subsides repeatedly. In gets aggravated when appearance of clouds in the sky, rains, cold weather, easterly winds and ''kapha'' enhancing food and behavior. The ''tamaka shwasa'' having above mentioned features is ''yapya'' (palliable) and in the initial stages it is curable disease. [55-62]
==== Types of ''Tamaka Shwasa'' ====
==== Types of ''Tamaka Shwasa'' ====
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ज्वरमूर्च्छापरीतस्य विद्यात् प्रतमकं तु तम् |
ज्वरमूर्च्छापरीतस्य विद्यात् प्रतमकं तु तम् |
इति प्रतमकसन्तमकश्वासौ |
इति प्रतमकसन्तमकश्वासौ |
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jvaramūrcchāparītasya vidyāt pratamakaṁ tu tam|
jvaramūrcchāparītasya vidyāt pratamakaṁ tu tam|
iti pratamakasantamakashvAsau |
iti pratamakasantamakashvAsau |
</div></div>
In a patient of ''tamaka shwasa'' if ''jwara'' (fever) and unconsciousness are occurring as complication, then it is called as ''pratamaka shwasa''. The ''shwasa'' produced due to ''udavarta'' (upward movement of ''vayu'' in ''koshtha''), dust, indigestion, excessive liquid accumulation in the body (''klinna kaya''), and suppression of natural urges results in increase of ''tama''. This gets relieved by following of cooling regimen. The person suffering from this ''shwasa'' feels as if he is submerged in darkness, thus it is known as ''santamaka''.[63-64]
In a patient of ''tamaka shwasa'' if ''jwara'' (fever) and unconsciousness are occurring as complication, then it is called as ''pratamaka shwasa''. The ''shwasa'' produced due to ''udavarta'' (upward movement of ''vayu'' in ''koshtha''), dust, indigestion, excessive liquid accumulation in the body (''klinna kaya''), and suppression of natural urges results in increase of ''tama''. This gets relieved by following of cooling regimen. The person suffering from this ''shwasa'' feels as if he is submerged in darkness, thus it is known as ''santamaka''.[63-64]
==== ''Kshudra shwasa'' ====
==== ''Kshudra shwasa'' ====
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रूक्षायासोद्भवः कोष्ठे क्षुद्रो वात उदीरयन् |
रूक्षायासोद्भवः कोष्ठे क्षुद्रो वात उदीरयन् |
इति श्वासाः समुद्दिष्टा हिक्काश्चैव स्वलक्षणैः |६८|
इति श्वासाः समुद्दिष्टा हिक्काश्चैव स्वलक्षणैः |६८|
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rūkṣāyāsōdbhavaḥ kōṣṭhē kṣudrō vāta udīrayan|
rūkṣāyāsōdbhavaḥ kōṣṭhē kṣudrō vāta udīrayan|
iti shvAsAH samuddiShTA hikkAshcaiva svalakShaNaiH |68|
iti shvAsAH samuddiShTA hikkAshcaiva svalakShaNaiH |68|
</div></div>
Due to intake of dry food and exertion, ''vata'' is mildly vitiated in ''koshtha'' and moves in the upward direction i.e respiratory tract resulting in ''kshudra shwasa''. The patient suffering from this type of ''shwasa'' does not have any affliction of various body parts and the functions are not affected. It is not very painful as it does not affect the channels of food and drinks nor does it cause pain to the sense organs. This is curable if the symptom is not completely manifested and the patient is strong. Thus all the types of ''hikka'' and ''shwasa'' are elaborated along with their signs and symptoms.[65-67]
Due to intake of dry food and exertion, ''vata'' is mildly vitiated in ''koshtha'' and moves in the upward direction i.e respiratory tract resulting in ''kshudra shwasa''. The patient suffering from this type of ''shwasa'' does not have any affliction of various body parts and the functions are not affected. It is not very painful as it does not affect the channels of food and drinks nor does it cause pain to the sense organs. This is curable if the symptom is not completely manifested and the patient is strong. Thus all the types of ''hikka'' and ''shwasa'' are elaborated along with their signs and symptoms.[65-67]
==== Necessity of quick management of ''hikka'' and ''shwasa'' ====
==== Necessity of quick management of ''hikka'' and ''shwasa'' ====
<div class="mw-collapsible mw-collapsed">
एषां प्राणहरा वर्ज्या घोरास्ते ह्याशुकारिणः ||६८||
एषां प्राणहरा वर्ज्या घोरास्ते ह्याशुकारिणः ||६८||
भेषजैः साध्ययाप्यांस्तु क्षिप्रं भिषगुपाचरेत् |
भेषजैः साध्ययाप्यांस्तु क्षिप्रं भिषगुपाचरेत् |
उपेक्षिता दहेयुर्हि शुष्कं कक्षमिवानलः ||६९||
उपेक्षिता दहेयुर्हि शुष्कं कक्षमिवानलः ||६९||
<div class="mw-collapsible-content">
ēṣāṁ prāṇaharā varjyā ghōrāstē hyāśukāriṇaḥ||68||
ēṣāṁ prāṇaharā varjyā ghōrāstē hyāśukāriṇaḥ||68||
bheShajaiH sAdhyayApyAMstu kShipraM bhiShagupAcaret |
bheShajaiH sAdhyayApyAMstu kShipraM bhiShagupAcaret |
upekShitA daheyurhi shuShkaM kakShamivAnalaH ||69||
upekShitA daheyurhi shuShkaM kakShamivAnalaH ||69||
</div></div>
Among them the fatal varieties (like ''maha hikka, gambhira hikka, vyapeta hikka, maha shwasa, urdhva shwasa, chhinna shwasa'' are incurable types) should not be treated. While the curable and controllable variety of ''hikka'' and ''shwasa'' should be treated with medicine quickly. If neglected then it destroys the ''prana'' of the patient as the fire burns away the dry grass very fast.[68-69]
Among them the fatal varieties (like ''maha hikka, gambhira hikka, vyapeta hikka, maha shwasa, urdhva shwasa, chhinna shwasa'' are incurable types) should not be treated. While the curable and controllable variety of ''hikka'' and ''shwasa'' should be treated with medicine quickly. If neglected then it destroys the ''prana'' of the patient as the fire burns away the dry grass very fast.[68-69]
==== Guidelines for treatment of ''hikka'' and ''shwasa'' ====
==== Guidelines for treatment of ''hikka'' and ''shwasa'' ====
<div class="mw-collapsible mw-collapsed">
कारणस्थानमूलैक्यादेकमेव चिकित्सितम् |
कारणस्थानमूलैक्यादेकमेव चिकित्सितम् |
निर्हृते सुखमाप्नोति स कफे दुष्टविग्रहे |
निर्हृते सुखमाप्नोति स कफे दुष्टविग्रहे |
स्रोतःसु च विशुद्धेषु चरत्यविहतोऽनिलः ||७६||
स्रोतःसु च विशुद्धेषु चरत्यविहतोऽनिलः ||७६||
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kāraṇasthānamūlaikyādēkamēva cikitsitam|
kāraṇasthānamūlaikyādēkamēva cikitsitam|
nirhRute sukhamApnoti sa kaphe duShTavigrahe |
nirhRute sukhamApnoti sa kaphe duShTavigrahe |
srotaHsu ca vishuddheShu caratyavihato~anilaH ||76||
srotaHsu ca vishuddheShu caratyavihato~anilaH ||76||
</div></div>
The etiological factors, site, origin of both ''hikka'' and ''shwasa'' are same and hence the treatment is also same. Kindly listen attentively the treatment of ''hikka'' and ''shwasa'' as known by the seers.
The etiological factors, site, origin of both ''hikka'' and ''shwasa'' are same and hence the treatment is also same. Kindly listen attentively the treatment of ''hikka'' and ''shwasa'' as known by the seers.
==== Treatment of remaining ''dosha'' ====
==== Treatment of remaining ''dosha'' ====
<div class="mw-collapsible mw-collapsed">
लीनश्चेद्दोषशेषः स्याद्धूमैस्तं निर्हरेद्बुधः |
लीनश्चेद्दोषशेषः स्याद्धूमैस्तं निर्हरेद्बुधः |
स्योनाकवर्धमानानां नाडीं शुष्कां कुशस्य वा |
स्योनाकवर्धमानानां नाडीं शुष्कां कुशस्य वा |
पद्मकं गुग्गुलुं लोहं शल्लकीं वा घृताप्लुतम् ||८०||
पद्मकं गुग्गुलुं लोहं शल्लकीं वा घृताप्लुतम् ||८०||
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līnaścēddōṣaśēṣaḥ syāddhūmaistaṁ nirharēdbudhaḥ|
līnaścēddōṣaśēṣaḥ syāddhūmaistaṁ nirharēdbudhaḥ|
syonAkavardhamAnAnAM nADIM shuShkAM kushasya vA |
syonAkavardhamAnAnAM nADIM shuShkAM kushasya vA |
padmakaM gugguluM lohaM shallakIM vA ghRutAplutam ||80||
padmakaM gugguluM lohaM shallakIM vA ghRutAplutam ||80||
</div></div>
The ''doshas'' remaining after the administration of ''vamana'' treatment should be expelled by means of ''dhuma'' (medicated smoking). The ''haridra'' (turmeric), roots of ''eranda'' (Ricinis communis Linn), ''laksha'' (Ficus Lacor Buch-Ham), ''manahshila'' (realger, an Arsenic compound), ''jatamansi'' (Nardostachys jatamansone BC), are powdered properly and wick is prepared. This wick is smeared with ghee and used for medicated smoking.
The ''doshas'' remaining after the administration of ''vamana'' treatment should be expelled by means of ''dhuma'' (medicated smoking). The ''haridra'' (turmeric), roots of ''eranda'' (Ricinis communis Linn), ''laksha'' (Ficus Lacor Buch-Ham), ''manahshila'' (realger, an Arsenic compound), ''jatamansi'' (Nardostachys jatamansone BC), are powdered properly and wick is prepared. This wick is smeared with ghee and used for medicated smoking.
==== Management of complications ====
==== Management of complications ====
<div class="mw-collapsible mw-collapsed">
स्वरक्षीणातिसारासृक्पित्तदाहानुबन्धजान् |
स्वरक्षीणातिसारासृक्पित्तदाहानुबन्धजान् |
मधुरस्निग्धशीताद्यैर्हिक्काश्वासानुपाचरेत् ||८१||
मधुरस्निग्धशीताद्यैर्हिक्काश्वासानुपाचरेत् ||८१||
<div class="mw-collapsible-content">
svarakṣīṇātisārāsr̥kpittadāhānubandhajān|
svarakṣīṇātisārāsr̥kpittadāhānubandhajān|
svarakShINAtisArAsRukpittadAhAnubandhajAn |
svarakShINAtisArAsRukpittadAhAnubandhajAn |
madhurasnigdhashItAdyairhikkAshvAsAnupAcaret ||81||
madhurasnigdhashItAdyairhikkAshvAsAnupAcaret ||81||
</div></div>
The ''hikka'' and ''shwasa'' patient accompanied with complications like feeble voice, diarrhea, ''raktapitta'' (bleeding disorder) should be treated with medicines having properties of sweet, unctuous, and cold. [81]
The ''hikka'' and ''shwasa'' patient accompanied with complications like feeble voice, diarrhea, ''raktapitta'' (bleeding disorder) should be treated with medicines having properties of sweet, unctuous, and cold. [81]
==== Precautions and guidelines for ''swedana'' (sudation) ====
==== Precautions and guidelines for ''swedana'' (sudation) ====
<div class="mw-collapsible mw-collapsed">
न स्वेद्याः पित्तदाहार्ता रक्तस्वेदातिवर्तिनः |
न स्वेद्याः पित्तदाहार्ता रक्तस्वेदातिवर्तिनः |
उदावर्ते तथाऽऽध्माने मातुलुङ्गाम्लवेतसैः |
उदावर्ते तथाऽऽध्माने मातुलुङ्गाम्लवेतसैः |
हिङ्गुपीलुबिडैश्चान्नं युक्तं स्यादनुलोमनम् ||८७||
हिङ्गुपीलुबिडैश्चान्नं युक्तं स्यादनुलोमनम् ||८७||
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na svēdyāḥ pittadāhārtā raktasvēdātivartinaḥ|
na svēdyāḥ pittadāhārtā raktasvēdātivartinaḥ|
udAvarte tathA~a~adhmAne mAtulu~ggAmlavetasaiH |
udAvarte tathA~a~adhmAne mAtulu~ggAmlavetasaiH |
hi~ggupIlubiDaishcAnnaM yuktaM syAdanulomanam ||87||
hi~ggupIlubiDaishcAnnaM yuktaM syAdanulomanam ||87||
</div></div>
===== Contra-indication for ''swedana'' in ''shwasa'' =====
===== Contra-indication for ''swedana'' in ''shwasa'' =====
==== Two types of patients as per ''dosha'' dominance ====
==== Two types of patients as per ''dosha'' dominance ====
<div class="mw-collapsible mw-collapsed">
हिक्काश्वासामयी ह्येको बलवान् दुर्बलोऽपरः |
हिक्काश्वासामयी ह्येको बलवान् दुर्बलोऽपरः |
वातिकान् दुर्बलान् बालान् वृद्धांश्चानिलसूदनैः |
वातिकान् दुर्बलान् बालान् वृद्धांश्चानिलसूदनैः |
तर्पयेदेव शमनैः स्नेहयूषरसादिभिः ||९०||
तर्पयेदेव शमनैः स्नेहयूषरसादिभिः ||९०||
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hikkāśvāsāmayī hyēkō balavān durbalō'paraḥ|
hikkāśvāsāmayī hyēkō balavān durbalō'paraḥ|
vAtikAn durbalAn bAlAn vRuddhAMshcAnilasUdanaiH |
vAtikAn durbalAn bAlAn vRuddhAMshcAnilasUdanaiH |
tarpayedeva shamanaiH snehayUSharasAdibhiH ||90||
tarpayedeva shamanaiH snehayUSharasAdibhiH ||90||
</div></div>
The patients suffering from ''hikka'' and ''shwasa'' are of two types i.e. one having strength and other weak. One has aggravation of ''kapha'' and other having dryness and ''vata'' predominance.
The patients suffering from ''hikka'' and ''shwasa'' are of two types i.e. one having strength and other weak. One has aggravation of ''kapha'' and other having dryness and ''vata'' predominance.
==== Contra-indication for Purification therapy in ''hikka'' and ''shwasa'' patients ====
==== Contra-indication for Purification therapy in ''hikka'' and ''shwasa'' patients ====
<div class="mw-collapsible mw-collapsed">
अनुत्क्लिष्टकफास्विन्नदुर्बलानां विशोधनात् |
अनुत्क्लिष्टकफास्विन्नदुर्बलानां विशोधनात् |
बर्हितित्तिरिदक्षाश्च जाङ्गलाश्च मृगद्विजाः |
बर्हितित्तिरिदक्षाश्च जाङ्गलाश्च मृगद्विजाः |
दशमूलीरसे सिद्धाः कौलत्थे वा रसे हिताः ||९३||
दशमूलीरसे सिद्धाः कौलत्थे वा रसे हिताः ||९३||
<div class="mw-collapsible-content">
anutkliṣṭakaphāsvinnadurbalānāṁ viśōdhanāt|
anutkliṣṭakaphāsvinnadurbalānāṁ viśōdhanāt|
barhitittiridakShAshca jA~ggalAshca mRugadvijAH |
barhitittiridakShAshca jA~ggalAshca mRugadvijAH |
dashamUlIrase siddhAH kaulatthe vA rase hitAH ||93||
dashamUlIrase siddhAH kaulatthe vA rase hitAH ||93||
</div></div>
If purification therapy is administered in the ''hikka shwasa'' patients without aggravation of ''kapha'', in patients contraindicated for ''swedana'' or in very weak patients, then the aggravated ''vayu'' afflicts ''marma'' (vital points) and results in death instantaneously.
If purification therapy is administered in the ''hikka shwasa'' patients without aggravation of ''kapha'', in patients contraindicated for ''swedana'' or in very weak patients, then the aggravated ''vayu'' afflicts ''marma'' (vital points) and results in death instantaneously.
==== Various formulations ====
==== Various formulations ====
<div class="mw-collapsible mw-collapsed">
निदिग्धिकां बिल्वमध्यं कर्कटाख्यां दुरालभाम् |
निदिग्धिकां बिल्वमध्यं कर्कटाख्यां दुरालभाम् |
पुष्कराह्वशटीव्योषमातुलुङ्गाम्लवेतसैः |
पुष्कराह्वशटीव्योषमातुलुङ्गाम्लवेतसैः |
योजयेदन्नपानानि ससर्पिर्बिडहिङ्गुभिः ||१०४||
योजयेदन्नपानानि ससर्पिर्बिडहिङ्गुभिः ||१०४||
<div class="mw-collapsible-content">
nidigdhikāṁ bilvamadhyaṁ karkaṭākhyāṁ durālabhām|
nidigdhikāṁ bilvamadhyaṁ karkaṭākhyāṁ durālabhām|
puShkarAhvashaTIvyoShamAtulu~ggAmlavetasaiH |
puShkarAhvashaTIvyoShamAtulu~ggAmlavetasaiH |
yojayedannapAnAni sasarpirbiDahi~ggubhiH ||104||
yojayedannapAnAni sasarpirbiDahi~ggubhiH ||104||
</div></div>
''Nidigdhikadi yoga'': ''Nidigdhika'' (Solanum surattense Burm. f), ''bilva'' (Aegle marmelos Corr.), ''karkta'' (Rhus succedania Linn.), ''duralabha'' (Fagonia cretica Linn.), ''trikanthaka'' (Tribulus terrestris Linn.), ''guduchi'' (Tinospora cordifolia Willd Miers ex Hook f. & Thoms ), ''chitraka'' (Plumbago zyelanica Linn.) and ''kulattha'' (horse gram- Dolicus lab lab) are taken in equal quantity and boiled in water as ''yusha'' and filtered. This filtrate is fried in ghee and taken with ''pippali'' (Piper longum Linn.), ''shunthi'' (Zingiber officinale Roxb.) and ''saindhava lavana'' (rock salt) is conducive to ''hikka shwasa'' patients.
''Nidigdhikadi yoga'': ''Nidigdhika'' (Solanum surattense Burm. f), ''bilva'' (Aegle marmelos Corr.), ''karkta'' (Rhus succedania Linn.), ''duralabha'' (Fagonia cretica Linn.), ''trikanthaka'' (Tribulus terrestris Linn.), ''guduchi'' (Tinospora cordifolia Willd Miers ex Hook f. & Thoms ), ''chitraka'' (Plumbago zyelanica Linn.) and ''kulattha'' (horse gram- Dolicus lab lab) are taken in equal quantity and boiled in water as ''yusha'' and filtered. This filtrate is fried in ghee and taken with ''pippali'' (Piper longum Linn.), ''shunthi'' (Zingiber officinale Roxb.) and ''saindhava lavana'' (rock salt) is conducive to ''hikka shwasa'' patients.
''Pushkaradi yavagu'': ''Yavagu'' prepared from ''pushkara'' (Inula racemosa Hook f.), ''shati'' (Hedychium spicatum Buch Ham.), ''vyosha'' (''maricha, pippali, shunthi''), ''matulunga'' (Citrus medica Linn.), ''amlavetasa'' (Garcenia morella Desr) and ''hingu'' (Ferula narthex Boiss.) should be used in ''hikka shwasa'' patient. [94-104]
''Pushkaradi yavagu'': ''Yavagu'' prepared from ''pushkara'' (Inula racemosa Hook f.), ''shati'' (Hedychium spicatum Buch Ham.), ''vyosha'' (''maricha, pippali, shunthi''), ''matulunga'' (Citrus medica Linn.), ''amlavetasa'' (Garcenia morella Desr) and ''hingu'' (Ferula narthex Boiss.) should be used in ''hikka shwasa'' patient. [94-104]
<div class="mw-collapsible mw-collapsed">
दशमूलस्य वा क्वाथमथवा देवदारुणः |
दशमूलस्य वा क्वाथमथवा देवदारुणः |
एते हि कफसंरुद्धगतिप्राणप्रकोपजाः [४] |
एते हि कफसंरुद्धगतिप्राणप्रकोपजाः [४] |
तस्मात्तन्मार्गशुद्ध्यर्थं देया लेहा न निष्कफे ||१२०||
तस्मात्तन्मार्गशुद्ध्यर्थं देया लेहा न निष्कफे ||१२०||
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daśamūlasya vā kvāthamathavā dēvadāruṇaḥ|
daśamūlasya vā kvāthamathavā dēvadāruṇaḥ|
ete hi kaphasaMruddhagatiprANaprakopajAH [4] |
ete hi kaphasaMruddhagatiprANaprakopajAH [4] |
tasmAttanmArgashuddhyarthaM deyA lehA na niShkaphe ||120||
tasmAttanmArgashuddhyarthaM deyA lehA na niShkaphe ||120||
</div></div>
Drinks in ''hikka shwasa'' patients: The patient suffering from ''hikka shwasa'' should drink water prepared in ''dashamula'' or ''devadaru'' (Cedrus deodara (Roxb.) Loud.) or ''madira'' (variety of alcohol) on feeling thirst.
Drinks in ''hikka shwasa'' patients: The patient suffering from ''hikka shwasa'' should drink water prepared in ''dashamula'' or ''devadaru'' (Cedrus deodara (Roxb.) Loud.) or ''madira'' (variety of alcohol) on feeling thirst.
==== Guidelines for management of ''tamaka shwasa'' ====
==== Guidelines for management of ''tamaka shwasa'' ====
<div class="mw-collapsible mw-collapsed">
कासिने च्छर्दनं दद्यात् स्वरभङ्गे च बुद्धिमान् |
कासिने च्छर्दनं दद्यात् स्वरभङ्गे च बुद्धिमान् |
उदीर्यते भृशतरं मार्गरोधाद्वहज्जलम् |
उदीर्यते भृशतरं मार्गरोधाद्वहज्जलम् |
यथा तथाऽनिलस्तस्य मार्गं नित्यं विशोधयेत् ||१२२||
यथा तथाऽनिलस्तस्य मार्गं नित्यं विशोधयेत् ||१२२||
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kāsinē cchardanaṁ dadyāt svarabhaṅgē ca buddhimān|
kāsinē cchardanaṁ dadyāt svarabhaṅgē ca buddhimān|
udIryate bhRushataraM mArgarodhAdvahajjalam |
udIryate bhRushataraM mArgarodhAdvahajjalam |
yathA tathA~anilastasya mArgaM nityaM vishodhayet ||122||
yathA tathA~anilastasya mArgaM nityaM vishodhayet ||122||
</div></div>
An intelligent doctor in ''shwasa'' associated with cough and hoarseness of voice should be administered ''vamana'' and in ''tamaka shwasa virechana'' should be given with ''vata-kaphahara'' medicines.
An intelligent doctor in ''shwasa'' associated with cough and hoarseness of voice should be administered ''vamana'' and in ''tamaka shwasa virechana'' should be given with ''vata-kaphahara'' medicines.
==== ''Shatyadi churna'' ====
==== ''Shatyadi churna'' ====
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शटीचोरकजीवन्तीत्वङ्मुस्तं पुष्कराह्वयम् |
शटीचोरकजीवन्तीत्वङ्मुस्तं पुष्कराह्वयम् |
वालकं च समं चूर्णं कृत्वाऽष्टगुणशर्करम् |
वालकं च समं चूर्णं कृत्वाऽष्टगुणशर्करम् |
सर्वथा तमके श्वासे हिक्कायां च प्रयोजयेत् ||१२४||
सर्वथा तमके श्वासे हिक्कायां च प्रयोजयेत् ||१२४||
<div class="mw-collapsible-content">
śaṭīcōrakajīvantītvaṅmustaṁ puṣkarāhvayam|
śaṭīcōrakajīvantītvaṅmustaṁ puṣkarāhvayam|
vAlakaM ca samaM cUrNaM kRutvA~aShTaguNasharkaram |
vAlakaM ca samaM cUrNaM kRutvA~aShTaguNasharkaram |
sarvathA tamake shvAse hikkAyAM ca prayojayet ||124||
sarvathA tamake shvAse hikkAyAM ca prayojayet ||124||
</div></div>
An equal quantity of the fine powders of ''shati'' (Hedychium spicatum Buch Ham.), ''choraka'' (Angelica glauca Edgew), ''jivanti'' (Leptadenia reticulate W & A.), ''tvak'' (Cinnamomum zeylanica Breyn), ''musta'' (Cyperus rotundus Linn.), ''pushkara mula'' (Inula recimosa Hook f.), ''surasa'' (Ocimum sanctum Linn.), ''tamalaka'' (Phyllanthus urinaria Linn.), ''pippali'' (Piper longum Linn.), ''agaru'' (Aquilaria agollacha Roxb.), ''nagara'' (Zingiber officinale Roxb.), ''balaka'' (Vetiveria zizinioidis (Linn.) Nash.) is mixed with eight parts of sugar should be kept and us in ''tamaka shwasa'' and ''hikka''. [123-124]
An equal quantity of the fine powders of ''shati'' (Hedychium spicatum Buch Ham.), ''choraka'' (Angelica glauca Edgew), ''jivanti'' (Leptadenia reticulate W & A.), ''tvak'' (Cinnamomum zeylanica Breyn), ''musta'' (Cyperus rotundus Linn.), ''pushkara mula'' (Inula recimosa Hook f.), ''surasa'' (Ocimum sanctum Linn.), ''tamalaka'' (Phyllanthus urinaria Linn.), ''pippali'' (Piper longum Linn.), ''agaru'' (Aquilaria agollacha Roxb.), ''nagara'' (Zingiber officinale Roxb.), ''balaka'' (Vetiveria zizinioidis (Linn.) Nash.) is mixed with eight parts of sugar should be kept and us in ''tamaka shwasa'' and ''hikka''. [123-124]
==== ''Muktadi churna'' ====
==== ''Muktadi churna'' ====
<div class="mw-collapsible mw-collapsed">
मुक्ताप्रवालवैदूर्यशङ्खस्फटिकमञ्जनम् |
मुक्ताप्रवालवैदूर्यशङ्खस्फटिकमञ्जनम् |
इति मुक्ताद्यं चूर्णम् |
इति मुक्ताद्यं चूर्णम् |
<div class="mw-collapsible-content">
muktāpravālavaidūryaśaṅkhasphaṭikamañjanam|
muktāpravālavaidūryaśaṅkhasphaṭikamañjanam|
iti muktAdyaM cUrNam |
iti muktAdyaM cUrNam |
</div></div>
Equal quantities of the ''bhasmas'' of ''mukta'' (pearls), ''pravala'' (coral), ''vaidurya'' (cat’s aye gem), ''shankha'' (conch), ''sphatika'' (crystal quartz), ''anjana'' (lead), ''sasara'' (potent crystals of above mentioned drugs), ''gandhaka'' (sulfur), ''arka'' (Calotropis procera (Ait) R Br.), ''sukshmaila'' (Elettaria cardomum Maton), ''lavana dvayam'' (sauvarchala and saindhava), ''tamra'' (copper), ''ayas'' (iron), ''rajata'' (silver), ''saugandhika'' (variety of ''manikya'', ruby), ''jatiphala'' (Myristica fragrans Houtt), seeds of ''shana, apamarga'' (Achyranthes aspera Linn. ) are given in the dose of one ''panitala'' (karsha-12gms) along with ghee and honey. The administration of this powder cures ''hikka, shwasa'' and ''kasa''. On application in the form of ''anjana'' (collyrium) to eyes destroys ''timira'' (blindness), ''kacha''(glaucoma), ''nilika, pushpaka,'' vision defects, itching of eyes, ''abhishyanda'' (conjunctivitis) and ''arma'' (pterigium).[125-128]
Equal quantities of the ''bhasmas'' of ''mukta'' (pearls), ''pravala'' (coral), ''vaidurya'' (cat’s aye gem), ''shankha'' (conch), ''sphatika'' (crystal quartz), ''anjana'' (lead), ''sasara'' (potent crystals of above mentioned drugs), ''gandhaka'' (sulfur), ''arka'' (Calotropis procera (Ait) R Br.), ''sukshmaila'' (Elettaria cardomum Maton), ''lavana dvayam'' (sauvarchala and saindhava), ''tamra'' (copper), ''ayas'' (iron), ''rajata'' (silver), ''saugandhika'' (variety of ''manikya'', ruby), ''jatiphala'' (Myristica fragrans Houtt), seeds of ''shana, apamarga'' (Achyranthes aspera Linn. ) are given in the dose of one ''panitala'' (karsha-12gms) along with ghee and honey. The administration of this powder cures ''hikka, shwasa'' and ''kasa''. On application in the form of ''anjana'' (collyrium) to eyes destroys ''timira'' (blindness), ''kacha''(glaucoma), ''nilika, pushpaka,'' vision defects, itching of eyes, ''abhishyanda'' (conjunctivitis) and ''arma'' (pterigium).[125-128]
===== ''Shatyadi churna'' =====
===== ''Shatyadi churna'' =====
<div class="mw-collapsible mw-collapsed">
शटीपुष्करमूलानां चूर्णमामलकस्य च |
शटीपुष्करमूलानां चूर्णमामलकस्य च |
मधुना संयुतं लेह्यं चूर्णं वा काललोहजम् ||१२९||
मधुना संयुतं लेह्यं चूर्णं वा काललोहजम् ||१२९||
<div class="mw-collapsible-content">
śaṭīpuṣkaramūlānāṁ cūrṇamāmalakasya ca|
śaṭīpuṣkaramūlānāṁ cūrṇamāmalakasya ca|
shaTIpuShkaramUlAnAM cUrNamAmalakasya ca |
shaTIpuShkaramUlAnAM cUrNamAmalakasya ca |
madhunA saMyutaM lehyaM cUrNaM vA kAlalohajam ||129||
madhunA saMyutaM lehyaM cUrNaM vA kAlalohajam ||129||
</div></div>
Equal quantity of fine powders of ''shati'' (Hedychium spicatum Buch Ham.), ''pushkaramula'' (Inula racemosa Hook f.) or ''amalaki'' (Emblica officinalis Gaertn.) or ''loha bhasma'' ( iron ore) should be licked along with honey.
Equal quantity of fine powders of ''shati'' (Hedychium spicatum Buch Ham.), ''pushkaramula'' (Inula racemosa Hook f.) or ''amalaki'' (Emblica officinalis Gaertn.) or ''loha bhasma'' ( iron ore) should be licked along with honey.
===== ''Nasya formulations'' =====
===== ''Nasya formulations'' =====
<div class="mw-collapsible mw-collapsed">
सशर्करां तामलकीं द्राक्षां गोश्वशकृद्रसम् |
सशर्करां तामलकीं द्राक्षां गोश्वशकृद्रसम् |
सकृदुष्णं सकृच्छीतं व्यत्यासाद्धिक्किनां पयः |
सकृदुष्णं सकृच्छीतं व्यत्यासाद्धिक्किनां पयः |
पाने नस्तःक्रियायां वा शर्करामधुसंयुतम् ||१३४||
पाने नस्तःक्रियायां वा शर्करामधुसंयुतम् ||१३४||
<div class="mw-collapsible-content">
saśarkarāṁ tāmalakīṁ drākṣāṁ gōśvaśakr̥drasam|
saśarkarāṁ tāmalakīṁ drākṣāṁ gōśvaśakr̥drasam|
sakRuduShNaM sakRucchItaM vyatyAsAddhikkinAM payaH |
sakRuduShNaM sakRucchItaM vyatyAsAddhikkinAM payaH |
pAne nastaHkriyAyAM vA sharkarAmadhusaMyutam ||134||
pAne nastaHkriyAyAM vA sharkarAmadhusaMyutam ||134||
</div></div>
Juice of ''tamalaki'' (Phyllanthus urinaria Linn.), ''draksha'' (Vitis vinifera Linn.), cow dung and horse mixed with sugar or equal quantities of jaggery, ginger should be used for licking or ''nasya''.
Juice of ''tamalaki'' (Phyllanthus urinaria Linn.), ''draksha'' (Vitis vinifera Linn.), cow dung and horse mixed with sugar or equal quantities of jaggery, ginger should be used for licking or ''nasya''.
===== Ghee formulations and other therapies =====
===== Ghee formulations and other therapies =====
<div class="mw-collapsible mw-collapsed">
अधोभागैर्घृतं सिद्धं सद्यो हिक्कां नियच्छति |
अधोभागैर्घृतं सिद्धं सद्यो हिक्कां नियच्छति |
कायस्थया च तत् पानाद्धिक्काश्वासौ प्रणाशयेत् |१४१|
कायस्थया च तत् पानाद्धिक्काश्वासौ प्रणाशयेत् |१४१|
<div class="mw-collapsible-content">
adhōbhāgairghr̥taṁ siddhaṁ sadyō hikkāṁ niyacchati|
adhōbhāgairghr̥taṁ siddhaṁ sadyō hikkāṁ niyacchati|
kAyasthayA ca tat pAnAddhikkAshvAsau praNAshayet |141|
kAyasthayA ca tat pAnAddhikkAshvAsau praNAshayet |141|
</div></div>
The administration of ghee prepared by boiling ''adhobhagahara'' (purgatives) drugs instantly cures ''hikka''. Administration of ''pippali'' (Piper longum Linn.) along with honey or juice of ''dhatri'' (Emblica officinalis Gaertn.), and ''kapittha'' (Limonia acidissima L.) alleviates ''hikka'' quickly.
The administration of ghee prepared by boiling ''adhobhagahara'' (purgatives) drugs instantly cures ''hikka''. Administration of ''pippali'' (Piper longum Linn.) along with honey or juice of ''dhatri'' (Emblica officinalis Gaertn.), and ''kapittha'' (Limonia acidissima L.) alleviates ''hikka'' quickly.
==== ''Tejovatyadi'' ghee ====
==== ''Tejovatyadi'' ghee ====
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तेजोवत्यभया कुष्ठं पिप्पली कटुरोहिणी ||१४१||
तेजोवत्यभया कुष्ठं पिप्पली कटुरोहिणी ||१४१||
इति तेजोवत्यादिघृतम् |
इति तेजोवत्यादिघृतम् |
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tējōvatyabhayā kuṣṭhaṁ pippalī kaṭurōhiṇī||141||
tējōvatyabhayā kuṣṭhaṁ pippalī kaṭurōhiṇī||141||
iti tejovatyAdighRutam |
iti tejovatyAdighRutam |
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''Tejovatyadi ghrita'': ''Tejovati'' (Zanthoxylun armatum DC.), ''abhaya'' (Terminalia chebula Retz.), ''kushtha'' (Saussurea lappa C.B. Clarke.), ''pippali'' (Piper longum Linn.), ''katukarohini'' (Picrorhiza kurroa Royle ex Benth), ''bhutika'' (Cymbopogon Citratus), ''paushkara mula'' (Inula recemosa Hook f.), ''palasha'' (Butea monosperma (Linn.) Kuntze.), ''chitraka'' (Plumbago zeylanica Linn.), ''shati'' (Hedychium spicatium Buch Ham.), ''sauvarchala'' (variety of salt), ''tamalaki'' (Phyllanthus urinaria Linn.), ''saindhava'' (rock salt), ''bilva'' (Aegle marmelos Corr.), ''talisa patra'' (Abies webbiana Lindle.), ''jivanti'' (Leptadenia reticulate W & A.), each are taken in one ''karsha'' quantity and ''hingu'' (Ferula narthex Boiss.) in 1/4th quantity and ghee in one ''prastha'' quantity (4 parts) and ghee is prepared as per classics. This ghee should be taken as per ones strength to conquer ''hikka'' and ''shwasa''. It is also effective in edema ''vataja arsha'' (hemorrhoids), ''grahani'' (digestive disorders), ''hritparshva rija'' (pain in the cardiac region and flanks).[141-144]
''Tejovatyadi ghrita'': ''Tejovati'' (Zanthoxylun armatum DC.), ''abhaya'' (Terminalia chebula Retz.), ''kushtha'' (Saussurea lappa C.B. Clarke.), ''pippali'' (Piper longum Linn.), ''katukarohini'' (Picrorhiza kurroa Royle ex Benth), ''bhutika'' (Cymbopogon Citratus), ''paushkara mula'' (Inula recemosa Hook f.), ''palasha'' (Butea monosperma (Linn.) Kuntze.), ''chitraka'' (Plumbago zeylanica Linn.), ''shati'' (Hedychium spicatium Buch Ham.), ''sauvarchala'' (variety of salt), ''tamalaki'' (Phyllanthus urinaria Linn.), ''saindhava'' (rock salt), ''bilva'' (Aegle marmelos Corr.), ''talisa patra'' (Abies webbiana Lindle.), ''jivanti'' (Leptadenia reticulate W & A.), each are taken in one ''karsha'' quantity and ''hingu'' (Ferula narthex Boiss.) in 1/4th quantity and ghee in one ''prastha'' quantity (4 parts) and ghee is prepared as per classics. This ghee should be taken as per ones strength to conquer ''hikka'' and ''shwasa''. It is also effective in edema ''vataja arsha'' (hemorrhoids), ''grahani'' (digestive disorders), ''hritparshva rija'' (pain in the cardiac region and flanks).[141-144]
==== ''Manahshiladi'' ghee ====
==== ''Manahshiladi'' ghee ====
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मनःशिलासर्जरसलाक्षारजनिपद्मकैः |
मनःशिलासर्जरसलाक्षारजनिपद्मकैः |
इति मनःशिलादिघृतम् |
इति मनःशिलादिघृतम् |
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manaḥśilāsarjarasalākṣārajanipadmakaiḥ|
manaḥśilāsarjarasalākṣārajanipadmakaiḥ|
iti manaHshilAdighRutam |
iti manaHshilAdighRutam |
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''Manashila'' (realgar), ''sarja rasa'' (exudate of Shorea robusta Gaertn.), ''laksha'' (Ficus lacor Buch Ham.), ''rajani'' (Curcuma longa Linn), ''padmaka'' (Nelumbo nucifera Gaertn.), ''manjishtha'' (Rubia cordifolia Linn.), ''alai'' (''Haratala''- yellow orpiment), are each taken in one ''karsha'' (12 gm) quantity and ghee in one ''prastha'' quantity and ghee is prepared in classical way. [145-146]
''Manashila'' (realgar), ''sarja rasa'' (exudate of Shorea robusta Gaertn.), ''laksha'' (Ficus lacor Buch Ham.), ''rajani'' (Curcuma longa Linn), ''padmaka'' (Nelumbo nucifera Gaertn.), ''manjishtha'' (Rubia cordifolia Linn.), ''alai'' (''Haratala''- yellow orpiment), are each taken in one ''karsha'' (12 gm) quantity and ghee in one ''prastha'' quantity and ghee is prepared in classical way. [145-146]
==== General guidelines for prevention and management ====
==== General guidelines for prevention and management ====
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यत्किञ्चित् कफवातघ्नमुष्णं वातानुलोमनम् |
यत्किञ्चित् कफवातघ्नमुष्णं वातानुलोमनम् |
तस्माच्छुद्धानशुद्धांश्च शमनैर्बृंहणैरपि |
तस्माच्छुद्धानशुद्धांश्च शमनैर्बृंहणैरपि |
हिक्काश्वासार्दिताञ्जन्तून् प्रायशः समुपाचरेत् ||१५०||
हिक्काश्वासार्दिताञ्जन्तून् प्रायशः समुपाचरेत् ||१५०||
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yatkiñcit kaphavātaghnamuṣṇaṁ vātānulōmanam|
yatkiñcit kaphavātaghnamuṣṇaṁ vātānulōmanam|
tasmAcchuddhAnashuddhAMshca shamanairbRuMhaNairapi |
tasmAcchuddhAnashuddhAMshca shamanairbRuMhaNairapi |
hikkAshvAsArditA~jjantUn prAyashaH samupAcaret ||150||
hikkAshvAsArditA~jjantUn prAyashaH samupAcaret ||150||
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The food, drinks and drugs having ''kapha-vatahara'' and ''ushna'' (hot) property which facilitate the normal movement of ''vata'' (''vatanulomana'') should be given in the patient of ''hikka'' and ''shwasa''.
The food, drinks and drugs having ''kapha-vatahara'' and ''ushna'' (hot) property which facilitate the normal movement of ''vata'' (''vatanulomana'') should be given in the patient of ''hikka'' and ''shwasa''.
==== Summary ====
==== Summary ====
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तत्र श्लोकः
तत्र श्लोकः
दुर्जयत्वे समुत्पत्तौ क्रियैकत्वे च कारणम् |
दुर्जयत्वे समुत्पत्तौ क्रियैकत्वे च कारणम् |
लिङ्गं पथ्यं च हिक्कानां श्वासानां चेह दर्शितम् ||१५१||
लिङ्गं पथ्यं च हिक्कानां श्वासानां चेह दर्शितम् ||१५१||
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tatra ślōkaḥ
tatra ślōkaḥ
durjayatve samutpattau kriyaikatve ca kAraNam |
durjayatve samutpattau kriyaikatve ca kAraNam |
li~ggaM pathyaM ca hikkAnAM shvAsAnAM ceha darshitam ||151||
li~ggaM pathyaM ca hikkAnAM shvAsAnAM ceha darshitam ||151||
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इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने हिक्काश्वासचिकित्सितं नाम सप्तदशोऽध्यायः ||१७||
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने हिक्काश्वासचिकित्सितं नाम सप्तदशोऽध्यायः ||१७||
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ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē hikkāśvāsacikitsitaṁnāma saptadaśō'dhyāyaḥ||17||
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē hikkāśvāsacikitsitaṁnāma saptadaśō'dhyāyaḥ||17||
ityagniveshakRute tantre carakapratisaMskRute~aprApte dRuDhabalasampUrite cikitsAsthAne hikkAshvAsacikitsitaM nAma saptadasho~adhyAyaH ||17||
ityagniveshakRute tantre carakapratisaMskRute~aprApte dRuDhabalasampUrite cikitsAsthAne hikkAshvAsacikitsitaM nAma saptadasho~adhyAyaH ||17||
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In the chapter of ''hikka'' and ''shwasa'' the reason for explaining them together, their similarity in causes, treatment, the features and ''pathyas'' are explained. Thus in the treatise by Agnivesha, redacted by Charaka and completed by Dridhabala, this concludes the chapter entitled [[Hikka Shwasa Chikitsa]].
In the chapter of ''hikka'' and ''shwasa'' the reason for explaining them together, their similarity in causes, treatment, the features and ''pathyas'' are explained. Thus in the treatise by Agnivesha, redacted by Charaka and completed by Dridhabala, this concludes the chapter entitled [[Hikka Shwasa Chikitsa]].