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== Introduction ==
 
== Introduction ==
 
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''Hikka'' (hiccups) and ''shwasa'' (dyspnea/shortness of breath) may be caused due to [[pandu]] roga with pathological signs of anemia (alpa rakta), abnormal fat metabolism(alpa medaska) and depletion of body constituents ([[dhatu]]-kshaya). [Chakrapani Cha.Sa.Chi. 17/1]. That is why this chapter follows the chapter on [[Pandu Chikitsa]]. The term 'Shwasa' denotes physiological process of respiration and pathological sign too. In physiological process, breathing without any distress is seen; however pathological signs can be diagnosed if person suffers any distress during breathing and has to take extra efforts for same.''Hikka'' and ''shwasa'' have common etiological factors (''karana'') like raja (pollen or dust particles), ''dhuma'' (smoke) etc., location (''sthana'') and treatment or ''mula''. For that reason, both conditions are described in the same chapter.
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''Hikka'' (hiccups) and ''shwasa'' (dyspnea/shortness of breath) may be caused due to [[pandu]] roga with pathological signs of anemia (alpa rakta), abnormal fat metabolism(alpa medaska) and depletion of body constituents ([[dhatu]]-kshaya). [Chakrapani Cha.Sa. [[Chikitsa Sthana ]] 17/1]. That is why this chapter follows the chapter on [[Pandu Chikitsa]]. The term 'Shwasa' denotes physiological process of respiration and pathological sign too. In physiological process, breathing without any distress is seen; however pathological signs can be diagnosed if person suffers any distress during breathing and has to take extra efforts for same.''Hikka'' and ''shwasa'' have common etiological factors (''karana'') like raja (pollen or dust particles), ''dhuma'' (smoke) etc., location (''sthana'') and treatment or ''mula''. For that reason, both conditions are described in the same chapter.
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''Hikka'' and ''shwasa'' are two diseases of serious nature which can be presented at terminal stages of life and as complication of  other diseases [Cha.Sa.Chi.17/6]. These can cause death if not treated properly. The etiological factors, site, origin of both ''hikka'' and ''shwasa'' are same, and hence the line of treatment is also common. The etiological factors related to food, regimen and mental faculties lead to the aggravation of ''vata'' in the ''pranavaha srotas'' and derangement of ''kapha'' situated in the chest region producing lethal blockage of ''prana vayu''.  
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''Hikka'' and ''shwasa'' are two diseases of serious nature which can be presented at terminal stages of life and as complication of  other diseases [Cha.Sa. [[Chikitsa Sthana]] 17/6]. These can cause death if not treated properly. The etiological factors, site, origin of both ''hikka'' and ''shwasa'' are same, and hence the line of treatment is also common. The etiological factors related to food, regimen and mental faculties lead to the aggravation of ''vata'' in the ''pranavaha srotas'' and derangement of ''kapha'' situated in the chest region producing lethal blockage of ''prana vayu''.  
    
The ''maha'' (severe form), ''gambhira'' (having depth) and ''vyapeta'' (originating after food and with complications) types of ''hikka'' are incurable.  If the ''vyapeta'' or ''yamala hikka'' (with two hiccups together) is associated with symptoms of emaciation, delirium, pain, excess thirst and stupor then it is incurable for treatment, while it is curable in non emaciated and mentally strong individual with unimpaired ''dhatus'' and ''indriyas'' performing their normal function. ''Kshudra hikka'' (minor variety)  and ''annaja hikka'' (due to improper food intake)  are curable types of ''hikka''. ''Maha'' (severe form), ''urdhva'' (shallow respiration) and ''chinna'' (irregular pattern dyspnea) ''shwasa'' are incurable and lead to death very fast. ''Tamaka'' (with black outs) and ''kshudra shwasa'' (minor variety) are curable if patient is strong, and disease is in early stage, while in weak patients they are ''yapya'' (work as palliatives).  
 
The ''maha'' (severe form), ''gambhira'' (having depth) and ''vyapeta'' (originating after food and with complications) types of ''hikka'' are incurable.  If the ''vyapeta'' or ''yamala hikka'' (with two hiccups together) is associated with symptoms of emaciation, delirium, pain, excess thirst and stupor then it is incurable for treatment, while it is curable in non emaciated and mentally strong individual with unimpaired ''dhatus'' and ''indriyas'' performing their normal function. ''Kshudra hikka'' (minor variety)  and ''annaja hikka'' (due to improper food intake)  are curable types of ''hikka''. ''Maha'' (severe form), ''urdhva'' (shallow respiration) and ''chinna'' (irregular pattern dyspnea) ''shwasa'' are incurable and lead to death very fast. ''Tamaka'' (with black outs) and ''kshudra shwasa'' (minor variety) are curable if patient is strong, and disease is in early stage, while in weak patients they are ''yapya'' (work as palliatives).  
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The patient suffering from ''hikka'' and ''shwasa'' should be treated with oleation, unctuous sudation to liquefy the accumulated ''kapha'', soften the channels and to facilitate ''vatanulomana'' (movement of ''vata'' in its normal direction). This should be followed by the administration elimination therapy in the form of ''vamana'' (emesis therapy), ''virechana'' (purgation), ''nasya'' and following of wholesome diet and regimen. The palliative medications should be administered keeping in view the condition of patient and stage of disease. Avoiding the causative factors and following wholesome regimen is important to prevent progress of disease and to reverse the pathogenesis. In brief ''shodhana'' followed by ''brimhana'' therapy (nourishing therapy) and ''shamana'' treatment (palliative therapy) are the ideal management methods in ''hikka'' and ''shwasa''. All diseases of respiratory system and channels transporting vital breath (pranvaha srotas) are treated based on the principles of management of shwasa laid down in this chapter. [Cha. Sa.Vimana Sthana 5/26]
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The patient suffering from ''hikka'' and ''shwasa'' should be treated with oleation, unctuous sudation to liquefy the accumulated ''kapha'', soften the channels and to facilitate ''vatanulomana'' (movement of ''vata'' in its normal direction). This should be followed by the administration elimination therapy in the form of ''vamana'' (emesis therapy), ''virechana'' (purgation), ''nasya'' and following of wholesome diet and regimen. The palliative medications should be administered keeping in view the condition of patient and stage of disease. Avoiding the causative factors and following wholesome regimen is important to prevent progress of disease and to reverse the pathogenesis. In brief ''shodhana'' followed by ''brimhana'' therapy (nourishing therapy) and ''shamana'' treatment (palliative therapy) are the ideal management methods in ''hikka'' and ''shwasa''. All diseases of respiratory system and channels transporting vital breath (pranvaha srotas) are treated based on the principles of management of shwasa laid down in this chapter. [Cha. Sa.[[Vimana Sthana]] 5/26]
 
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