Hikka Shwasa Chikitsa: Difference between revisions
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<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>''' | ||
{{Infobox | {{Infobox | ||
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|data7 = Ojha S.N., Mali P. | |data7 = Ojha S.N., Mali P. | ||
|label8 = Editors | |label8 = Editors | ||
|data8 = Singh G., Goyal M., Deole Y.S., Basisht G. | |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]] | ||
|label9 = Year of publication | |label9 = Year of publication | ||
|data9 = 2020 | |data9 = 2020 | ||
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<big>''' Abstract </big>''' | <big>''' Abstract </big>''' | ||
< | <p style="text-align:justify;">The chapter deals with the etio-pathogenesis and management of ''hikka'' (hiccups) and ''shwasa'' (dyspnea). The general causative factors include dietary and environmental pathogens and specific pathogenesis is due to involvement of [[vata]] and [[kapha]] as major [[dosha]]. Thus five types of ''hikka'' and ''shwasa'' are elaborated. The classification is based upon clinical presentation of disease and includes three types each of ''hikka'' and ''shwasa'' with bad prognostic signs pointing to imminent death. The description comprehends basic principles of management focused on removing obstruction of [[kapha]] and allowing proper flow of [[vata]] by means of purification therapies, sudation, nasal errhines, medicated smoking and various formulations. The management emphasizes on nourishment and pacification therapies to successfully treat and prevent ''shwasa'' and ''hikka'' conditions. Depletion therapies are strongly contra-indicated as they may worsen the condition of patient and disease. </p> | ||
The chapter deals with the etio-pathogenesis and management of ''hikka'' (hiccups) and ''shwasa'' (dyspnea). The general causative factors include dietary and environmental pathogens and specific pathogenesis is due to involvement of [[vata]] and [[kapha]] as major [[dosha]]. Thus five types of ''hikka'' and ''shwasa'' are elaborated. The classification is based upon clinical presentation of disease and includes three types each of ''hikka'' and ''shwasa'' with bad prognostic signs pointing to imminent death. The description comprehends basic principles of management focused on removing obstruction of [[kapha]] and allowing proper flow of [[vata]] by means of purification therapies, sudation, nasal errhines, medicated smoking and various formulations. The management emphasizes on nourishment and pacification therapies to successfully treat and prevent ''shwasa'' and ''hikka'' conditions. Depletion therapies are strongly contra-indicated as they may worsen the condition of patient and disease. | |||
'''Keywords''': ''Shwasa, hikka,'' dyspnea, hiccups, ''tamaka shwasa,'' bronchial asthma, respiratory disorders, [[vamana]], therapeutic emesis, [[virechana]], therapeutic purgation, ''swedana'', sudation. | '''Keywords''': ''Shwasa, hikka,'' dyspnea, hiccups, ''tamaka shwasa,'' bronchial asthma, respiratory disorders, [[vamana]], therapeutic emesis, [[virechana]], therapeutic purgation, ''swedana'', sudation. | ||
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*Environmental factors: Dust, smoke and wind, residing in cold place, use of cold water. | *Environmental factors: Dust, smoke and wind, residing in cold place, use of cold water. | ||
*Regimen: | *Regimen: Excessive exercise, excessive sexual intercourse, excess walking, | ||
*Diet: Intake of dry food, ''vishamashana'' (food in excessive or less quantity at irregular time) | *Diet: Intake of dry food, ''vishamashana'' (food in excessive or less quantity at irregular time) | ||
*Conditions: Accumulation of '' | *Conditions: Accumulation of [[ama]]'', anaha'' (constipation associated with flatulence), dryness in the body, excessive depletion (''apatarpana''), weakness, injury to ''marmas'' (vital points), rapid change in exposure to heat and cold, diarrhea, fever, vomiting, rhinitis, ''kshata'' (injury), ''kshaya'' (wasting), ''raktapitta'' (bleeding disorder), ''[[udavarta]]'' (upward movement of [[vata]]), ''visuchika'' (enteritis), ''alasaka'' (sluggish bowel), ''[[pandu]]'' (anemia) and intake of poisons can result in ''hikka'' and ''shwasa''. | ||
*Diet: Regular intake of ''nishpava'' (beans), ''masha'' (black gram), ''pinyaka'' (oil cake), ''tila taila'' (sesame oil), ''pishta'' (cakes and pastry), ''shaluka'' (lotus stem), ''vishtambhi anna'' (food aggravating [[vata]]), ''vidahi'' (food causing burning sensations), heavy to digest food, flesh of aquatic and marshy animals, curd, raw milk, ''abhishyandhi'' (ingredients leading to obstruction of channels), food aggravating [[kapha]] | *Diet: Regular intake of ''nishpava'' (beans), ''masha'' (black gram), ''pinyaka'' (oil cake), ''tila taila'' (sesame oil), ''pishta'' (cakes and pastry), ''shaluka'' (lotus stem), ''vishtambhi anna'' (food aggravating [[vata]]), ''vidahi'' (food causing burning sensations), heavy to digest food, flesh of aquatic and marshy animals, curd, raw milk, ''abhishyandhi'' (ingredients leading to obstruction of channels), food aggravating [[kapha]] | ||
*Injury: Injury to throat and chest | *Injury: Injury to throat and chest | ||
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कफाधिकस्तथैवैको रूक्षो बह्वनिलोऽपरः ||८८|| | कफाधिकस्तथैवैको रूक्षो बह्वनिलोऽपरः ||८८|| | ||
कफाधिके बलस्थे च वमनं सविरेचनम् | | |||
कुर्यात् पथ्याशिने धूमलेहादिशमनं ततः ||८९|| | कुर्यात् पथ्याशिने धूमलेहादिशमनं ततः ||८९|| | ||
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kaphādhikastathaivaikō rūkṣō bahvanilō'paraḥ||88|| | kaphādhikastathaivaikō rūkṣō bahvanilō'paraḥ||88|| | ||
kaphādhikē balasthē ca vamanaṁ savirēcanam| | |||
kuryāt pathyāśinē dhūmalēhādiśamanaṁ tataḥ||89|| | kuryāt pathyāśinē dhūmalēhādiśamanaṁ tataḥ||89|| | ||
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kaphAdhikastathaivaiko rUkSho bahvanilo~aparaH ||88|| | kaphAdhikastathaivaiko rUkSho bahvanilo~aparaH ||88|| | ||
kaphAdhike balasthe ca vamanaM savirecanam | | |||
kuryAt pathyAshine dhUmalehAdishamanaM tataH ||89|| | kuryAt pathyAshine dhUmalehAdishamanaM tataH ||89|| | ||
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*''Anulomana'' (treating [[vata]] to move in normal direction) is the principle of management for obstructed [[vata]] in case of ''hikka'' and ''shwasa''. | *''Anulomana'' (treating [[vata]] to move in normal direction) is the principle of management for obstructed [[vata]] in case of ''hikka'' and ''shwasa''. | ||
*''Shwasa'' associated with cough and hoarseness of voice should be treated with [[vamana]] (therapeutic emesis) | *''Shwasa'' associated with cough and hoarseness of voice should be treated with [[vamana]] (therapeutic emesis) | ||
*In ''tamaka shwasa, [[virechana]] (therapeutic purgation) should be given with [[vata]]-[[kapha]]hara medicines. | *In ''tamaka shwasa, [[virechana]] (therapeutic purgation) should be given with [[vata]]-[[kapha]]hara medicines. '' | ||
*It is always required to keep the path of [[vata]], clean (respiratory tract) by frequent purification therapies and removing obstruction. | *It is always required to keep the path of [[vata]], clean (respiratory tract) by frequent purification therapies and removing obstruction. | ||
*Purification therapies like [[vamana]] and [[virechana]] shall be administered after assessing ''bala''(strength)of patient. | *Purification therapies like [[vamana]] and [[virechana]] shall be administered after assessing ''bala''(strength)of patient. | ||
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===Experience based views=== | ===Experience based views=== | ||
In chronic cases of Shwasa internal administration of unctuous substance ( | In chronic cases of Shwasa, internal administration of unctuous substance (abhyantara [[snehana]]) in pure form or medicates formulation like dashamula ghrita is useful to control [[vata]] [[dosha]]. This reduces dryness (kharatva) of respiratory tract (pranavah srotas) and pacifies movement of [[vata]] (vatanulomana). In chronic stage of svasa, [[vata]] becomes more dominant while in new cases [[Kapha]] dominancy is observed.<ref> Personal email communication by Dr. Mali Pawan, dt. January 03, 2020 </ref> | ||
Drugs prescribed for [[Pandu]], [[Shotha]] and [[Kasa]] may be used in the management of Shwasa(Su.Utt 51/43). Drugs prescribed for Kasa, Kshaya, | Drugs prescribed for [[Pandu]], [[Shotha]] and [[Kasa]] may be used in the management of Shwasa(Su.Utt 51/43). Drugs prescribed for [[Kasa]], Kshaya, chhardi and hikka can be used for Shwasa.(A.H.ch.59) | ||
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