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Line 2,052: − + + + − Drugs prescribed for [[Pandu]], [[Shotha]] and [[Kasa]] may be used in the management of Shwasa(Su.Utt 51/43). Drugs prescribed for Kasa, Kshaya, chchardi and hikka can be used for Shwasa.(A.H.ch.59)+
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{{#seo:
{{#seo:
|title=Hikka Shwasa Chikitsa
|title=Hikka Shwasa Chikitsa
|type=article
|type=article
}}
}}
<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
|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
<big>''' Abstract </big>'''
<big>''' Abstract </big>'''
<div style="text-align:justify;">
<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. </div>
'''Keywords''': ''Shwasa, hikka,'' dyspnea, hiccups, ''tamaka shwasa,'' bronchial asthma, respiratory disorders, [[vamana]], therapeutic emesis, [[virechana]], therapeutic purgation, ''swedana'', sudation.
कफाधिकस्तथैवैको रूक्षो बह्वनिलोऽपरः ||८८||
कफाधिकस्तथैवैको रूक्षो बह्वनिलोऽपरः ||८८||
कफाधिके बलस्थे च वमनं सविरेचनम् |
कुर्यात् पथ्याशिने धूमलेहादिशमनं ततः ||८९||
कुर्यात् पथ्याशिने धूमलेहादिशमनं ततः ||८९||
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||
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||
=== Origin of diseases ===
=== Origin of diseases ===
The origin of hikka shwas diseases occurs at the site of Pitta dosha (Pitta sthana) which is lower part of stomach and duodenum from undigested food substances. [Chakrapani Cha.Sa. [[Chikitsa Sthana]] 17/8] The upper part of stomach is referred to as the site for kapha dosha,.[Chakrapani Cha.Sa. [[Sutra Sthana]] 20/8]. Therefore the lower end of stomach and duodenum is considered as the site of origin of shwasa and hikka. Derangement of digestion and metabolism is an important basic pathological event leading to vitiation of kapha and its manifestation (vyakti sthana) in chest.
The origin of hikka shwas diseases occurs at the site of [[Pitta]] [[dosha]] ([[Pitta]] sthana) which is lower part of stomach and duodenum from undigested food substances. [Chakrapani Cha.Sa. [[Chikitsa Sthana]] 17/8] The upper part of stomach is referred to as the site for kapha dosha,.[Chakrapani Cha.Sa. [[Sutra Sthana]] 20/8]. Therefore the lower end of stomach and duodenum is considered as the site of origin of shwasa and hikka. Derangement of digestion and metabolism is an important basic pathological event leading to vitiation of kapha and its manifestation (vyakti sthana) in chest.
=== Pathogenesis ===
=== Pathogenesis ===
Derangement of digestion and metabolism (agnimandya) causes malformation and nourishment of all body tissues ([[dhatu]]). This further leads to vitiation of kapha and pitta dosha resulting in increase in vata dosha. [Chakrapani Cha.Sa. [[Sutra Sthana]] 6/34]
Derangement of digestion and metabolism (agnimandya) causes malformation and nourishment of all body tissues ([[dhatu]]). This further leads to vitiation of [[kapha]] and [[pitta]] [[dosha]] resulting in increase in [[vata]] [[dosha]]. [Chakrapani Cha.Sa. [[Sutra Sthana]] 6/34]
===Causes of shwasa ===
===Causes of shwasa ===
The management protocol for hikka and shwasa includes following:
The management protocol for hikka and shwasa includes following:
#Snehana (unction or oleation): Chest massage on the front, back and sides) with hot sesame oil or mahanarayana oil mixed with rock salt
#[[Snehana]](unction or oleation): Chest massage on the front, back and sides) with hot sesame oil or mahanarayana oil mixed with rock salt
#Swedana (sudation): Fomentation with dashamula kwatha or erandamula kwatha vapors by means of steam (bashpa) or through a tube (nadi).
#[[Swedana]] (sudation): Fomentation with dashamula kwatha or erandamula kwatha vapors by means of steam (bashpa) or through a tube (nadi).
#Vamana (therapeutic emesis) with mixture of piper (pippali), rock salt and honey, decoction of yasthtimadhu and madanaphala are also used.
#[[Vamana]] (therapeutic emesis) with mixture of piper (pippali), rock salt and honey, decoction of yasthtimadhu and madanaphala are also used.
#Virechana(therapeutic purgation) with eranda taila (castor oil),draksha kwatha and triphala kwatha
#[[Virechana]](therapeutic purgation) with eranda taila (castor oil),draksha kwatha and triphala kwatha
#Shamana medicines: Following drugs are used in treatment of hikka and shwasa:
#Shamana medicines: Following drugs are used in treatment of hikka and shwasa:
##Pippali
##Pippali
===Experience based views===
===Experience based views===
In chronic cases of Shwasa internal administration of unctuous substance (snehapana) 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>
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, chhardi and hikka can be used for Shwasa.(A.H.ch.59)
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== References ==
== References ==