fitnessblog

AIAPGET Points

–       The Main Doshas involved in causation of Chardi are Udana and Vyana Vata.

–       ABHAKTA RUK – pain when no food is taken – is a feature of Kaphaja Chardi.

–       The symptoms of KRIMIJA HRDROGA are also present in KRIMIJA CHARDI.

–       JWARAGHNA KASHAYAS can be given to patients suffering from Chardi. (Su.Ut.49/17-18)

–       Ksheera-Ghrtam cures Vataja Chardi. (Su.Ut.49/18)

For More AIAPGET Points from this chapter and also for content and preparation, please join our SARATHI Program.

The 49th chapter of Uttaratantra of Sushruta Samhita is named as Chardi Pratiședha. This chapter deals with Treatment of Vomiting.

अथातश्छर्दिप्रतिषेधमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound Chardi pratiṣedha- treatment of vomiting; as revealed by the venerable Dhañvañtari.

Nidāna – causes and pathogenesis

अतिद्रवैरतिस्निग्धैरहृद्यैर्लवणैरति |
अकाले चातिमात्रैश्च तथाऽसात्म्यैश्च भोजनैः ||३||
श्रमात् क्षयात्तथोद्वेगादजीर्णात् कृमिदोषतः |
नार्याश्चापन्नसत्त्वायास्तथाऽतिद्रुतमश्नतः ||४||
अत्यन्तामपरीतस्य छर्देर्वै सम्भवो ध्रुवम् |
(बीभत्सैर्हेतुभिश्चान्यैर्द्रुतमुत्क्लेशितो बलात्) ||५||

Below mentioned are the causes of chardi – vomiting –

–       consumption of foods which are very liquid, very unctuous (fatty), unpleasant and very salty;

–       foods consumed at improper time,

–       consumption of foods in more quantity and

–       consumption of unaccustomed foods,

–       excessive exertion,

–       decrease / depletion of tissues,

–       mental fluctuations,

–       indigestion,

–       infestation by worms (intestinal parasites),

–       pregnancy,

–       consuming food very quickly,

–       too much accumulation of ama (undigested food in the alimentary canal),

–       horrifying causes (such as sight of blood, worms, pus, foul smell etc) and

–       sudden bouts of emotions

These causes will definitely cause vomiting.

Nirukti – definition

छादयन्नाननं वेगैरर्दयन्नङ्गभञ्जनैः |
निरुच्यते छर्दिरिति दोषो वक्त्राद्विनिश्चरन् ||६||

This disease is called chardi because –

–        it covers the mouth by the bouts of food and other materials coming up,

–        produces discomfort to the body by causing bending of the body and

–        the doshas are expelled out from the mouth

Samprapti – Pathogenesis

दोषानुदीरयन् वृद्धानुदानो व्यानसङ्गतः |
ऊर्ध्वमागच्छति भृशं विरुद्धाहारसेवनात् ||७||

Firstly, the Udana Vata and Vyana Vata would get aggravated (on exposure to the causative factors). The aggravated vata sub-types force the doshas to move upwards. These doshas come out of the mouth. All these happen due to consumption of incompatible (mutually antagonistic) foods.

Pūrvarūpa – premonitory symptoms

प्रसेको हृदयोत्क्लेशो भक्तस्यानभिनन्दनम् |
पूर्वरूपं मतं छर्द्या यथास्वं च विभावयेत् ||८||

Below mentioned are the premonitory symptoms of vomiting –

–        excessive salivation,

–        oppression in the chest (nausea),

–        dislike for food

The same symptoms will be present even in the next stage also (i.e. when the disease gets manifested, the same premonitory symptoms will become the symptoms of the disease also).

Rūpa – clinical features

प्रच्छर्दयेत् फेनिलमल्पमल्पं शूलार्दितोऽभ्यर्दितपार्श्वपृष्ठः |
श्रान्तः सघोषं बहुशः कषायं जीर्णेऽधिकं साऽनिलजा वमिस्तु ||९||

Features (symptoms) of Vataja Chardi – vomiting caused by aggravated vata –

–        frequent vomiting,

–        the material is frothy and less in quantity,

–        is accompanied by pain in flanks and back,

–        tiredness,

–        vomiting happens with great sound,

–        material which is vomited is astringent in taste and

–        more often, vomiting happens after digestion of food

योऽम्लं भृशं वा कटुतिक्तवक्त्रः पीतं सरक्तं हरितं वमेद्वा |
सदाहचोषज्वरवक्त्रशोषो मूर्च्छान्वितः पित्तनिमित्तजा सा ||१०||

Features (symptoms) of Pittaja Chardi – vomiting caused by aggravated pitta –

–        the material which has been vomited is very sour,

–        taste in mouth is pungent or bitter,

–        the material is yellow, mild-red or green in colour,

–        associated with – burning sensation, sucking pain, fever, dryness of throat and fainting

यो हृष्टरोमा मधुरं प्रभूतं शुक्लं हिमं सान्द्रकफानुविद्धम् |
अभक्तरुग्गौरवसादयुक्तो वमेद्वमी सा कफकोपजा स्यात् ||११||

Features (symptoms) of Kaphaja Chardi – vomiting caused by aggravated vata –

–        presence of horripilations,

–        vomited material is sweet in taste,

–        is large in quantity,

–        white in colour,

–        cold,

–        mixed with thick kapha (mucus, phlegm),

–        pain when no food is taken,

–        feeling of heaviness and

–        debility of the body

सर्वाणि रूपाणि भवन्ति यस्यां सा सर्वदोषप्रभवा मता तु |१२|

Features (symptoms) of Chardi – vomiting caused by all three doshas – In this kind of vomiting, all symptoms of all the three doshas are present mixed together.

बीभत्सजा दौहृदजाऽऽमजा च सात्म्यप्रकोपात् कृमिजा च या [६] हि |
सा पञ्चमी तां च विभावयेत्तु दोषोच्छ्रयेणैव यथोक्तमादौ ||१२||

Añya vidha – Other kind of (fifth) vomiting –

Vomiting caused by the below mentioned factors is considered as fifth kind of the disease –

–        that caused by sight, smell etc. of horrifying things,

–        pregnancy,

–        indigestion,

–        consumption of unaccustomed foods and

–        presence of worms – intestinal parasites / worms

The aggravation of doshas in this type of chardi should be determined accordingly.

शूलहृल्लासबहुला कृमिजा च विशेषतः |
कृमिहृद्रोगतुल्येन लक्षणेन च लक्षिता ||१३||

Pain and nausea are the prominent symptoms of vomiting caused by krimis – worms. Symptoms of heart disease produced by krimi – worms – will also be present.

क्षीणस्योपद्रवैर्युक्तां सासृक्पूयां सचन्द्रिकाम् |
छर्दि प्रसक्तां कुशलो नारभेत चिकित्सितुम् ||१४||

The physician should not commence treatment for vomiting when it is associated with the below mentioned features / symptoms –

–        vomiting occurring in emaciated persons which is accompanied with complications,

–        vomited material is mixed with blood, pus and shining particles and

–        there is continuous vomiting

आमाशयोत्क्लेशभवा हि सर्वास्तस्माद्धितं लङ्घनमेव तासु ||१५||
वमीषु बहुदोषासु छर्दनं हितमुच्यते |
विरेचनं वा कुर्वीत यथादोषोच्छ्रयं भिषक् ||१६||
संसर्गश्चानुपूर्वेण यथास्वं भेषजायुतः |१७|

All kinds of vomiting arise from vitiation of the stomach. Therefore fasting is beneficial in all kinds of vomiting.

Vomiting or Purgation should be administered depending on doshas aggravated is beneficial in cases of vomiting caused by great aggravation of doshas.

After this, regimen of liquid diet i.e. peya, vilepi etc. should be administered along with suitable medicines.

लघूनि परिशुष्काणि सात्म्यान्यन्नानि चाचरेत् ||१७||
यथास्वं च कषायाणि ज्वरघ्नानि प्रयोजयेत् |१८|

Light to digest (easily digestible), well dried and accustomed foods should be consumed. Decoctions mentioned in the treatment (cure) of fevers may also be administered here.

Vataja chardi cikitsă

हन्यात् क्षीरघृतं पीतं छर्दिं पवनसम्भवाम् ||१८||
ससैन्धवं पिबेत् सर्पिर्वातच्छर्दिनिवारणम् |
मुद्गामलकयूषो वा ससर्पिष्कः ससैन्धवः |
यवागूं मधुमिश्रां वा पञ्चमूलीकृतां पिबेत् ||१९||
पिबेद्वा व्यक्तसिन्धूत्थं फलाम्लं वैष्किरं रसम् |
सुखोष्णलवणं चात्र हितं स्नेहविरेचनम् ||२०||
Vomiting produced by vata is cured by consumption of ghee made from milk.

The other useful recipes / formulations which can be used to cure vataja chardi include –

–        ghee mixed with saindhava lavana or

–        soup of mudga and amalaka added with ghee and saindhava or

–        yavagu – thick gruel prepared with laghu pancamula herbs added with honey or

–        juice of sour fruits, soup of meat of viskira birds, added with saindhava lavana or

–        oily purgative mixed with salt and made comfortably warm

Pittaja chardi chikitsa

पित्तोपशमनीयानि पाक्यानि शिशिराणि च |
कषायाण्युपयुक्तानि घ्नन्ति पित्तकृतां वमीम् ||२१||
शोधनं मधुरैश्चात्र द्राक्षारससमायुतैः |
बलवत्यां प्रशंसन्ति सर्पिस्तैल्वकमेव च ||२२||

Vomiting caused by pitta is cured by drinking decoctions of herbs which mitigate pitta and which are cold in potency.

Purgation should be given with the below mentioned recipes –

–        herbs of sweet taste mixed with juice of draksa or

–        Tilvaka Ghrta – in strong persons (as explained in chikitsa sthana, chapter 4)

Kaphaja chardi chikitsa

आरग्वधादिनिर्यूहं दशाङ्गयोगमेव वा |
पाययेताथ सक्षौद्रं कफजायां चिकित्सकः ||२३||

Decoction prepared from the herbs of aragvadhadi gana group or of dasanga yoga (dasamula kwatha) group added with honey should be administered by the physician in cases of vomiting produced by kapha.

Tridoşaja chardi chikitsa

कृतं गुडूच्या विधिवत् कषायं हिमसञ्ज्ञितम् |
तिसृष्वपि भवेत् पथ्यं माक्षिकेण समन्वितम् ||२४||

Cold infusion of Guduci should be prepared as per procedure. Honey should be added to this infusion and administered. It is best suited for vomiting caused by all the three doshas together.

Añya chardi chikitsa

बीभत्सजां हृद्यतमैर्दौहृदीं काङ्क्षितैः फलैः |
लङ्घनैर्वमनैश्चामां सात्म्यैः सात्म्यप्रकोपजाम् ||२५||
कृमिहृद्रोगवच्चापि कृमिजां साधयेद्वमीम् |
वितरेच्च यथादोषं शस्तं विधिमनन्तरम् ||२६||

Administering things which are pleasant to the mind is the remedy for vomiting caused by horrifying things.

Vomiting due to pregnancy should be treated by fulfilling her desires.

Administering vomiting and purgation therapies are the best ways of treating vomiting caused by ama.

If vomiting is caused by use of unaccustomed things, treatment should be given by providing accustomed things.

Likewise, therapies prescribed for krimija hrdroga should be administered in the treatment of vomiting caused by worms.

Afterwards, the treatments appropriate to the aggravated doshas should be administered.

दधित्थरससंसक्तां पिप्पलीं माक्षिकान्विताम् |
मुहुर्मुहुर्नरो लीढ्वा छर्दिभ्यः प्रवि(ति)मुच्यते ||२७||
समाक्षिका मधुरसा पीता वा तण्डुलाम्बुना |
तर्पणं वा मधुयुतं तिसृणामपि भेषजम् ||२८||
स्वयङ्गुप्तां सयष्ट्याह्वां तण्डुलाम्बुमधुद्रवाम् |
पिबेद्यवागूमथवा सिद्धां पत्रैः करञ्जजैः ||२९||
युक्ताम्ललवणाः पिष्टाः कुस्तुम्बुर्योऽथवा हिताः |
तण्डुलाम्बुयुतं खादेत् कपित्थं त्र्यूषणेन वा ||३०||

Vomiting would get cured by licking often the paste of pippali added and mixed in juice of dadhici (kapittha) and honey. 

Below mentioned are the ideal recipes for treating all three kinds of vomiting –

–        juice of madhurasa (murva) mixed with honey or rice-wash

–        tarpana i.e. mixture of corn flour, ghee and sugar, added with honey

Paste of Svayamgupta and Yasti should be made. This paste should be added with rice-wash and honey and consumed.

Alternatively Yavagu – thick gruel prepared from Karajna leaves may be consumed.

Also, paste of Kustumbari added with sour things and salt is also beneficial.

Kapittha also may be consumed along with rice-wash or tryushana.

सिताचन्दनमध्वाक्तं लिह्याद्वा मक्षिकाशकृत् |
पिबेत् पयोऽग्नितप्तं च निर्वाप्य गृहगोधिकाम् ||३१||
सर्पिःक्षौद्रयुतान् वाऽपि लाजशक्तून् पिबेत्तथा |
सर्पिःक्षौद्रसितोपेतां मागधीं वा लिहेत्तथा ||३२||
धात्रीरसे चन्दनं वा घृष्टं मुद्गदलाम्बुना |
कोलामलकमज्जानं लिह्याद्वा त्रिसुगन्धिकम् ||३३||
सक्षौद्रां शालिलाजानां यवागूं वा पिबेन्नरः |
घ्रेयाण्युपहरेच्चापि मनोघ्राणसुखानि च ||३४||
जाङ्गलानि च मांसानि शुभानि पानकानि च |
भोजनानि विचित्राणि कुर्यात्सर्वास्वतन्द्रितः ||३५||

For licking – excreta of flies added with sugar, sandalwood and honey should be used.

Grha Godha i.e. house lizards should be fried and made red hot in fire. It should then be put into milk and that milk may be consumed. Alternatively, powder of Magadhi may be licked mixed with ghee and honey.

Paste of Candana – sandalwood should be prepared with juice of Dhatri. This may be consumed along with water.

Also, soup of mudga or marrow (fleshy part) of kola and amalaka, added with trisugandha (trijataka) may be licked.

Yavagu should be prepared with Sali or Laja. It should be added with honey and may be consumed.

The patient should inhale substances which are pleasing to the mind and nose.

Below mentioned things should be used without any laxity –

–        meat of animals of arid lands,

–        good sweet syrups and snacks (eatables) of different kinds which are pleasing to the mind

इति श्री सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे छर्दिप्रतिषेधो नाम एकादशोऽध्यायः, आदितः) एकोनपञ्चाशत्तमोऽध्यायः।।४९।।

Thus ends the forty ninth chapter by name Chardi pratişedha in Uttarasthana of Suśruta samhita.

AIAPGET Points

–        In HIKKA, the person feels as if YAKRIT, PLIHA and ANTRANI are coming out of their mouth.

–        The five kinds of HIKKA are – Annaja, Yamala, Kshudra, Gambhira and Mahati.

–        Kshudra Hikka arises from JATRUMULA.

–        Gambhira Hikka begins from NABHI.

–        GAMBHIRA & MAHATI Hikka are incurable. (Su.Ut.50/15)

–        HIKKA can be cured by VAMANA in patients who are not very emaciated.

For More AIAPGET Points from this chapter and also for content and preparation, please join our SARATHI Program.

The 50th chapter of Uttaratantra of Sushruta Samhita is named as Hikkā Pratiședha. This chapter deals with Treatment of Hiccup.

अथातो हिक्काप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound Hikkā pratiṣedha- treatment of hiccups: as revealed by the venerable Dhanvantari.

Nidāna – causes

विदाहिगुरुविष्टम्भिरूक्षाभिष्यन्दिभोजनैः |
शीतपानासनस्थानरजोधूमानिलानलैः ||३||
व्यायामकर्मभाराध्ववेगाघातापतर्पणैः |
आमादोषाभिघातस्त्रीक्षयदोषप्रपीडनैः ||४||
विषमाशनाध्यनशनैस्तथा समशनैरपि |
हिक्का श्वासश्च कासश्च नृणां समुपजायते ||५||

Below mentioned are the causes for hiccup, dyspnoea and cough in human beings –

–        consumption of foods which cause heartburn,

–        foods which are hard / difficult for digestion,

–        foods which tend to cause constipation, which are dry and create more moisture inside the body tissues,

–        excessive drinking of cold water,

–        sitting on cold surfaces and staying in cold places,

–        exposure to dust, smoke, breeze and fire,

–        excessive indulgence in physical exercises,

–        lifting heavy weights in excess,

–        walking for long duration,

–        suppression of naturally manifested body urges,

–        malnutrition,

–        ama dosha i.e. excessive accumulation of undigested food in the body,

–        injury,

–        excessive indulgence in copulation,

–        decrease / depletion of body tissues,

–        aggravation of doshas in the body,

–        indulgence in consumption of food in wrong ways including – visamasana (eating food at improper time), adhyasana (consuming excessive quantity of food often), anasana (not taking food at all or eating food in very less quantity) and samasana (eating mixture of healthy and unhealthy foods)

Nirukti – definition

मुहुर्मुहुर्वायरुदेति सस्वनो यकृत्प्लिहान्त्राणि मुखादिवाक्षिपन् |
स घोषवानाशु हिनस्त्यसून् यतस्ततस्तु हिक्केति भिषग्भिरुच्यते ||६||

Vayu – mainly udana and prana vata would abnormally move in upward direction accompanied with sound. While in upward movement, this aggravated vata causes shaking of liver, spleen and intestines and the person would feel as if these organs are coming out of the mouth with a loud sound. This condition would cause troubles to life. Due to these events happening, this disease is called hikka – hiccup by the physicians.

Vidha – kinds

अन्नजां यमलां क्षुद्रां गम्भीरां महतीं तथा |
वायुः कफेनानुगतः पञ्च हिक्काः करोति हि ||७||

Vata (aggravation) followed by kapha (getting aggravated) produces five kinds of Hikka by names –

–        Annaja Hikka,

–        Yamala Hikka,

–        Ksudra Hikka,

–        Gambhira Hikka and

–        Mahati Hikka

Pūrvarūpa – premonitory symptoms

मुखं कषायमरतिर्गौरवं कण्ठवक्षसोः |
पूर्वरूपाणि हिक्कानामाटोपो जठरस्य च ||८||

Below mentioned are the premonitory symptoms of hiccup –

–        experiencing astringent taste in the mouth,

–        restlessness,

–        feeling of heaviness in the throat and chest and

–        gurgling noise in the abdomen

Rūpa – clinical features

Annaja hikkā

त्वरमाणस्य चाहारं भुञ्जानस्याथवा घनम् |
वायुरन्नैरवस्तीर्णः कटुकैरर्दितो भृशम् ||९||
हिक्कयत्यूर्ध्वगो भूत्वा तां विद्यादन्नजां भिषक् |१०|
Causes –

–        gulping food in hurry,

–        eating solid / hard foods in excess and

–        eating pungent foods in excess

Due to the above said causes, vata would get blocked by food and produce hiccups. This hikka is known as Annaja Hikka i.e. hiccup produced by food, by physicians.

Yamala hikka

चिरेण यमलैर्वेगैर्या हिक्का सम्प्रवर्तते ||१०||
कम्पयन्ती शिरोग्रीवं यमलां तां विनिर्दिशेत् |११|

Yamala means two or twin or pair. Hiccup which comes in pairs after long periods of time is called Yamala Hikka. This hikka causes shaking of head and neck.

Kṣudra hikka

विकृष्टकालैर्या वेगैर्मन्दैः समभिवर्तते ||११||
क्षुद्रिका नाम सा हिक्का जत्रुमूलात् प्रधाविता |१२|

Below mentioned are the features of Ksudra Hikka –

–        hiccup appears at any time,

–        it has mild bouts and

–        arises from the base of the shoulders / neck

Gambhīrā hikkā

नाभिप्रवृत्ता या हिक्का घोरा गम्भीरनादिनी ||१२||
शुष्कौष्ठकण्ठजिह्वास्यश्वासपार्श्वरुजाकरी |
अनेकोपद्रवयुता गम्भीरा नाम सा स्मृता ||१३||

Below mentioned are the features / symptoms of Gambhira Hikka –

–        starts from umbilicus, deep inside,

–        accompanied with loud sounds,

–        causes dryness of lips, throat, tongue and mouth,

–        dyspnoea,

–        pain in flanks and

–        has many associated complications

Mahati hikka

मर्माण्यापीडयन्तीव सततं या प्रवर्तते |
देहमायम्य वेगेन घोषयत्यतितृष्यतः |
महाहिक्केति सा ज्ञेया सर्वगात्रप्रकम्पिनी ||१४||

Below mentioned are the features of Mahati Hikka –

–        it hurts the marmas – vital organs / fatal spots

–        bouts come up constantly,

–        bouts cause bending of the body,

–        hiccup is associated with loud sounds,

–        person has profound thirst and

–        shaking of whole body

आयम्यते हिक्काऽतोङ्गानि यस्य दृष्टिश्चोर्ध्वं ताम्यते यस्य गाढम् |
क्षीणोऽन्नद्विट् कासते यश्च हिक्की तौ द्वावन्त्यौ वर्जयेद्धिक्कमानौ ||१५||

The person suffering from Hikka should be refused (not to be treated) when hikka presents with the below mentioned features –

–        the person expands / stretches his body during the bouts of hiccup,

–        gaze of the person is fixed upward,

–        person becomes deeply unconscious and

–        is emaciated,

–        dislikes foods and

–        coughs frequently and

–        when he suffers from the last two kinds of hikka i.e. gambhira hikka and mahati hikka

Hikka cikitsā – treatment of hiccup

प्राणायामोद्वेजनत्रासनानि सूचीतोदैः सम्भ्रमश्चात्र शस्तः |१६|

Below mentioned are beneficial measures –

–        doing pranayama – controlling breathing patterns,

–        using harsh words and abusing the patient,

–        threatening the patient,

–        pricking the patient with needles and

–        causing agitation in the mind of the patient

यष्ट्याह्वं वा माक्षिकेणावपीडे पिप्पल्यो वा शर्कराचूर्णयुक्ताः ||१६||
सर्पिः कोष्णं क्षीरमिक्षो रसो वा नातिक्षीणे छर्दनं शान्तिहेतोः [१] |१७|

Avapida means nasal drops. In hiccups, the below mentioned recipes shall be used (instilled into the nose) as avapida –

–        yastimadhu mixed with honey or

–        pippali mixed with sugar powder, warm ghee, milk or sugarcane juice

In persons who are not very emaciated, hiccups can be cured by producing vomiting.

नारीपयःपिष्टमशुक्लचन्दनं घृतं सुखोष्णं च ससैन्धवं तथा ||१७||
चूर्णीकृतं सैन्धवमम्भसाऽथवा निहन्ति हिक्कां च हितं च नस्यतः |१८|

Below mentioned recipes put into the nose are also beneficial (in curing hikka) –

–        woman’s milk (breastmilk), paste of rakta candana, ghrta and saindhava lavana or

–        powder of saindhava lavana dissolved in water

युञ्ज्याद्धूमं शालनिर्यासजातं नैपालं वा गोविषाणोद्भवं वा ||१८||
सर्पिःस्निग्धैश्चर्मबालैः कृतं वा हिक्कास्थाने स्वेदनं चापि कार्यम् |१९|

Smoke of one of the below mentioned shall be inhaled by the patient –

–        sala niryasa – gum / resin of sala tree,

–        naipala – manassila or

–        horn, leather and hairs of cow mixed with ghee

At the site of origin of hiccup, fomentation should also be done.

क्षौद्रोपेतं गैरिकं काञ्चनाह्वं लिह्याद्भस्म ग्राम्यसत्त्वास्थिजं वा ||१९||
तद्वच्छ्वाविन्मेषगोशल्य(ल्ल)कानां रोमाण्यन्तर्धूमदग्धानि चात्र |
मध्वाज्याक्तं बर्हिपत्रप्रसूतमेवं भस्मौदुम्बरं तैल्वकं वा ||२०||
स्वर्जिक्षारं बीजपूराद्रसेन क्षौद्रोपेतं हन्ति लीढ्वाऽऽशु हिक्काम् |२१|

Below mentioned recipes should be mixed with honey and given to the patient for licking –

–        Svarna Gairika or

–        Ash of bones of domestic animals or

–        ash of hairs (thorns) of porcupine, ram, cow and hedgehog burnt in a closed pot

–        ash of feather of peacock licked with honey and ghee or

–        ash of udumbara licked with honey and ghee or

–        ash of tilvaka trees licked with honey and ghee or

–        sarji kshara mixed with juice of bijapura and honey

All these recipes would quickly cure hiccups.

सर्पिःस्निग्धा घ्नन्ति हिक्कां यवाग्वः कोष्णग्रासाः पायसो वा सुखोष्णः ||२१||

Yavagu – thick gruel or Payasa – milk pudding should be consumed comfortably warm, added with ghee. This would cure hiccups. 

शुण्ठीतोये साधितं क्षीरमाजं तद्वत् पीतं शर्करासंयुतं वा |
आतृप्तेर्वा सेव्यमानं निहन्याद् घ्रातं हिक्कामाशु मूत्रं त्वजाव्योः ||२२||
सपूतिकीटं लशुनोग्रगन्धाहिङ्ग्वब्जमाचूर्ण्य सुभावितं तत् |२३|

Below mentioned recipes would quickly cure hikka –

–        goat’s milk boiled with decoction of sunthi, added with sugar and consumed,

–        inhaling smell of urine of goat or sheep for some minutes, till satisfaction,

–        powder of putikita (an insect emitting bad smell), lasuna, ugragandha, hingu and abja (kamala) soaked for many times in the urine of goat or sheep and inhaled

क्षौद्रं सितां वारणकेशरं च पिबेद्रसेनेक्षुमधूकजेन ||२३||
पिबेत् पलं वा लवणोत्तमस्य द्वाभ्यां पलाभ्यां हविषः समग्रम् |२४|

Varanakesara (Nagakesara) should be mixed with honey, sugar and juice of sugarcane and madhuka. It should be licked by the patient.

Likewise, the patient should consume one pala (40gm) of saindhava lavana mixed with two pala (80gm) ghee.

हरीतकीं कोष्णजलानुपानां पिबेद्घृतं क्षारमधूपपन्नम् ||२४||
रसं कपित्थान्मधुपिप्पलीभ्यां शुक्तिप्रमाणं प्रपिबेत् सुखाय ||२५||

For obtaining comfort from hikka, the patient should consume the below mentioned recipes –

–        Haritaki added with Yava Ksara and honey, followed by drinking warm water,

–        juice of Kapittha mixed with honey and pippali should be consumed in a quantity of one sukti (20gm)

कृष्णां सितां चामलकं च लीढं सशृङ्गवेरं मधुनाऽथवाऽपि |
कोलास्थिमज्जाञ्जनलाजचूर्णं हिक्का निहन्यान्मधुनाऽवलीढम् ||२६||

Below mentioned recipes are also useful –

–        powder of krishna, sita (sugar), amalaka and srngavera should be licked with honey or

–        powder of kernel of kola seeds, anjana (sauvira anjana) and laja (fried paddy) should be licked with honey

पाटलायाः फलं पुष्पं गैरिकं कटुरोहिणी |
खर्जूरमध्यं मागध्यः काशीशं दधिनाम च ||२७||
चत्वार एते योगाः स्युः प्रतिपादप्रदर्शिताः |
मधुद्वितीयाः कर्तव्यास्ते हिक्कासु विजानता ||२८||

Powder of below mentioned four formulae stated in quarter verses, would cure hiccup, if they are licked, added and mixed with honey –

–        fruits and flowers of patala or

–        gairika and katurohini or

–        seeds of kharjura and magadha or

–        kasisa and dadhinama (kapittha)

कपोतपारावतलावश(ल्ल)कश्वदंष्ट्रगोधावृषदंशजान् रसान् |
पिबेत् फलाम्लानहिमान् ससैन्धवान् स्निग्धांस्तथैवर्ष्यमृगद्विजोद्भवान् ||२९||

Soup of meat of the below mentioned animals and birds should be consumed warm, added with juice of sour fruits and saindhava lavana –

–        kapota – pigeon,

–        paravata – dove,

–        lava bird,

–        sallaik – porcupine,

–        svadamstra – mouse deer,

–        godha – iguana lizard,

–        vrsadamsa – jungle cat,

–        rsyamrga – black deer,

–        two kinds of animals i.e. jangala and viskira

विरेचनं पथ्यतमं ससैन्धवं घृतं सुखोष्णं च सितोपलायुतम् |
सदागतावूर्ध्वगतेऽनुवासनं वदन्ति केचिच्च हिताय हिक्किनाम् ||३०||

Below mentioned interventions are useful in persons having hiccup –

–        virecana – purgation,

–        ghee added with saindhava lavana and sitopala and consumed comfortably warm,

–        anuvasana basti – oil / unctuous enema – is the best for vata which has started moving upwards in patients of hikka (according to opinion of some others)

इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे हिक्काप्रतिषेधो नाम (द्वादशो-ऽध्यायः, आदितः) पञ्चाशत्तमोऽध्यायः।।५०।।

Thus ends the fiftieth chapter by name Hikka pratişedha in Uttarasthana of Suśruta Samhita.