Ashtanga Hridayam Chikitsa sthanam Chapter 4:  Shwasa Hidhma Chikitsitam Adhyaya (Treatments of dyspnea and hiccup)        

The 4th chapter of Cikitsasthanam of Ashtanga Hridayam is named as Svasa-Hidhma Cikitsitam Adhyayah. This chapter deals with the explanation of ‘treatment of dyspnea and hiccup’.

The topics covered in this chapter include –

–        Snehana, Svedana – oleation and sudation
–        Vamana – emesis therapy
–        Virechana – purgation therapy
–        Dhumapana – inhalation of smoke
–        Sudation, poultice and ama destroying treatments
–        Combating vata vitiation
–        Treatment of dyspnea and hiccup associated with diseases like emaciation etc
–        Soups in treatment of dyspnea and hiccup
–        Peya (gruels) in treatment of dyspnea and hiccup
–        Dashamuladi Kashayam
–        Diet schedule in the treatment of dyspnea and hiccup
–        Diet inclusions in the treatment of dyspnea and hiccup
–        Dasamuladi Kvatha
–        Pippalyadi Siddha Takra in Svasa
–        Suramanda and other medicines for svasa
–        Treating association of doshas in dyspnea and hiccup
–        Pippalimuladi yoga
–        Jivantyadi Curna
–        Shatyadi Curna
–        Guda Nagara Yoga
–        Nasal drops in dyspnea and hiccup
–        Tejovatyadi Ghrta
–        Various Ghrta in treatment of hiccup and dyspnea
–        Non medicinal measures in treatment of hiccup and dyspnea
–        Vata alleviating interventions in in treatment of hiccup and dyspnea
–        Brimhana, Shamana and Karshana in treatment of hiccup and dyspnea
–        Treatment of consumption, vomiting and cough in treatment of hiccup and dyspnea

Pledge by the author(s)

अथातो श्वासहिध्माचिकित्सितं व्याख्यास्याम: व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘treatment of dyspnea and hiccup’. Thus say (pledge) Atreya and other sages.

Sneha Svedana: Oleation and sudation

श्वासहिध्मा यतस्तुल्यहेत्वाद्याः साधनं ततः ।
तुल्यमेव तदार्तं च पूर्वं स्वेदैरुपाचरेत् ॥ १ ॥
स्निग्धैर्लवणतैलाक्तं तैः खेषु ग्रथितः कफः ।
सुलीनोऽपि विलीनोऽस्य कोष्ठं प्राप्तः सुनिर्हरः ॥ २ ॥
स्रोतसां स्यान्मृदुत्वं च मरुतश्चानुलोमता ।
Since dyspnea and hiccup are similar in their causes etc., their treatments are also similar. Therefore persons suffering from these two diseases, should be administered sudation therapy first, with unctuous liquids, oils mixed with salt, (Abhyanga with heated oils mixed with salts) by these (oleation and sudation) the solid kapha though adhering in the channels gets liquefied in the channels, and comes into the alimentary tract to be expelled out easily, the channels become soft and vata gets its(normal) downward movement.

Vamana: Emesis therapy

स्विन्नं च भोजयेदन्नं स्निग्धमानूपजै रसैः ॥ ३ ॥
दध्युत्तरेण वा दद्यात् ततोऽस्मै वमनं मृदु ।
विशेषात्कासवमथुहृद्ग्रहस्वरसादिने ॥ ४ ॥
पिप्पलीसैन्धवक्षौद्रयुक्तं वाताविरोधि यत् ।
After sudation treatment, the patient should be made to eat cooked rice, mixed with unctuous substances such as ghee; along with juice (soup) of meat of animals of marshy land with curds, or then a mild emesis therapy should be given to him, especially for those who are suffering from – cough, vomiting, catching pain in the heart region, and diminution of voice, by using – Piper longum, rock salt, and honey which does not aggravate Vata.

Vamana: Emesis therapy

निर्हृते सुखमाप्नोति स कफे दुष्टविग्रहे ॥ ५ ॥
स्रोतःसु च विशुद्धेषु चरत्यविहतोऽनिलः ।
When the kapha gets expelled from the vitiated body (channels of the lungs especially) there will be great comfort, when the channels become clear, Vata begins to move unhindered.

Virechana: Purgation therapy

ध्मानोदावर्ततमके मातुलुङ्गाम्लवेतसैः ॥ ६ ॥
हिङ्गुपीलुविडैर्युक्तमन्नं स्यादनुलोमनम् ।
ससैन्धवं फलाम्लं वा कोष्णं दद्याद्विरेचनम् ॥ ७ ॥
If there is flatulence, upward movement of Vata, Tamaka (a variety of dyspnea, Asthma), and cooked rice mixed with Citrus medica, Garcinia pedunculata, Ferula narthex, Salvadora persica, Vida salt, acts as laxative.

By administering – Saindhava mixed with any sour fruit followed by warm water, purgation should be given.

Virechana: Purgation therapy

एते हि कफसंरुद्धगतिप्राणप्रकोपजाः ।
तस्मात्तन्मार्गशुद्ध्यर्थमूर्ध्वाधः शोधनं हितम् ॥ ८ ॥
उदीर्यते भृशतरं मार्गरोधाद्वहज्जलम् ।
यथा तथानिलस्तस्य मार्गमस्माद्विशोधयेत् ॥ ९ ॥
Since these – (svasa and Hidhma) are born from the obstruction of the passage of Prana vayu by Kapha, it is beneficial to clear the passage by administration of purifactory therapy of both the upper and lower parts of the body (Emesis & Purgation). By the obstruction of the passages the internal fluid becomes greatly increased (and obstruct the passage) also Vata obstructs the passages. So, hence its (of Vata) passage also be cleared.

Dhumapana: Inhalation of smoke

अशान्तौ कृतसंशुद्धेर्धूमैर्लीनं मलं हरेत् ।
If by the above treatment the disease does not subside, the Mala (Dosha) which is adhering deep inside, should be removed out by inhalation of smoke (of herbs) after purifying the patient (by emesis and purgation therapies).

Dhumapana: Inhalation of smoke

हरिद्रापत्रमेरण्डमूलं लाक्षां मनःशिलाम् ॥ १० ॥
सदेवदार्वलं मांसीं पिष्ट्वा वर्तिं प्रकल्पयेत् ।
तां घृताक्तां पिबेद्धूमं यवान्वा घृतसंयुतान् ॥ ११ ॥
मधूच्छिष्टं सर्जरसं घृतं वा गुरु वागुरु ।
चन्दनं वा तथा शृङ्गं बालान्वा स्नाव वा गवाम् ॥ १२ ॥
ऋक्षगोधाकुरङ्गैणचर्मशृङ्गखुराणि वा ।
गुग्गुलुं वा मनोह्वां वा शालनिर्यासमेव वा ॥ १३ ॥
शल्लकीं गुग्गुलुं लोहं पद्मकं वा घृताप्लुतम् ।
Leaves of Curcuma longa, root of Ricinus communis, Laccifer lacca, Realgar, Cedrus deodara, yellow orpiment / yellow arsenic, Nardostachys jatamansi are made into a paste and a wick (resembling a cigar) is prepared. It should be lubricated with ghee and smoked; or smoke of Hordeum vulgare mixed with ghee; or with bee wax, Vateria indica ghee or smoke of Aquilaria malaccensis or of Santalum album or of horn hair sinews of the cow; or the skin, horn of bear, and hoofs of bear, lizard, antelope, or deer. Or Commiphora mukul, realgar, of resin of Shorea robusta, Boswellia serrata, Commiphora mukul, Aquilaria malaccensis or Prunus cerasoides each one lubricated with ghee.

Sudation, poultice and ama destroying treatments

अवश्यं स्वेदनीयानामस्वेद्यानामपि क्षणम् ॥ १४ ॥
स्वेदयेत्ससिताक्षीरसुखोष्णस्नेहसेचनैः ।
उत्कारिकोपनाहैश्च स्वेदाध्यायोक्तभेषजैः ॥ १५ ॥
उरः कण्ठं च मृदुभिः सामे त्वामविधिं चरेत् ।
Sudation therapy is essential for those who are fit for it for those who are unfit for it, sudation for a short duration should be given either by pouring warm milk mixed with sugar, or oil, or by poultice, and warm poultices prepared from herbs mentioned in the chapter on sudation therapy (chapter 17 sutrasthana) especially over the chest and throat in a softer way, in case of presence of Ama, treatment to get over it (such as Deepana, Pacana etc) should be done.

Combating vata vitiation

अतियोगोद्धतं वातं दृष्ट्वा पवननाशनैः ॥ १६ ॥
स्निग्धै रसाद्यैर्नात्युष्णैरभ्यङ्गैश्च शमं नयेत् ।
If Vata Dosha is observed, to have increased due to excess bouts / administration of purifactory therapies, by all Vatahara measures, it should be pacified, by (drinking) of meat soup mixed with fat and anointing the body with oils which are not too hot.

Combating vata vitiation

अनुत्क्लिष्टकफास्विन्नदुर्बलानां हि शोधनात् ॥ १७ ॥
वायुर्लब्धास्पदो मर्म संशोष्याशु हरेदसून् ।
कषायलेहस्नेहाद्यैस्तेषां संशमयेदतः ॥ १८ ॥
Vata gets aggravated by purifactory therapies in persons in whom Kapha has not been excited (slightly increased), who have not been administered sudation therapy, and who are weak. The aggravated vata gains access to the vital organs (the chest /lungs in the present context), causes dryness in it and leads to death quickly. Hence it should be mitigated by the use of decoctions, confections, oleation therapy etc.

Treatment of dyspnea and hiccup associated with diseases like emaciation etc.

क्षीणक्षतातिसारासृक्पित्तदाहानुबन्धजान् ।
मधुरस्निग्धशीताद्यैर्हिध्माश्वासानुपाचरेत् ॥ १९ ॥
hidhmā – hiccup, śvāsaan – dyspnea, kṣīṇa kṣata – associated with emaciation, injury to chest, atisāra – diarrhea, asṛkpitta dāha anubandhajān – bleeding diseases associated with burning sensation, should be treated with herbs and foods that are sweet, unctuous, cold in potency.

Treatment of dyspnea and hiccup associated with diseases like emaciation etc.

कुलत्थ दशमूलानां क्वाथे स्यु: जाङ्गला रसाः ।
Juice and soups of meat of animals of desert-like regions processed in the decoction of kulattha – Dolichos biflorus, daśamūlānāṃ – Dashamula.

Soups in treatment of dyspnea and hiccup

यूषाश्च शिग्रुवार्ताककासघ्नवृषमूलकैः ॥ २० ॥
पल्लवैर्निम्बकुलकबृहतीमातुलुङ्गजैः ।
व्याघ्रीदुरालभाशृङ्गीबिल्वमध्यत्रिकण्टकैः ॥ २१ ॥
सामृताग्निकुलत्थैश्च यूषः स्यात्क्वथितैर्जले ।
तद्वद्रास्नाबृहत्यादिबलामुद्गैः सचित्रकैः ॥ २२ ॥
Soup / gruel prepared from śigru – Moringa oleifera, vārtāka – Solanum indicum, kāsaghna – Tephrosia purpurea, vṛṣa – Adhatoda vasica, mūlakaiḥ – Raphanus sativus, tender leaves of nimba – Azadirachta indica, kulaka – Trichosanthes dioica, bṛhatī – Solanum indicum, mātuluṅgajaiḥ – Citrus medica, vyāghrī – Solanum xanthocarpum, durālabhā – Fagonia cretica, śṛṅgī – Pistacia chinensis, bilvamadhya – marrow of Aegle marmelos, trikaṇṭakaiḥ – Tribulus terrestris, sāmṛtā – Tinospora cordifolia, agni – Plumbago zeylanica, kulatthai: ca – Dolichos biflorus, yūṣaḥ syāt – soup is prepared kvathitai: jale – by boiling in water, likewise, rāsnā – Pluchea lanceolata, bṛhatī ādi – Solanum indicum and others (harsva Pancamula), balā – Sida cordifolia, mudgaiḥ – Vigna radiata, sa citrakaiḥ – Plumbago zeylanica.

Peya (gruels) in treatment of dyspnea and hiccup

पेया च चित्रकाजाजीशृङ्गीसौवर्चलैः कृता ।
दशमूलेन वा कासश्वासहिध्मारुजापहा ॥ २३ ॥
Thin gruel prepared from citraka – Plumbago zeylanica, ajājī – Cuminum cyminum, śṛṅgī – Pistacia chinensis, sauvarcalaiḥ – black salt, daśamūlena vā – from group of 10 roots rujāpahā – relives the pain (distress) caused by kāsa – cough, śvāsa – dyspnea, hidhmā – and hiccup.

Dashamuladi Kashayam

दशमूलशठीरास्ना भार्गीबिल्वर्द्धिपौष्करैः ।
कुलीरशृङ्गीचपलातामलक्यमृतौषधैः ॥ २४ ॥
पिबेत्कषायं जीर्णेऽस्मिन्पेयां तैरेव साधिताम् ।

Decoction of daśamūla – group of 10 roots, śaṭhī – Curcuma zedoaria, rāsnā – Pluchea lanceolata, bhārgī – Clerodendrum serratum, bilva – Aegle marmelos, ṛddhi – Habenaria intermidia, pauṣkaraiḥ – Inula racemosa, kulīra śṛṅgī – Pistacia integerrima, capalā – Piper longum, tāmalakī – Phyllanthus fraternus, amṛtauṣadhaiḥ – Tinospora cordifolia and Zingiber officinale should be consumed; After it is digested thin gruel should be consumed processed with them only (the same herbs).

Diet schedule in the treatment of dyspnea and hiccup

शालिषष्टिकगोधूमयवमुद्गकुलत्थभुक् ॥ २५ ॥
कासहृद्ग्रहपार्श्वार्ति हिध्माश्वासप्रशान्तये ।
सक्तून् वार्काङ्कुरक्षीरभावितानां समाक्षिकान् ॥ २६ ॥
kāsa – The person suffering with cough, hṛdgraha – catching pain in the heart, pārśvārti – flanks, hidhmā – hiccup, śvāsa – and dyspnea, bhuk – should eat foods prepared from śāli – rice, ṣaṣṭika – Sastika rice, godhūma – wheat, yava – barley, mudga – green gram, kulattha – and horse gram. Or the flour of Hordeum vulgare soaked and ground in the milky sap of sprouts of Calotropis gigantea mixed with honey should be consumed with decoction of dashamula etc.

Diet inclusions in the treatment of dyspnea and hiccup

अन्ने च योजयेत् क्षारहिङ्ग्वाज्यविडदाडिमान् ॥ २७ ॥
सपौष्करशठीव्योषमातुलुङ्गाम्लवेतसान् ।
दशमूलस्य वा क्वाथमथवा देवदारुणः ॥ २८ ॥
kṣāra – Alkalies, hiṅgu – Ferula narthex, ājya – ghee, viḍa – Vida salt, dāḍimān – Punica granatum, sa pauṣkara – Inula racemosa, śaṭhī – Curcuma zedoaria, vyoṣa – Piper longum, Piper nigrum and Zingiber officinale, mātuluṅga – Citrus medica, amlavetasān – Garcinia indica, should be included in the diet.

Dashamuladi Kvatha

दशमूलस्य वा क्वाथमथवा देवदारुणः ॥ २८ ॥
पिबेद्वा वारुणीमण्डं हिध्माश्वासी पिपासितः ।
Decoction of daśamūlasya vā – group of 10 roots or devadāruṇaḥ – of Cedrus deodara, vāvāruṇīmaṇḍaṃ – or clear fluid of beer should be consumed by the Patients of hidhmā – hiccup, śvāsī – dysponea, pipāsitaḥ – and when they are thirsty

Pippalyadi Siddha Takra in Shvasa

पिप्पलीपिप्पलीमूलपथ्याजन्तुघ्नचित्रकैः ॥ २९ ॥
कल्कितैर्लेपिते रूढे निःक्षिपेद्घृतभाजने ।
तक्रं मासस्थितं तद्धि दीपनं श्वासकासजित् ॥ ३० ॥
A mud pot smeared inside with ghee is given a layer of coating with the paste of – pippalī – Piper longum, pippalīmūla – Roots of Piper longum, pathyā – Terminalia chebula, jantughna – Embelia ribes, citrakaiḥ – Plumbago zeylanica. After the paste dries up; the pot is filled with buttermilk and kept undisturbed for a month; this is carminative śvāsa kāsajit – and cures dyspnea and coughs.

Suramanda and other medicines for shvasa

पाठां मधुरसां दारु सरलं च निशि स्थितम् ।
सुरामण्डेऽल्पलवणं पिबेत्प्रसृतसम्मितम् ॥ ३१ ॥
भार्गीशुण्ठ्यौ सुखाम्भोभिः क्षारं वा मरिचान्वितम् ।
स्वक्वाथपिष्टां लुलितां बाष्पिकां पाययेत वा ॥ ३२ ॥
pāṭhāṃ – Cissampelos pareira, madhurasāṃ – Marsdenia tenacissima, dāru – Cedrus deodara, saralaṃ – Pinus roxburghii, surāmaṇḍe ca – are soaked in Scum of beer and kept overnight; alpa lavaṇaṃ – adding little salt, it should be drunk consumed in 1 prasrta quantity – 96 ml bhārgī – Clerodendrum serratum, śuṇṭhyau – Zingiber officinale, followed by (or mixed with) drinking warm water; kṣāraṃ vā – mixed with alkali of Hordeum vulgare maricānvitam – and Piper nigrum; or drink bāṣpikāṃ piṣṭāṃ – paste of Ferula jaeschkeana macerated with its own decoction.

Treating association of doshas in dyspnea and hiccup

स्वरसः सप्तपर्णस्य पुष्पाणां वा शिरीषतः ।
हिध्माश्वासे मधुकणायुक्तः पित्तकफानुगे ॥ ३३ ॥
उत्कारिका तुगाकृष्णामधूलीघृतनागरैः ।
पित्तानुबन्धे योक्तव्या पवने त्वनुबन्धिनि ॥ ३४ ॥
श्वाविच्छशामिषकणाघृतशल्यकशोणितैः ।
सुवर्चलारसव्योषसर्पिर्भिः सहितं पयः ॥ ३५ ॥
अनु शाल्योदनं पेयं वातपित्तानुबन्धिनि ।
चतुर्गुणाम्बुसिद्धं वा छागं सगुडनागरम् ॥ ३६ ॥
Fresh juice of saptaparṇasya – Alstonia scholaris, or of the flowers of śirīṣataḥ – Albizia lebbeck madhu kaṇā yuktaḥ – mixed with honey and Piper longum should be consumed in hidhmā – hiccup and śvāse – dysponea caused by Pitta followed (associated with) by Kapha; cake prepared with tugā – Bamboo manna, kṛṣṇā – Piper longum, madhūlī – Eleusine coracana, ghṛta – ghee, nāgaraiḥ – Zingiber officinale when Pitta is the secondary Dosha; when vata is the secondary Dosha, (Utkarika prepared from) the meat of śvāavicchaśa – porcupine and rabbit, kaṇā- Piper longum, ghṛta – ghee, śalyaka śoṇitaiḥ – blood of porcupine, suvarcalā – black salt, meat juice, Piper longum, Piper nigrum and Zingiber officinale, sarpirbhiḥ sahitaṃ – along with ghee, payaḥ – and milk should be drunk after a meal of rice when vata and Pitta are the secondary Doshas chāgaṃ – or goat’s milk boiled with four times quantity of water (and reduced to a quarter) saguḍa nāgaram – should be consumed mixed with jaggery and Zingiber officinale.

Pippalimuladi yoga

पिप्पलीमूलमधुकगुडगोऽश्वशकृद्रसान् ।
हिध्माभिष्यन्दकासघ्नाल्लिह्यान् मधुघृतान्वितान् ॥ ३७ ॥
pippalīmūla – Roots of Piper longum, madhuka – Glycyrrhiza glabra, guḍa – jaggery, juice of fresh dung of cow or horse madhu ghṛtānvitān – mixed with honey and ghee should be licked, which cures hidhmā – hiccup, abhiṣyanda – conjunctivitis, and kāsaghnāt – cough.

Pippalimuladi yoga

गोगजाश्ववराहोष्ट्रखरमेषाजविड्रसम् ।
समध्वेकैकशो लिह्याद्बहुश्लेष्माथवा पिबेत् ॥ ३८ ॥
चतुष्पाच्चर्मरोमास्थिखुरशृङ्गोद्भवां मषीम् ।
तथैव वाजिगन्धाया लिह्याच्छ्वासी कफोल्बणः ॥ ३९ ॥
शठीपौष्करधात्रीर्वा पौष्करं वा कणान्वितम् ।
गैरिकाञ्जनकृष्णा वा स्वरसं वा कपित्थजम् ॥ ४० ॥
रसेन वा कपित्थस्य धात्रीसैन्धवपिप्पलीः ।
घृतक्षौद्रेण वा पथ्याविडङ्गोषणपिप्पलीः ॥ ४१ ॥
कोललाजामलद्राक्षापिप्पलीनागराणि वा ।
गुडतैलनिशाद्राक्षाकणारास्नोषणानि वा ॥ ४२ ॥
पिबेद्रसाम्बुमद्याम्लैर्लेहौषधरजांसि वा ।
Juice of fresh dung of go – cow, gajāśva – elephant, horse, varāhoṣṭra – boar, camel, khara – donkey, meṣāja – ram or goat each one separately mixed with honey, should be licked (in small quantity) or swallowed when kapha is greatly increased. shvāsī kapholbaṇaḥ – The patient of dyspnea who has great increase of kapha should lick (with honey) maṣīm – the ash / soot of quadruped’s skin, hairs, bones, hoof or horns;similarly the ash of vājigandhā – Withania somnifera, the powder of śaṭhī Curcuma zedoaria, pauṣkara – Inula racemosa, dhātrī: – vā Emblica officinalis, pauṣkaraṃ vā – Inula racemosa, kaṇānvitam – Piper longum; gairika – hematite, añjana – Antimony, kṛṣṇā vā – or Piper longum, or fresh juice of kapitthajam – Limonia acidissima, dhātrī – or (powder) of Emblica officinalis, saindhava – rock salt, pippalīḥ – Piper longum, or with the juice of kapitthasya – Limonia acidissim, pathyā – or (powder) Terminalia chebula, viḍaṅga – Embelia ribes, ūṣaṇa – Piper nigrum, pippalīḥ – Piper longum, ghṛta – with ghee, kṣaudreṇa vā – and honey, kola – or Ziziphus mauritiana, lājāmala – parched grains, Emblica officinalis (?), drākṣā – Vitis vinifera, pippalī – Piper longum, nāgarāṇi vā – and Zingiber officinale or guḍa jaggery, taila – oil, niśā – Curcuma longa, drākṣā – Vitis vinifera, kaṇā – Piper longum, rāsna – Pluchea lanceolata, ūṣaṇāni vā – and Piper nigrum should be consumed with juice of meat, water, wine, sour syrups or juices, onfections or powders of herbs.

Jivantyadi Churna

जीवन्तीमुस्तसुरसत्वगेलाद्वयपौष्करम् ॥ ४३ ॥
चण्डातामलकीलोहभार्गीनागरवालकम् ।
कर्कटाख्याशठीकृष्णानागकेसरचोरकम् ॥ ४४ ॥
उपयुक्तं यथाकामं चूर्णं द्विगुणशर्करम् ।
पार्श्वरुग्ज्वरकासघ्नं हिध्माश्वासहरं परम् ॥ ४५ ॥
jīvantī – Leptadenia reticulate, musta – Cyperus rotundus, surasa – Ocimum sanctum, tvak – Cinnamomum zeylanicum, elādvaya – two kinds of Elettria cardamom, pauṣkaram – Inula racemosa, caṇḍā – Macaranga peltata, tāmalakī – Phyllanthus niruri, loha – Aquilaria agallocha, bhārgī – Clerodendrum serratum, nāgara – Zingiber officinale, vālakam – Pavonia odorata, karkaṭākhyā – Pistacia integerrima, śaṭhī – Curcuma zedoaria, kṛṣṇā – Piper longum, nāgakesara – Messua ferrea, corakam – Angelica glauca, are made into nice powder and double in quantity of sugar is mixed, and used as and when desired, it cures pain in the flanks, jvara – fever, kāsaghnaṃ – and cough, hidhmā – and and best to relieve hiccup, śvāsaharaṃ param – and dysponea.

Shatyadi Churna

शठीतामलकीभार्गीचण्डावालकपौष्करम् ।
शर्कराष्टगुणं चूर्णं हिध्माश्वासहरं परम् ॥ ४६ ॥
Powder of śaṭhī – Curcuma zedoaria, tāmalakī – Phyllanthus niruri, bhārgī – Clerodendrum serratum, caṇḍā – Angelica glauca, vālaka – Pavonia odorata, pauṣkaram – Inula racemosa, mixed with eight parts of śarkarā – sugar, hidhmā – is best of cure hiccup, śvāsaharaṃ param – and dysponea.

Guda Nagara Yoga

तुल्यं गुडं नागरं च भक्षयेन्नावयेत वा ।
Equal parts of guḍaṃ – jaggery, nāgaraṃ ca – and Zingiber officinaleshould be consumed (daily) or used as Nasal drops (for cure of hiccup and dysponea).

Nasal drops in dyspnea and hiccup

लशुनस्य पलाण्डोर्वा मूलं गृञ्जनकस्य वा ॥ ४७ ॥
चन्दनाद्वा रसं दद्यान्नारीक्षीरेण नावनम् ।
स्तन्येन मक्षिकाविष्ठामलक्तकरसेन वा ॥ ४८ ॥
ससैन्धवं घृताच्छं वा सिद्धं स्तन्येन वा घृतम् ।
कल्कितैर्मधुरद्रव्यैस्तत्पिबेन्नावयेत वा ॥ ४९ ॥
सकृदुष्णं सकृच्छीतं व्यत्यासात् ससितामधु ।
तद्वत्पयस्तथा सिद्धमधोभागौषधैर्घृतम् ॥ ५० ॥
Juice of laśuna – Allium sativum, palāṇḍo: – vā Allium cepa, mūlaṃ gṛñjanakasya vā – or root of Daucas carota, candanāt vā – or Santalum album, nārīkṣīreṇa – mixed with breast milk should be put into the nose; or excreta of honey bee with breast milk āma laktaka rasena vā – or juice Alaktaka (lac) or thin fluid of ghee mixed with Saindhava or medicated ghee prepared with the paste of kalkita the paste of herbs of herbs of sweet taste mixed with breast milk should be consumed or used as nasal drops, or honey mixed with sugar (may be instilled into the nose) alternatively making it warm or cold, similarly the milk, or medicated ghee prepared from purgative herbs (to be put into the nose).

Nasal drops in dyspnea and hiccup

कणासौवर्चलक्षारवयःस्थाहिङ्गुचोरकैः ।
सकायस्थैर्घृतं मस्तुदशमूलरसे पचेत् ॥ ५१ ॥
तत्पिबेज्जीवनीयैर्वा लिह्यात्समधु साधितम् ।
Medicated ghee prepared from kaṇā – Piper longum, sauvarcala – sauvchala salt, kṣāra – yavaksara – alkali of Hordeum vulgare, vayaḥsthā – Emblica officinalis, hiṅgu – Ferula narthex, corakaiḥ – medicated ghee prepared from Kana (piper longum), sauvarcala (sauvchal salt), Ksara (yavaksara – alkali of Hordeum vulgare), Vayastha (Emblica officinalis), Hingu (Ferula narthex), Coraka (Angelica glauca) sakāyasthai: – and Terminalia chebula(made into a paste), mastu – mastu, daśamūlarase – and decoction of Dasamula, of that (ghee) prepared from herbs of Jivaniya Gana should be consumed mixed with honey.

Tejovatyadi Ghrita

तेजोवत्यभया कुष्ठं पिप्पली कटुरोहिणी ॥ ५२ ॥
भूतीकं पौष्करमूलं पलाशश्चित्रक: शटी ।
पटुद्वयं तामलकी जीवन्ती बिल्वपेशिका ॥ ५३ ॥
वचा पत्रं च तालीसं कर्षांशैस्तैर्विपाचयेत् ।
हिङ्गुपादैर्घृतप्रस्थं पीतमाशु निहन्ति तत् ॥ ५४ ॥
शाखानिलार्शो ग्रहणी हिध्माहृत्पार्श्ववेदना: ।
Medicated ghee is prepared with decoction of Zanthoxylum alatum, Terminalia chebula, Saussurea lappa, Piper longum, Picrorhiza kurroa, Cymbopogon citrates, Inula racemosa, Butea monosperma, Plumbago zeylanica, Curcuma zedoaria, the two types of salt, Phyllanthus niruri, Leptadenia reticulata, tender fruits of Aegle marmelos, Acorus calamus, Cinnamomum tamala, Abbies webbiana – Each one karsha (12 g), one fourth of karsha (3 g), and one Prastha of ghrita (768 g). This recipe when consumed cures quickly the diseases of vata localized in the extremities, tissues, arśo – hemorrhoids, grahaṇī – disorders of the duodenum, hidhmā – hiccup hṛt pārśva vedanā: – and pain in the region of the heart and the flanks.

Various Ghrita in treatment of hiccup and dyspnea

अर्धांशेन पिबेत्सर्पिः क्षारेण पटुनाऽथवा ॥ ५५ ॥
धान्वन्तरं वृषघृतं दाधिकं हपुषादि वा ।
Dhanvatara ghrita (described in prameha cikitha vide chapter 12), vrisha ghrita (described in Rakta-Pitta vide chapter2), Dadhika Ghrta (described in Gulma chapter 14), or Hapushadi Ghrita (described in udara chapter 15), should be consumed (ghee), mixed with half its quantity of either alkali or salt.

Non medicinal measures in treatment of hiccup and dyspnea

शीताम्बुसेकः सहसा त्रासविक्षेपभीशुचः ॥ ५६ ॥
हर्षेर्ष्योच्छ्वासरोधाश्च हितं कीटैश्च दंशनम् ।
Sudden showering of cold water, sudden fatigue / fear, shaking of the body, fear, sorrow and joy, jealousy, obstruction to expiration, and stinging by insects are beneficial.

Vata alleviating interventions in in treatment of hiccup and dyspnea

यत्किञ्चित् कफवातघ्नमुष्णं वातानुलोमनम् ॥ ५७ ॥
तत्सेव्यं प्रायशो यच्च सुतरां मारुतापहम् ।
Any other treatment which subdues kapha and Vata, which is hot (heat producing), causing downward movement of vata should be adopted especially those which subdue vata.

Brimhana, Shamana and Karshana in treatment of hiccup and dyspnea

सर्वेषां बृंहणे ह्यल्पः शक्यश्च प्रायशो भवेत् ॥ ५८ ॥
नात्यर्थं शमनेऽपायो भृशोऽशक्यश्च कर्षणे ।
शमनैर्बृंहणैश्चातो भूयिष्ठं तानुपाचरेत् ॥ ५९ ॥
In all the cases of dyspnea and hiccup, this risks (complications, incurability etc.) occurring from nourishing therapy are probably less and will be easily curable (manageable); that (risk) occurring from palliative therapy is also not very great, whereas that occurring from debilitating therapy is very difficult, (hiccup and dyspnea) should be treated more with palliative and nourishing therapies.

Treatment of consumption, vomiting and cough in treatment of hiccup and dyspnea

कासश्वासक्षयच्छर्दिहिध्माश्चान्योऽन्यभेषजैः ॥ ५९अब ॥
kāsa – Cough, śvāsa – dyspnea, kṣaya: – consumption, chardi – vomiting, hidhmāśca – and hiccup anyo anya bheṣajaiḥ – can be treated with therapies indicated for one another.

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने श्वासहिध्माचिकित्सितं नाम चतुर्थोऽध्याय: ॥४॥
Thus, ends the chapter, svasa-hidhma-cikitsa, the fourth in Cikitsa sthana of asthangahrdaya Samhita composed by Srimad Vaghata, son of Vaidyapati Simhagupta.