• Introduction
• Roopa (clinical features)
• Treatment
• Commonly used drugs

Introduction
This disease has been given this name because the sound produced during this ailment is 'hic'. The causes, pre-symptoms, number of hidhma (hiccup) are the same as those of shwasa.

The ailment of hikka has been classified in the following categories:

• Annaja Hidhma
• Kshudra Hidhma
• Yamala Hidhma
• Mahati Hidhma
• Gambhira Hidhma

Roopa (clinical features)

• Annaja Hikka
  Hiccups are produced by the consumption of foods and drinks that are tough, improper, dry and penetrating. All these types of food items aggravate Maruta (vata) that hiccups that are painless. If the hiccups are followed by sneezing and subsiding with the use of accustomed foods & drinks it is known as Annaja Hikka (hiccup produced by unaccustomed food).
  
  
• Kshudra Hikka
  The Hiccups starting from the root base of shoulders with mild and soft bouts caused due to increased exertion that consequently increases pavana (vata) produces Kshudra (minor).
  
  
• Yamala Hikka
  As it comes in pairs, with force (vega) and during parinamkala (digestion) of food it is called vegini and parinamvati Hikka that commences after taking food & increases during period of digestion, coming up in pairs, causing tremors of head & neck, flatulence severe thirst, irrelevant talk, vomiting, diarrhea, unsteady eyes, & yawning.
  
  
• Maha Hikka
  This hikka arises from deep inside with great sound & forceful bouts. This hikka is manifested with rigidity (loss of movements) of the brows, eyes are red & full of tears, loss of movements of the body, speech, memory & general awareness, obstructing the passage of food, producing a feeling as though vital organs are being hit, bending of the body backwards, and emaciation.
  
  
• Gambhira Hikka
  This starts from either pakvashaya (large intestine) or nabhi (umbilicus) and has similar features as Maha Hikka like more yawning and a vibrating sound (of hiccup).

Treatment

• Snehan- Svedana (Oleation and Sudation)
  • Hidhma patients should have administered Sweda (Sudation) after anointing the body with oil mixed with salt. After sudation, the patient should be made to eat rice, dadhi (curds). Then, a mild emesis therapy should be given, especially for those who have cough, vomiting, catching pain in the region of the heart and diminution of voice, by using Pippali, Saindhava and honey, which is not opposed to Vata (which does not aggravate vata). Following method must be a purgative drug mixed with saindhava and any sour fruit followed by warm water should be administered to produce purgation. It is beneficial to clear the passage by administration of purifactory therapy of both the upper and lower parts of the body.
    
    If by the above treatment the disease does not subside the Kapha dosha leaves of haridra, root of eranda, laksha, manashila, devadaru, ela, and mansi, are made into a paste and a cigarette prepared. It should be lubricated with ghee and smoked. Or smoke of yava mixed with ghee, or smoke of madhucchista, sarjarasa and mixed with ghee; or smoke of aguru or of chandana or of guggulu, of manohva or of resin of sala, sallaki, guggulu, aguru or padmaka-each one lubricated with ghee.
    
    Swedana (sudation therapy) is essential for those who are fit for it and even those who are unfit, should be given sudation for a moment (short duration) either by pouring warm milk mixed with sugar, or oil; or by utkarika and upanaha (warm poultices) especially over the chest and throat.
  
  
  
• A mud pot smeared inside with ghee coated (inside) with the paste of pippli, pippalimula, pathya, jantughna and chitraka. After the paste dries up; the pot is filled with takra (buttermilk) and kept undisturbed for a month; this is carminative and cures dyspnoea, hidhma and cough.
  
  
• Jivanti, musta, surasa, tvak, eladvaya, pushkara, tamalaki, aguru bharangi, nagara, karkata, shathi, krishna, nagakeshara, are made into nice powder and mixed with sugar, double its quantity are used as when desired. It cures pain in the flanks, fever and cough and best to relieve hiccup and dyspnoea. Cough, dyspnoea, constipation, vomiting and hiccup should be treated with therapies indicated for one another.

Decoction

• Dashamula
• Shathi
• Raasana
• Bharangi
• Bilva
• Riddhi
• Pushkara
• Tamalaki
• Amruta
• Ausadha (nagara)

Commonly Used Drugs

• Churna
  • Shatayadi Churna- Bhaisajya- Ratnavali
  • Haridradi Churna- Bhaisajya Ratnavali
  • Shrungyadi Churna- Bhaisajya Ratnavali
  
  
  
• Lauha
  • Pippaladya Lauha- Bhaishajya Ratnavali
  
  
  
• Rasa Kalpa
  • Shwasa Kuthar- Bhaishajya Ratnavali
  • Shwas Kaasa Chintamani Rasa- Bhaishajya Ratnavali
  • Swarna vasant Malati- Bhaishajya Ratnavali
  • Sutshekhar Rasa- Yog Ratnakar
  
  
  
• Aasav
  • Kanakasav- Bhaishajya Ratnavali
  
  
  
• Ghrita
  • Tejovatyadya Ghrita- Bhaishajya Ratnavali
  
  
  
• Bhasma
  • Abhrak- Ras Raj Sunder
  • Raupya- Rasendra Saar Sangraha
  • Shrung Bhrama- Ras Tarangini
  • Suvarna Bhasma- Siddhayog Sangraha
  • Moti Bhasma- Ras Tarangini & Rasendra Saar Sangraha
  
  
  
• Arishtha
  • Draksharishtha- Bharat Bhaishajya Ratnakar
  
  
  
• Pishthi
  • Praval Pishthi- Ayurved Saar Sangraha
  • Moti Pishthi- Ayurved Saar Sangraha