The 4th chapter of Nidanasthanam of Ashtanga Hridayam is called as Shvasa Hidhma Nidanam Adhyayah. This chapter offers with the reason of ‘prognosis of dyspnoea and hiccough’.
The matters lined on this chapter embody –
– Shvasa Nidana – causes of dyspnea
– Shvasa bheda – sorts of dyspnea
– Samprapti – pathogenesis of dyspnoea
– Purvarupa – premonitory signs of dyspnea
– Rupa – signs of Kshudra, Tamaka, Chinna, Maha and Urdhwa shvasa
– Sadhyasadhyata – prognosis of dyspnea
– Hidhma Nidana – prognosis of hiccough
– Rupa – signs of Annaja, Kshudra, Yamala, Maha and Gambhira Hikka
– Sadhyasadhyata – prognosis of hiccough
– Hiccough and dyspnea trigger fast dying amongst all ailments
Pledge by the writer(s)
अथातो श्वासहिध्मानिदानं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ॥
After having provided prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘prognosis of dyspnoea and hiccough’. Thus say (pledge) atreya and different sages.
Shvasa Nidana (causes of dyspnoea)
कासवृद्ध्या भवेच्छ्वासः पूर्वैर्वा दोषकोपनैः।
आमातीसार वमथु विषपाण्डुज्वरैरपि॥१॥
रजोधूमानिलैर्मर्मघातादतिहिमाम्बुना।
Shvasa (dyspnea) arises by improve of cough, or by causes described earlier which result in aggravations of the Doshas. Additionally, by diarrhea as a result of indigestion, vomiting, poisons, anemia, fever; publicity to mud, smoke, and breeze; damage to very important organs and consuming of very chilly water.
Shvasa Bheda (sorts)
क्षुद्रकस्तमकश्छिन्नो महानूर्ध्वश्च पञ्चमः॥२॥
Kshudra, Tamaka, Chinna, Mahan, and Urdhva – are its 5 sorts
Samprapti (pathogenesis)
कफोपरुद्धगमनः पवनो विष्वगास्थितः।
प्राणोदकान्नवाहीनि दुष्टः स्रोतांसि दूषयन्॥३॥
उरःस्थः कुरुते श्वासमामाशयसमुद्भवम्।
Pavana (Vata) obstructed in its motion by Kapha, spreading in all instructions, vitiates the channels of Prana (respiration), Udaka (water) and Anna (meals), positioned within the chest and produces Svasa (dyspnea) arising from the Amasaya (abdomen).
Purvarupa (premonitory signs)
प्राग्रूपं तस्य हृत्पार्श्वशूलं प्राणविलोमता॥४॥
आनाहः शङ्खभेदश्च
Its premonitory signs are- ache within the area of the center and flanks, upward motion of Prana (respiration), flatulence and splitting ache within the temples (sides of the brow).
Rupa (medical options)
Ksudra Shvasa
तत्रायासातिभोजनैः।
प्रेरितः प्रेरयेत्क्षुद्रं स्वयं संशमनं मरुत्॥५॥
Marut (Vata) aggravated by exertion and overeating, produces KsudraSvasa, which subsides by itself (with none remedy)
Notes: That is heavy respiratory on exertion, passes off quickly by relaxation and never troublesome.
Tamaka Shvasa
प्रतिलोमं सिरागच्चन्नुदीर्यपवनः कफम्।
परिगृह्य शिरोग्रीवमुरः पार्श्वे च पीडयन्॥६॥
कासं घुर्घुरकं मोहमरुचिपीनसं तृषम्।
करोति तीव्रवेगं च श्वासं प्राणोपतापिनम्॥७॥
प्रताम्येत्तस्य वेगेन निष्ठ्यूतान्ते क्षणं सुखी।
कृच्छ्राच्छयानः श्वसितिनिषण्णः स्वास्थ्यमृच्चति॥८॥
उच्छ्रिताक्षो ललाटेन स्विद्यता भृशमर्तिमान्।
विशुष्कास्यो मुहुःश्वासी काङ्क्षत्युष्णं सवेपथुः॥९॥
मेघाम्बुशीतप्राग्वातैः श्लेष्मलैश्चविवर्धते।
सयाप्यस्तमको साध्यो नवो वा बलिनो भवेत्॥१०॥
ज्वरमूर्छायुतः शीतैः शाम्येत्प्रतमकस्तुसः।
Pavana (Vata) getting aggravated begins to maneuver within the upward route within the Siras (Srotas or channels of respiration), aggravates the Kapha additionally and produces Shvasa – dyspnoea with catching ache within the head and neck, chest and flanks; cough accompanied with cracking sound, delusion, lack of style/urge for food, operating within the nostril, and thirst; the bouts of respiration are very forceful producing nice misery to life, the affected person goes into darkness (loses consciousness of the environment) by its power, finds momentary consolation after expectorations; is unable to breath whereas mendacity and finds consolation on sitting; eyes are gazing up (large open) brow sweating, experiences nice misery; mouth is dry, bouts of dyspnea are frequent, needs scorching comforts, and accompanied with tremors (shivering); the circumstances will get elevated by accumulation of clouds within the sky, consuming chilly water, chilly breeze, direct breeze and ingestion of drugs which trigger improve of Kapha. This TamakaSvasa is Yapya (incurable however controllable, persists for very long time), could also be curable if of latest onset and in those that are sturdy. It’s referred to as Pratamaka (Svasa) when related to fever and fainting and subsiding by chilly (meals, drinks and so on.).
Notes: – This situation is recognized as Bronchial Bronchial asthma in fashionable parlance.
Chinna Shvasa
छिन्नाच्छ्वसिति विच्छिन्नं मर्मच्छेद रुजार्दितः॥११॥
सस्वेदमूर्छः सानाहो वस्तिदाहनिरोधवान्।
अधोदृग्विप्लुताक्षश्च मुह्यन्रक्तैकलोचनः॥१२॥
शुष्कास्यः प्रलपन्दीनो नष्टच्छायोविचेतनः।
With Chinnasvasa the individual breathes with interruptions, has reducing ache within the very important organs, accompanied with ache, sweating, fainting, flatulence, burning sensation and obstruction within the urinary bladder; gazes downward, eyes are unsteady (of stuffed with tears), goes in for delusion (or coma), one eye is offended – purple in coloration, mouth dry, talks irrelevant; feels helpless (unable to do any skinny, incapable to resist) with lack of shade (complexion) and lack of consciousness.
Notes: – This situation is recognized as Cheyne – stokes respiration and seems often on the terminal phases of many ailments.
Maha shvasa
महतामहतादीनो नादेन श्वसितिक्रथन्॥१३॥
उद्धूयमानः संरब्धो मत्तर्षभ इवानिशम्।
प्रणष्टज्ञानविज्ञानो विभ्रान्त नयनाननः॥१४॥
वक्षः समाक्षिपन्बद्धमूत्रवर्चाविशीर्णवाक्।
शुष्ककण्ठोमुहुर्मुह्यन्कर्णशङ्खशिरोऽतिरुक्॥१५॥
With Mahasvasa, the individual has heavy respiratory, feels helpless (unable to resist the difficulty), respirations are accompanied with sound like loud night breathing (brought on by sudden interruption of breath), trembling and agitated, he produces steady sound of excessive pitch (from the nostril) resembling that of a bull; widespread sense and intelligence are misplaced, eyes and face are unsteady; chest constricted / transfer violently; obstruction of urine and feaces, damaged, voice, dryness of the throat, frequent delusions and extreme ache within the ears, temples and head
Notes: – This situation additionally seems on the terminal phases of many ailments.
Urdhva Shvasa
दीर्घमूर्ध्वं श्वसित्यूर्ध्वान्न च प्रत्याहरत्यधः।
श्लेष्मावृतमुखस्रोताः क्रुद्धगन्धवहार्दितः॥१६॥
ऊर्ध्वदृग्वीक्षते भ्रान्तमक्षिणीपरितः क्षिपन्।
मर्मसु च्छिद्यमानेषु परिदेवी निरुद्धवाक्॥१७॥
From Urdhva Svasa, the individual has extended upward breathings (expirations) however incapacity of bringing it downwards (inspirations), the mouth of the channels are lined with shleshma (Kapha); Gandhvaha (Vata) being aggravated the affected person has an upward gaze, rolling eye balls and a terrified look, has extreme ache as if his very important organs are being lower, the individual is in grief (cries) and his speech choked
Sadhyasadhyata (prognosis)
एते सिध्येयुरव्यक्ताव्यक्ताः प्राणहरा ध्रुवम्।
Success might end result (by efficient remedy) when these (Mahan, Urdhva and Chinna sorts) usually are not nicely manifest (seem with few gentle signs) however when nicely manifest seem with all signs profoundly) are certain to remove the life
Hidhma (Hikka) Nidana (prognosis of hiccup)
श्वासैकहेतुप्राग्रूप सङ्ख्या प्रकृतिसंश्रयाः॥१८॥
हिध्माभक्तोद्भवा क्षुद्रा यमला महतीति च।
गम्भीरा च
Causes, premonitory signs, quantity (sorts), pathogenesis and place of Hidhma (hiccup) are the identical as these of Svasa (dyspnoea). Hidhma (hiccup) is of 5 sorts; viz, that produced by meals (Annaja), Ksudra, Yamala, Mahatiand Gambhira
Rupa (medical options)
Annaja Hikka
मरुत्तत्रत्वरयायुक्तिसेवितैः॥१९॥
रूक्षतीक्ष्णखरासात्म्यैरन्नपानैः प्रपीडितः।
करोति हिध्मामरुजां मन्दशब्दां क्षवानुगाम्॥२०॥
शमं सात्म्यान्नपानेन या प्रयाति च सान्नजा।
Marut (Vata) getting aggravated by consuming meals quickly and improperly, by partaking meals and drinks that are dry, penetrating, tough (coarse) and unaccustomed, produces hiccup which is painless, of gentle sound, adopted with sneezing, and subsiding with (the usage of) accustomed meals and drinks is named Annaja Hikka (hiccup produced by meals).
Kshudra Hikka
आयासात्पवनः क्षुद्रः क्षुद्रां हिध्मां प्रवर्तयेत्॥२१॥
जत्रुमूलप्रविसृतामल्पवेगां मृदुं च सा।
वृद्धिमायास्यतो याति भुक्तमात्रे च मार्दवम्॥२२॥
Pavana (Vata) present process slight improve from exertion, produces Kshudra Hidhma (minor hiccup) ranging from the foundation (base) of the shoulders, with gentle and comfortable bouts, will increase by exertion and subsides instantly after consuming meals.
Yamala Hikka
चिरेण यमलैर्वेगैराहारे या प्रवर्तते।
परिणामोन्मुखेवृद्धिं परिणामे च गच्छति॥२३॥
कम्पयन्तीशिरोग्रीवमाध्मातस्यातितृष्यतः।
प्रलापच्छर्द्यतीसार नेत्रविप्लुति जृम्भिणः॥२४॥
यमला वेगिनी हिध्मा परिणामवती च सा।
That, commencing a very long time after taking meals and rising through the interval of digestion and after digestion, bouts arising in pairs, inflicting tremors of the top and neck, flatulence, extreme thirst, irrelevant speak, vomiting, diarrhea, unsteady eyes and yawnings, is Yamala Hidhma additionally referred to as Vegini, and Parinamavati Hikka (hiccup arising in pairs) associated to digestion.
Maha Hikka
स्तब्धभ्रूशङ्खयुग्मस्य सास्रविप्लुतचक्षुषः॥२५॥
स्तम्भयन्तीतनुं वाचं स्मृतिं सञ्ज्ञां च मुष्णती।
रुन्धती मार्गमन्नस्य कुर्वती मर्मघट्टनम्॥२६॥
पृष्ठतोनमनं शोषं महाहिध्माप्रवर्तते।
महामूला महाशब्दा महावेगा महाबला॥२७॥
Maha Hikka, manifests with rigidity (lack of motion) of the brows, temples and sides of the neck; eyes are purple and stuffed with tears, stiffness of the physique (lack of actions of the physique) lack of speech, reminiscence and normal consciousness, obstructing the passage of meals, producing a sense of important organs being hit, bending of the physique backwards and emaciation; it arises from deep inside, with nice sound and forceful bouts and highly effective manifestation.
Gambhira Hikka
पक्वाशयाद्वा नाभेर्वा पूर्ववद्या प्रवर्तते।
तद्रूपा सा मुहुः कुर्याज्जृम्भामङ्गप्रसारणम्॥२८॥
गम्भीरेणानुनादेन गम्भीरा
That which begins both from Pakvasaya (giant gut) or Nabhi (umbilicus), much like the earlier kind (Maha Hikka) in its options producing extra yawnings and growth of the physique continuously with a vibrating sound of hiccup is Gambhira Hikka.
Sadhyasadhyatha (prognosis)
तासु साधयेत्।
आद्येद्वे वर्जयेदन्त्ये सर्वलिङ्गां च वेगिनीम्॥२९॥
सर्वाश्च सञ्चितामस्य स्थविरस्य व्यवायिनः।
व्याधिभिः क्षीणदेहस्य भक्तच्छेदक्षतस्य वा॥३०॥
Amongst these, the primary two sorts must be handled, the final two rejected; so additionally the Vegini (Yamala) which has all its options; all of the sorts must be rejected in individuals who’ve accumulation of Ama of their physique, who’re of previous age, who indulging an excessive amount of of sexual exercise, who’re emaciated by ailments and by absence of meals.
Hiccough and dyspnea trigger fast dying amongst all ailments
सर्वेऽपि रोगानाशाय नत्वेवं शीघ्रकारिणः।
हिध्माश्वासौ यथा तौ हि मृत्युकाले कृतालयौ॥३१॥
All ailments are going to kill however not as shortly as hiccup and dyspnea; these two reside very near the time of dying
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहिताया तृतीये निदानस्थाने श्वासहिध्मानिदानं नाम चतुर्थोऽध्याय: ।।१॥
That ends the chapter SvasaHidhma Nidana the fourth in Nidana Sthana of Ashtanga Hrudaya Samhita composed by Sri MadVaghbhata son of Sri Vaidyapati Simha Gupta.
