A Management of Chronic Frequent Hiccup by Kankasava

Hikka is a disease of serious nature and can cause death if not treated properly. 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 are elaborated. The classification is based upon clinical presentation of disease and includes three types each of Hikka with bad prognostic signs pointing to worse condition. 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 the Hikka conditions. Depletion therapies are strongly contraindicated as they may worsen the condition of patient and disease.A 60 years old patient came in opd with complaint of frequent hiccup since 1 month. He has taken allopathic medicine for this but found no result. The condition was managed by Kanakasav 40 ml BD with leuke warm water before meal internally and got instant result. Within one day he became normal.


Introduction
Vayu (udana and pranavaha) moves upward accompanied with sound causing shaking of the liver, spleen and intestines, comes out of the mouth with loud sound and causes troubles to life, hence it is called Hikka (hiccups). i Hikka and shwasaare two diseases of serious nature and can cause death if not treated properly. The etiological factors, site, origin of both Hikka and Shwasa are same, and hence the line of treatment is also common. The etiological factors related to food, regimen and mental faculties lead to the aggravation of vata in the pranavahasrotas and derangement of kapha situated in the chest region producing lethal blockage of prana vayu.In BruhatatrayeeHikkavyadhi (hiccup) is mentioned under pranavahasrotasa (respiratory system). As compared to the other vyadhi'sHikka. In Hikkavyadhi "hikhik"sound is produced, hence it is named as Disease Hikka. ii Vitiated vata dosha along with kapha dosha obstructs the pranavaha, udakavaha and annavahasrotasa(respiratory system, watery elements & digestive system) and produces different types of Hikkavyadhi. iii Hikka can be correlated in modern science with hiccup. A hiccup is an involuntary contraction (myoclonic jerk) of the diaphragm that may repeat several times per minute. iv It is clear that to treat Hikka and Swasavyadhi as early as possible is needful to avoid further complications as well as possibility of death of the patients.
Acharya charaka described five types of Hikkavyadhi'si.e.Maha, Gambhira, vyapeta, kshudra, and Annaja. v Yamala is mentioned by Madhavakara instead of vyapeta. vi Acharya vaghbhata had described kshudra and AnnajaHikka are sadhya (curable) and Mahati and Gambhira areasadhya (uncurable) or presented with all symptoms in yamala it can be asadhya (uncurable). vii Ayurvedic classical texts had described different kalpa as well as Ekaldravya for the management of Hikkavyadhi. According to modern medicine management of hiccups many drugs are being used but not particular treatment is known to be especially effective. viii But it is observed many times that the disease like Hikka is relieved immediately by certain Ayurvedic drugs. Here we observed immediate effect of Kanakasava ix on Hikka in Ayurveda

PATIENT INFORMATION
Patient 60 years old presented in OPD of Shalakyadept.ITRAjamnagar, with complaint of frequent Hiccup since 1month.Patient , said to be asymptomatic 1 month back sudden patient started to hiccups. He consulted physician and took medicine as anta-acid,muscle relaxtant. For the above complaints he went to multiple doctors and took various treatments for hiccupsresulting in no relief.
On arrival to our OPD, his general condition was good. With this clinical presentation, on the basis of visual inspection the patient was diagnosed as a case of Hikka.He came here for Ayurvedic management. Meanwhile initial and routine blood investigations like Complete Blood Count, Urine Routine & Microscopic and Blood Sugar levels were sent to the labs which were within normal limits.

Conclusion
By the above works we can conclude that Kanakasava act in different mechanisms to perform their activity.it act by bronchodilator activity, some by anti histamine activity, some by antitussive properties some by mast cell stabilizing activity, antibacterial/viral properties etc.

Decleration of patient consent
Authors clarify that they have obtained patient consent form , where the patient has given his consent for reporting the case with the photographs and other clinical information in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal her identity , but anonymity cannot be guaranteed.

Financial support and sponsorship
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