1. Heart-burn producing, heavy, constipating, dry and abhishyandi articles of food (which produces excessive amount of mucus)
2. Cold foods and drinks and cool climate
3. Excessive exposure to dust, smoke, sun and winds
4. Overexertion due to physical exercise, hard work, weight lifting and travelling long distances on foot
5. Suppression of natural evacuatory urges and
6. Nutritional deficiencies may produce hiccough, dyspnoea and cough in the human beings.
1. Annaja Hikka (Due to presence of gastric irritants in food)
2. Yamla Hikka (Twin Hiccough)
3. Kshudra Hikka (Mild form of Hiccough)
4. Gambhira Hikka (Severe Hiccough)
5. Mahati Hikka or Maha hikka (Serious Hiccough)
Prodromal Symptoms: All types of hiccoughs show following premonitory symptoms:
1. A feeling of heaviness in the throat and the chest.
2. Astringent taste in the mouth.
3. Borborygmi in the abdomen.
Clinical Features of all types of Hikka:
1. Annaja Hikka (Due to Gastric irritation by food and drinks):
Excessive intake of food and drinks together suddenly irritates the vaayu which then transversing upwards produces hiccough; the physicians consider this variety of hiccough to be dietetic (annaja) in origin.
2. Yamla (Twin) Hikka:
The hiccough which comes up in two successive bouts at some interval and which shakes the head and neck is called yamla hiccough.
3. Kshudra (Mild) Hiccough:
The hiccough which occurs in the feeble bouts at long intervals and shakes the head upto root of the neck only is known as kshudra hiccough.
4. Gambhira (severe) Hiccough:
When violent bouts of hiccough originate from the umbilical region accompanied with loud sounds and are associated with many complications, that type of hiccough is known as gambhira hiccough.
5. Maha Hikka (The Serious Hiccough):
That variety of hiccough which keeps on coming continuously as if afflicting the vital organs and shakes the entire body is known as maha hikka. It is also known as mahati hikka.
When during the bout of hiccough, the body becomes stretched and the eyes roll upwards, whereas usually a position of flexion is adopted, the person becomes thin, has an aversion to food and sneezes excessively- these patients and the last two hiccoughs (gambhira and maha hikka) should be discarded from the treatment.
Hiccough occurring in persons with excessive accumulation of doshas, with emaciation due to starvation or debilitated due to diseases and in the elderly patients or in those who indulge excessively in sexual intercourse proves fatal within a short period. Yamla hiccough also becomes fatal if associated with the complications of delirium, pain, confusion and thirst.
On the other hand, yamla hiccough in the unemaciated and indistressed patients with the normally functioning body tissues and organs is curable; otherwise it would be fatal.