Abstract
Background: Hiccups is described in Ayurveda as a disorder of Pranavaha Srotas (respiratory system) and is classified among Shighrapranahara Vyadhi (disease which causes immediate death) due to its potentially fatal nature if not managed promptly. It is primarily caused by aggravated Vata and Kapha obstructing Prana, Udaka, and Annavaha Srotas (respiratory, body fluid and food carrying channels) resulting in repetitive involuntary diaphragmatic contractions. Classical texts advocate Trāsana Chikitsa Startling therapy / Shock therapy (psychological stimulation therapy) and Viddha Karma (Therapeutic puncturing / Needling therapy) as emergency interventions. Objective: To evaluate the clinical efficacy of Viddha Karma at Nasagra (tip of nose) combined with oral Triphala Masi with Madhu (honey) in the management of persistent hiccups. Case details: This single case study was conducted on a 40-year-old male patient presenting with persistent hiccups for 12 hours continuously. Viddha Karma was performed on the tip of nose once daily for three consecutive days. Additionally, Triphala Masi was administered orally with honey as during the treatment period. Clinical assessment was based on frequency, duration, and recurrence of hiccups. Results: The patient showed marked reduction in hiccups frequency after the first sitting, with complete remission observed by the third day. No recurrence was reported during follow-up. The intervention demonstrated rapid symptomatic relief without adverse effects. Conclusion: Viddha Karma at Tip of nose, supported by Triphala Masi with honey proved to be an effective and safe intervention in acute hiccups. This case validates classical Ayurveda principles, particularly Trāsana Chikitsa, in contemporary clinical practice.

Key words: Ayurveda, Hiccups, Trāsana Chikitsa, Triphala Masi, Viddha Karma