Sushruta Samhita Uttaratantra Chapter 62 Uñmāda Pratişedha (Remedy of Madness)

AIAPGET POINTS

1. Mano Dukha Janya Unmada and Vishaja Unmada are the fifth and sixth sorts of Unmada in response to Sushruta, aside from 3 sorts of doshaja Unmadas (Vataja, Pittaja and Kaphaja) and Sannipataja (4th sort, brought on by all three doshas).
2. In line with Sushruta, the Apravruddha and Taruna Avastha of Vishaja Unmada are known as Mada. (Su.Ut.62/5)
3. Bhrama, talked about as one of many Purvarupas of Unmada has been described as – Chakragatasya Va – as if spinning on a wheel.
4. When the substances of Kalyanaka Ghrta are ready with herbs belonging to Jivaniya Gana and 4 components of milk (as an alternative of two components), it turns into MAHAKALYANAKA Ghrta.
5. Sira Vimokshana is indicated to be carried out in uras, apanga and lalata within the remedy of Unmada.
6. Sushruta advises Sneha Basti to be given after the doshas subside, within the remedy of Unmada.
7. Sushruta prescribes remedy ideas of Apasmara and Graha to be included in remedy of Unmada additionally.
8. Sushruta advises removing of Shoka Shalya in Manoja Unmada.

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The 62nd chapter of Uttaratantra of Sushruta Samhita is known as as Uñmāda Pratiședha. This chapter offers with Remedy of Madness.

अथात उन्मादप्रतिषेधमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We are going to now expound Uñmäda pratiṣedha – remedy of madness; as revealed by the venerable Dhanvantari.

Nirukti – definition

मदयन्त्युद्ध(द्ग)ता दोषा यस्मादुन्मार्गमाश्रिताः |
मानसोऽयमतो व्याधिरुन्माद इति कीर्तितः ||३||

A illness wherein the drastically aggravated doshas get localized within the higher paths of the physique and produce abnormalities (toxicity) within the thoughts is named Unmada (madness). Unmada is taken into account as a illness of the thoughts.

एकैकशः समस्तैश्च दोषैरत्यर्थमूर्च्छितैः |
मानसेना च दुःखेन स पञ्चविध उच्यते ||४||
विषाद्भवति षष्ठश्च यथास्वं तत्र भेषजम् |
स चाप्रवृद्धस्तरुणो मदसञ्ज्ञां बिभर्ति च ||५||

Unmada is of 5 sorts –

–        one by every dosha individually – vataja, pittaja and kaphaja,

–        one by all doshas drastically aggravated collectively – samasta dosha or sannipataja and

–        the fifth sort is brought on by manasa dukha – distress or disturbance of the thoughts

The sixth type of unmada is produced by visa – poison. This situation, when not drastically developed and nonetheless younger (newly manifested), bears the title Mada (intoxication).

Pūrvarūpa – premonitory signs

मोहोद्वेगौ स्वनः श्रोत्रे गात्राणामपकर्षणम् |
अत्युत्साहोऽरुचिश्चान्ने स्वप्ने कलुषभोजनम् ||६||
वायुनोन्मथनं चापि भ्रमश्चक्रगतस्य वा |
यस्य स्यादचिरेणैव उन्मादं सोऽधिगच्छति ||७||

Beneath talked about are the premonitory signs of Unmada –

–        delusion,

–        emotional bouts,

–        noise within the ears,

–        debility of the physique,

–        nice enthusiasm,

–        lack of style or lack of want for meals,

–        desires as if he’s consuming soiled meals,

–        experiencing twisting pains within the physique,

–        giddiness as if spinning on a wheel

These signs would result in Unmada very quickly. 

Laksana – medical options

रूक्षच्छविः परुषवाग्धमनीततो वा शीतातुरः कृशतनुः स्फुरिताङ्गसन्धिः |
आस्फोटयत्यटति गायति नृत्यशीलो विक्रोशति भ्रमति चाप्यनिलप्रकोपात् ||८||

Vātaja Unmada Signs – Beneath talked about are the signs of Unmada produced by Vata –

–        roughness of the pores and skin and speech (voice),

–        seen outstanding blood vessels,

–        want for chilly issues,

–        emaciation of the physique,

–        throbbing within the physique components and joints,

–        the individual breaks issues,

–        he wanders, sings, dances, weeps or screams and shivers

तृट्स्वेददाहबहुलो बहुभुग्विनिद्रश्छायाहिमानिलजलान्तविहारसेवी |
तीक्ष्णो हिमाम्बुनिचयेऽपि स वह्निशङ्की पित्ताद्दिवा नभसि पश्यति तारकाश्च ||९||

Pittaja Unmada Signs – Beneath talked about are the signs of Unmada produced by Pitta –

–        extreme thirst, sweating and burning sensation,

–        he eats extra meals and sleeps much less,

–        he resides in shade,

–        has want for chilly breeze and likes to remain within the neighborhood of water reservoirs,

–        is violent,

–        suspects the presence of fireplace even in ice and water and

–        sees stars within the sky even within the day time

छर्द्यग्निसादसदनारुचिकासयुक्तो योषिद्विविक्तरतिरल्पमतिप्रचारः |
निद्रापरोऽल्पकथनोऽल्पभुगुष्णसेवी रात्रौ भृशं भवति चापि कफप्रकोपात् ||१०||

Kaphaja Unmada Signs – Beneath talked about are the signs of Unmada produced by kapha –

–        vomiting,

–        weak point of digestive hearth,

–        debility of the physique,

–        lack of style,

–        cough,

–        want for firm of girls in solitude,

–        is low (poor) in intelligence,

–        talks much less,

–        at all times sleepy,

–        eats much less meals,

–        has want for warm issues and

–        signs enhance after taking the meals and at night time time

सर्वात्मके पवनपित्तकफा यथास्वं संहर्षिता इव च लिङ्गमुदीरयन्ति ||११||

Sannipātaja Unmada Signs – All of the signs of all of the three doshas are drastically exaggerated in Unmada brought on by all of the three doshas collectively (mixed aggravation). The signs behave in a method as if competing with each other.

चौरैर्नरेन्द्रपुरुषैररिभिस्तथाऽन्यैर्वित्रासितस्य धनबान्धवसङ्क्षयाद्वा |
गाढं क्षते मनसि च प्रियया रिरंसोर्जायेत चोत्कटतरो मनसो विकारः ||१२||
चित्रं स जल्पति मनोनुगतं विसञ्ज्ञो गायत्यथो हसति रोदिति मूढसञ्ज्ञः |१३|

Manoja Unmada Signs – The thoughts turns into drastically injured (disturbed) and produces Unmada within the individuals –

–        who’re threatened by thieves (robbers, murderers and so forth),

–        who’re threatened by officers (safety, troopers, guards and so forth) of the king,

–        who’re threatened by enemies and such different folks,

–        who’ve misplaced wealth and family or

–        who has a powerful want to copulate along with his / her beloved (and never having the ability to do)

This situation is named Manoja Unmada.

An individual affected by such situation –

–        talks in another way,

–        reveals the wishes of his thoughts with out his information,

–        sings,

–        laughs and

–        weeps

रक्तेक्षणो हतबलेन्द्रियभाः सुदीनः श्यावाननो विषकृतेऽथ भवेत् परासुः ||१३||

Visaja Unmada – Beneath talked about are the signs of Unmada brought on by poisons –

–        reddishness of the eyes,

–        lack of power,

–        lack of sense of notion,

–        lack of complexion (color),

–        timidness,

–        bluish coloration of face (mouth) and

–        the individual seems like he’s going to die quickly

Cikitsā – remedy

स्निग्धं स्विन्नं तु मनुजमुन्मादार्तं विशोधयेत् |
तीक्ष्णैरुभयतोभागैः शिरसश्च विरेचनैः ||१४||
विविधैरवपीडैश्च सर्षपस्नेहसंयुतैः |
योजयित्वा तु तच्चूर्णं घ्राणे तस्य प्रयोजयेत् ||१५||
सततं धूपयेच्चैनं श्वगोमांसैः सुपूतिभिः |
सर्षपानां च तैलेन नस्याभ्यङ्गौ हितौ सदा ||१६||

Beneath talked about are the overall remedy ideas of Unmada –

These affected by Unmada ought to be administered with the beneath talked about remedies –

–        oleation and sudation therapies to start with, adopted by

–        therapeutic emesis, purgation and purgation to the pinnacle (errhines) – with robust herbs and

–        completely different sorts of avapida (nasal drops) combined with mustard oil and

–        powder of medicinal herbs (used for nasya) ought to be blown into the nostril of the affected person and

–        the affected person ought to be uncovered to the fumes of flesh of canine or cow, that are foul smelling and

–        sarsapa taila – mustard oil could also be used for administering nasal drops and in addition for anointing the physique

Kşobhotpādana – shock remedy

दर्शयेदद्भुतान्यस्य वदेन्नाशं प्रियस्य वा |
भीमाकारैर्नरैर्नागैर्दान्तैर्व्यालैश्च निर्विषैः ||१७||
भीषयेत् संयतं पाशैः कशाभिर्वाऽथ ताडयेत् |
यन्त्रयित्वा सुगुप्तं वां त्रासयेत्तं तृणाग्निना ||१८||
जलेन तर्जयेद्वाऽपि रज्जुघातैर्विभावयेत् |
बलवांश्चापि संरक्षेत् जलेऽन्तः परिवासयेत् |
प्रतुदेदारया चैनं मर्माघातं विवर्जयेत् |
वेश्मनोऽन्तः प्रविश्यैनं रक्षंस्तद्वेश्म दीपयेत् ||१९||
सापिधाने जरत्कूपे सततं वा निवासयेत् |२०|

The affected person of unmada ought to be put right into a zone of shock (which constitutes shock remedy) by doing the beneath mentioned –

–        he ought to be proven great or awe inspiring sights,

–        intimated of the dying of individuals whom he loves probably the most,

–        be threatened by individuals of terrifying form and dimension,

–        be threatened by elephants and wild animals which have been tamed and that are additionally non-poisonous (or whose poison has been eliminated),

–        be threatened by binding him with ropes or beating him with whips,

–        be tied and hidden in an remoted / solitary place or

–        be threatened with hearth of burning hay or burning water or

–        be crushed with whip or

–        a powerful affected person could also be saved immersed in water whereas defending his life or

–        be pricked with needles, avoiding harm to marmas – very important spots or

–        be saved inside a home and the home set on hearth whereas taking care to guard him from the fireplace or getting burnt by hearth or

–        saved inside an enormous pot and canopy it with lid 

त्र्यहात्त्र्यहाद्यवागूश्च तर्पणान् वा प्रदापयेत् ||२०||
केवलानम्बुयुक्तान् वा कुल्माषान् वा बहुश्रुतः |
हृद्यं यद्दीपनीयं च तत्पथ्यं तस्य भो(यो)जयेत् |

The clever doctor ought to give the beneath talked about to the affected person affected by unmada –

–        yavagu i.e. thick gruel or tarpana – flour added with ghee, sugar, honey and so forth – as soon as in each three days or

–        kulmasa – cooked pulses together with water or

–        meals that are pleasing, likable or good for coronary heart (hrdya) and in addition

–        meals that are wholesome and which enhance starvation

Kalyāņaka ghrta

विडङ्गत्रिफलामुस्तमञ्जिष्ठादाडिमोत्पलैः |
श्यामैलवालुकैलाभिश्चन्दनामरदारुभिः ||२२||
बर्हिष्ठरजनीकुष्ठपर्णिनीसारिवाद्वयैः |
हरेणुकात्रिवृद्दन्तीवचातालीसकेशरैः ||२३||
द्विक्षीरं साधितं सर्पिर्मालतीकुसुमैः सह |
गुल्मकासज्वरश्वासक्षयोन्मादनिवारणम् ||२४||
एतदेव हि सम्पक्वं जीवनीयोपसम्भृतम् |
चतुर्गुणेन दुग्धेन महाकल्याणमुच्यते ||२५||
अपस्मारं ग्रहं शोषं क्लैब्यं कार्श्यमबीजताम् |
घृतमेतन्निहन्त्याशु ये चादौ गदिता गदाः ||२६||

Decoction of the beneath talked about substances ought to be ready –

–        vidanga,

–        triphala,

–        musta,

–        manjistha,

–        dadima,

–        utpala,

–        syama,

–        elavaluka,

–        ela,

–        candana,

–        amaradaru,

–        barhistha,

–        rajani,

–        kustha,

–        parnini,

–        two sorts of sariva,

–        harenuka,

–        trivrt,

–        danti,

–        vaca,

–        talisa and

–        malati kusuma

This decoction is added with one a part of ghee and two components of milk (double the amount of ghee), boiled and processed and medicated ghee is ready. This ghee is called Kalyanaka Ghrta.

This medicated ghee cures stomach tumour, cough, fever, dyspnoea, consumption and madness.

When the identical ghee is cooked with the addition of herbs belonging to the Jivaniya Gana group and 4 components of milk, it turns into Mahakalyanaka Ghrta.

Mahakalyanaka Ghrta cures epilepsy, seizure by grahas (demons), consumption, impotence, emaciation, loss or absence of semen and in addition different illnesses named above.

Phala Ghrta

बर्हिष्ठकुष्ठमञ्जिष्ठाकटुकैलानिशाह्वयैः |
तगरत्रिफलाहिङ्गुवाजिगन्धामरद्रुमैः ||२७||
वचाऽजमोदाकाकोलीमेदामधुकपद्मकैः |
सशर्करं हितं सर्पिः पक्वं क्षीरचतुर्गुणम् ||२८||
बालानां ग्रहजुष्टानां पुंसा दुष्टाल्परेतसाम् |
ख्यातं फलघृतं स्त्रीणां वन्ध्यानां चाशु गर्भदम् ||२९||

Decoction of the beneath talked about substances ought to be ready –

–        Barhistha,

–        Kustha,

–        Manjistha,

–        Katuka,

–        Ela,

–        Nisahvaya,

–        Tagara,

–        Triphala,

–        Hingu,

–        Vajigandha,

–        Agara dhuma,

–        Vaca,

–        Ajamoda,

–        Kakoli,

–        Meda,

–        Madhuka and

–        Padmaka

To this decoction, one a part of ghee and 4 components of milk are added, boiled and processed and medicated ghee is ready. This ghee is consumed, combined with sugar.

This medicated ghee is called Phala Ghrta. It’s helpful for youngsters seized by grahas, for males having vitiated or scanty semen. It additionally bestows being pregnant to infertile girls.

ब्राह्मीमैन्द्रीं विडङ्गानि व्योषं हिङ्गु सुरां जटाम् |
विषघ्नीं लशुनं रास्नां विशल्यां सुरसां वचाम् ||३०||
ज्योतिष्मतीं नागरं च अनन्तामभयां तथा |
सौराष्ट्रीं च समांशानि गजमूत्रेण पेषयेत् ||३१||
छायाविशुष्कास्तद्वर्तीर्योजयेद्विधिकोविदः |
अवपीडेऽञ्जनेऽभ्यङ्गे नस्ये धूमे प्रलेपने ||३२||

Beneath talked about substances are taken in equal portions –

–        Brahmi,

–        Aindri,

–        Vidanga,

–        Vyosa,

–        Hingu,

–        Sura (Surahva),

–        Jata,

–        Visaghni (Haridra),

–        Lasuna,

–        Rasna,

–        Visalia,

–        Surasa,

–        Vaca,

–        Jyotismati,

–        Nagara,

–        Ananta (utpala sariva),

–        Anbhaya and

–        Saurastri

They’re macerated within the urine of elephants, made into small wicks (draggees) and dried in shade.

This ought to be used for a lot of functions like – avapida (nasal drops), anointing the physique, nasal medicine, inhalation of smoke and utility as paste on the physique. Solely the physicians who’re effectively versed within the strategies of utilizing them ought to administer them as and when wanted.

उरोपाङ्गललाटेषु सिराश्चास्य विमोक्षयेत् |३३|

Venepuncture ought to be carried out on the beneath talked about websites of the physique –

–        chest,

–        outer angle of the attention and

–        brow

अपस्मारक्रियां चापि ग्रहोद्दिष्टां च कारयेत् ||३३||
शान्तदोषं विशुद्धं च स्नेहबस्तिभिराचरेत् |३४|

In unmada, remedies indicated for apasmara and graha may additionally be carried out.

The affected person ought to be handled with sneha basti (oil enema) after the doshas subside.

उन्मादेषु च सर्वेषु कुर्याच्चित्तप्रसादनम् |
मृदुपूर्वां मदेऽप्येवं क्रियां मृद्वीं प्रयोजयेत ||३४||

All strategies to purify the thoughts (which might make the thoughts calm and free the individuals from unhealthy feelings) ought to be carried out in all types of Unmada. It ought to be preceded by purificatory therapies which ought to be administered in delicate proportions. These therapies ought to be administered mildly even in instances of mada (intoxication).

शोकशल्यं व्यपनयेदुन्मादे पञ्चमे भिषक् |
विषजे मृदुपूर्वां च विषघ्नीं कारयेत् क्रियाम् ||३५||

The doctor ought to take away the reason for grief within the fifth type of unmada (manasika). Anti-poisonous remedies ought to be adopted after administering delicate purificatory therapies in instances of unmada produced by poison.

इति श्री सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते भूतविद्यातन्त्रे उन्मादप्रतिषेधोनाम (तृती-योऽध्यायः, आदितः) द्विषष्टितमोऽध्यायः।।६२।।

Thus ends the sixty-second chapter by title Uñmāda Pratiședha in Uttara Sthana of Suśruta Samhita.