Changes

''Vatika apasmara'' is characterized by trembling, grinding of teeth, frothing from the mouth, and gasping. The patient gets visual hallucinations of objects which are rough, reddish brown or black in color. [9]

''Vatika apasmara'' is characterized by trembling, grinding of teeth, frothing from the mouth, and gasping. The patient gets visual hallucinations of objects which are rough, reddish brown or black in color. [9]

==== ''Apasmara'' with ''pitta'' dominance ====

==== ''Apasmara'' with ''[[pitta]]'' dominance ====

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''Paittika apasmara'' is characterized by yellowish froth, body, face and eyes. He gets visual hallucinations of yellow or blood-red objects. He has thirst, hot sensation (sensation of heat), and sees fire all over his surroundings. [10]

''Paittika apasmara'' is characterized by yellowish froth, body, face and eyes. He gets visual hallucinations of yellow or blood-red objects. He has thirst, hot sensation (sensation of heat), and sees fire all over his surroundings. [10]

==== ''Apasmara'' with ''kapha'' dominance ====

==== ''Apasmara'' with ''[[kapha]]'' dominance ====

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The ''shlaishmika apasmara'' is characterized by whitish froth (from the mouth), body, face and eyes, (feeling of) cold, heaviness due to stiff body. The patient gets hallucinations of white objects and recovers late. [11]

The ''shlaishmika apasmara'' is characterized by whitish froth (from the mouth), body, face and eyes, (feeling of) cold, heaviness due to stiff body. The patient gets hallucinations of white objects and recovers late. [11]

==== ''Apasmara'' with mixed features of all ''dosha'' dominance and prognosis ====

==== ''Apasmara'' with mixed features of all ''[[dosha]]'' dominance and prognosis ====

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The vitiated ''doshas'' lead to paroxysms of ''apasmara'' once in fifteen days, twelve days or a month. The paroxysm may occur even after a shorter period.[13]

The vitiated ''[[dosha]]s'' lead to paroxysms of ''apasmara'' once in fifteen days, twelve days or a month. The paroxysm may occur even after a shorter period.[13]

=== Management of ''apasmara'' ===

=== Management of ''apasmara'' ===

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The heart, channels and mind which are obstructed by ''doshas'' shall rouse up or cleared first by strong remedial measures like ''vamana'' (emetic therapy) etc. [14]

The heart, channels and mind which are obstructed by ''[[dosha]]s'' shall rouse up or cleared first by strong remedial measures like ''[[vamana]]'' (emetic therapy) etc. [14]

=== Purification based on ''dosha'' dominance ===

=== Purification based on ''dosha'' dominance ===

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''Vatika apasmara'' shall be treated mainly with ''basti'' (medicated enema) therapy; ''Paittika apasmara'' shall mainly be treated with ''virechana'' (purgation) therapy and ''shlaishmika apasmara'' shall mainly be treated with ''vamana'' (emesis) therapy.[15]

''Vatika apasmara'' shall be treated mainly with ''[[basti]]'' (medicated enema) therapy; ''Paittika apasmara'' shall mainly be treated with ''[[virechana]]'' (purgation) therapy and ''shlaishmika apasmara'' shall mainly be treated with ''[[vamana]]'' (emesis) therapy.[15]

=== Assurance and counselling therapy ===

=== Assurance and counselling therapy ===

==== Indications ====  

==== Indications ====  

The medicated ghee shall be taken for treating ''apasmara, kamala'' (jaundice) and ''jwara''.[17]

The medicated ghee shall be taken for treating ''apasmara, kamala'' (jaundice) and ''[[jwara]]''.[17]

=== ''Mahapanchagavya ghee'' ===

=== ''Mahapanchagavya ghee'' ===

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Two ''prasthas'' of ghee should be added with one ''kamsa'' of each of milk and sugarcane juice; sixteen ''prasthas'' of the decoction of ''kasmarya'' and one ''karsa'' of each of the ten drugs belonging to ''jivaniya'' group (vide Sutra 4: 9) and cooked. This medicated ghee instantaneously cures epilepsy caused by ''vayu'' and ''pitta''.[29]

Two ''prasthas'' of ghee should be added with one ''kamsa'' of each of milk and sugarcane juice; sixteen ''prasthas'' of the decoction of ''kasmarya'' and one ''karsa'' of each of the ten drugs belonging to ''jivaniya'' group (vide Sutra 4: 9) and cooked. This medicated ghee instantaneously cures epilepsy caused by ''[[vata]]'' and ''[[pitta]]''.[29]

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#ashes of the hair in the tail of the cow.  [40]

#ashes of the hair in the tail of the cow.  [40]

=== Drugs for ''nasya'' (nasal errhines) ===

=== Drugs for ''[[nasya]]'' (nasal errhines) ===

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Oil (one part) should be cooked with goat’s urine (four parts) and the paste of ''haritaki, bibhitaki, amalaki, shunthi, pippali, maricha, pitadru'' (''devadaru''), ''yavakshara, phaninjhaka, shyama, apamarga'' and fruits of ''karanja''. (One fourth part in total). Inhalation of this medicated oil cures ''apasmara'' (epilepsy).[43-44]

Oil (one part) should be cooked with goat’s urine (four parts) and the paste of ''haritaki, bibhitaki, amalaki, shunthi, pippali, maricha, pitadru'' (''devadaru''), ''yavakshara, phaninjhaka, shyama, apamarga'' and fruits of ''karanja''. (One fourth part in total). Inhalation of this medicated oil cures ''apasmara'' (epilepsy).[43-44]

=== ''Pradhamana nasya'' formulation ===

=== ''Pradhamana [[nasya]]'' formulation ===

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The powder of ''pippali, vrishchikali, kushtha, saindhava, lavana, sauvarchala lavana, samudra lavana, vida lavana, audbhida lavana'' (vide sutra 1:88-89) and ''bhargi'' should be administered in the form of ''pradhamana nasya'' (in which powders of drugs are blown into the nostrils of the patient.) This is an excellent recipe (for curing epilepsy).[45]

The powder of ''pippali, vrishchikali, kushtha, saindhava, lavana, sauvarchala lavana, samudra lavana, vida lavana, audbhida lavana'' (vide sutra 1:88-89) and ''bhargi'' should be administered in the form of ''pradhamana [[nasya]]'' (in which powders of drugs are blown into the nostrils of the patient.) This is an excellent recipe (for curing epilepsy).[45]

=== Medicated wicks ===

=== Medicated wicks ===

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In some patients of epilepsy, exogenous factors are secondarily involved and in such cases signs and symptoms are manifested over and above those of the ''doshas'' (endogenous factors). Such patients should be treated on the lines suggested for exogenous types of ''unmada'' (insanity) (refer to Chapter 9 of this section, i.e., [[Unmada Chikitsa]]).[53].

In some patients of epilepsy, exogenous factors are secondarily involved and in such cases signs and symptoms are manifested over and above those of the ''[[dosha]]s'' (endogenous factors). Such patients should be treated on the lines suggested for exogenous types of ''unmada'' (insanity) (refer to Chapter 9 of this section, i.e., [[Unmada Chikitsa]]).[53].

=== ''Mahagada chikitsa'' (management of ''atattvabhinivesha'') ===

=== ''Mahagada chikitsa'' (management of ''atattvabhinivesha'') ===

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If a person is indulged in habitual intake of impure food, due to suppression of manifested natural urges, excessive intake of cold, hot, unctuous, un-unctuous food (incompatible food with contradictory properties) etc, the (vitiated) ''doshas'' afflict channels of mind and intellect and abide into heart. The ''rajas'' (one of the attributes of the mind) and ''moha'' or ''tamas'' (another attribute of mind), occlude the person’s self. Excessively aggravated ''rajas'' and ''tamas'' cover mind and intellect, disturbing the functions of heart, making the person stupid and mentally weak. This leads to improper judgment regarding eternal and ephemeral events and wholesome and unwholesome objects. The expert physicians call this ''mahagada'' (grave disease) as ''atattvabhinivesha''. [57- 60]

If a person is indulged in habitual intake of impure food, due to suppression of manifested natural urges, excessive intake of cold, hot, unctuous, un-unctuous food (incompatible food with contradictory properties) etc, the (vitiated) ''[[dosha]]s'' afflict channels of mind and intellect and abide into heart. The ''[[rajas]]'' (one of the attributes of the mind) and ''moha'' or ''[[tamas]]'' (another attribute of mind), occlude the person’s self. Excessively aggravated ''[[rajas]]'' and ''[[tamas]]'' cover mind and intellect, disturbing the functions of heart, making the person stupid and mentally weak. This leads to improper judgment regarding eternal and ephemeral events and wholesome and unwholesome objects. The expert physicians call this ''mahagada'' (grave disease) as ''atattvabhinivesha''. [57- 60]

=== Management of ''atattvabhinivesha'' ===

=== Management of ''atattvabhinivesha'' ===

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This (disease) shall be treated with oleation and fomentation therapies followed by purification therapies like therapeutic emesis etc. Then after doing ''samsarjana krama'' (observing specific dietary regimen after purification), diet and drinks which are promoters of intellect should be administered. Juice of ''brahmi'' mixed with ''panchagavya ghrita'' described above (refer to verses 16-17) should be administered. Similarly, other ''medhya rasayanas'' (promoters of intellect) like ''shankhapushpi'' should be given.  [61- 62]

This (disease) shall be treated with oleation and fomentation therapies followed by purification therapies like therapeutic emesis etc. Then after doing ''samsarjana krama'' (observing specific dietary regimen after purification), diet and drinks which are promoters of intellect should be administered. Juice of ''brahmi'' mixed with ''panchagavya ghrita'' described above (refer to verses 16-17) should be administered. Similarly, other ''medhya [[rasayana]]s'' (promoters of intellect) like ''shankhapushpi'' should be given.  [61- 62]

Friends, sympathizers, preceptors preaching religious sermons, philosophers should inculcate into him knowledge, understanding, patience, memory and the power of meditation. [63]

Friends, sympathizers, preceptors preaching religious sermons, philosophers should inculcate into him knowledge, understanding, patience, memory and the power of meditation. [63]

#Etiological factors of epilepsy;  

#Etiological factors of epilepsy;  

#the mode of vitiation of ''doshas'';  

#the mode of vitiation of ''[[dosha]]s'';  

#signs and symptoms in general and of different varieties of epilepsy;   

#signs and symptoms in general and of different varieties of epilepsy;   

#treatment of different types of epilepsy; and  

#treatment of different types of epilepsy; and  

#Improper and impure diet is considered to affect mental functions adversely leading to formation of background for disease. The dietary causative factors may act on gut-brain axis to affect the neuro-pathology in case of psychiatric diseases like ''apasmara''.

#Improper and impure diet is considered to affect mental functions adversely leading to formation of background for disease. The dietary causative factors may act on gut-brain axis to affect the neuro-pathology in case of psychiatric diseases like ''apasmara''.

#When this afflicted person is confronted with distressful adverse situation including negative emotions like worries, passion, fright, anger, grief, anxieties, he suffers from ''apasmara''.  

#When this afflicted person is confronted with distressful adverse situation including negative emotions like worries, passion, fright, anger, grief, anxieties, he suffers from ''apasmara''.  

#The pathophysiology clearly indicates role of somatic imbalances and psychic disturbances as sequential events. The inter-communication between physical entities and psychological entities is very important for continuation of health. Consciousness flows through this co-ordination to make a person alive. Therefore, when this co-ordination is disturbed, it presents as disturbance of psychological faculties. The pathology of ''apasmara'' starts with vitiated ''dosha'' and ends into bewildered state of mind.

#The pathophysiology clearly indicates role of somatic imbalances and psychic disturbances as sequential events. The inter-communication between physical entities and psychological entities is very important for continuation of health. Consciousness flows through this co-ordination to make a person alive. Therefore, when this co-ordination is disturbed, it presents as disturbance of psychological faculties. The pathology of ''apasmara'' starts with vitiated ''[[dosha]]'' and ends into bewildered state of mind.

#Heart (center of consciousness and emotional intelligence) and brain (center of memory and logical intelligence) together form ''manovaha srotas'' (functional system of mind). The co-ordination of these two centers is important for normal functioning of mind. If this is afflicted, it leads to psychiatric diseases.   

#Heart (center of consciousness and emotional intelligence) and brain (center of memory and logical intelligence) together form ''manovaha srotas'' (functional system of mind). The co-ordination of these two centers is important for normal functioning of mind. If this is afflicted, it leads to psychiatric diseases.   

#Removal of obstruction of ''dosha'' in the heart-brain connection, channels and mind by strong purification therapies is management principle of ''apasmara''.

#Removal of obstruction of ''[[dosha]]'' in the heart-brain connection, channels and mind by strong purification therapies is management principle of ''apasmara''.

#''Basti'' (therapeutic enema) in ''vata'' dominant ''apasmara, virechana'' (therapeutic purgation) in ''pitta'' dominant ''apasmara'' and ''vamana'' (therapeutic emesis) in ''kapha'' dominant ''apasmara'' are specific therapies.  

#''[[Basti]]'' (therapeutic enema) in ''[[vata]]'' dominant ''apasmara, [[virechana]]'' (therapeutic purgation) in ''[[pitta]]'' dominant ''apasmara'' and ''[[vamana]]'' (therapeutic emesis) in ''[[kapha]]'' dominant ''apasmara'' are specific therapies.  

#''Ashwasana'' (assurance therapy) and psychological counseling are advised to remove psychological stressors that provoke ''apasmara vega''(episode).

#''Ashwasana'' (assurance therapy) and psychological counseling are advised to remove psychological stressors that provoke ''apasmara vega''(episode).

The first principle of [[Ayurveda]] states that life is continuum of healthy coordination between body, mind, soul and sensory-motor organs. [[Ayurveda]] considers the mind and body work in symbiotic relationship with each other. When one is affected, other is also affected. Both are emphasized as abode for sensation of pain. The mind and body can’t be separated in water tight compartment.  

The first principle of [[Ayurveda]] states that life is continuum of healthy coordination between body, mind, soul and sensory-motor organs. [[Ayurveda]] considers the mind and body work in symbiotic relationship with each other. When one is affected, other is also affected. Both are emphasized as abode for sensation of pain. The mind and body can’t be separated in water tight compartment.  

=== Relation between diet, ''dosha'' specificity and ''apasmara'' ===

=== Relation between diet, ''[[dosha]]'' specificity and ''apasmara'' ===

Role of pure diet is important, because it nourishes mind, enriches senses and motor organs. The ''Panchakosha'' theory of Yoga states that the sheath of mind (''manomaya kosha'') is nourished through sheath of food (''annamaya kosha'') only. Therefore, following proper, pure diet and dietary habits is necessary for preventing psychiatric disorders.  

Role of pure diet is important, because it nourishes mind, enriches senses and motor organs. The ''Panchakosha'' theory of Yoga states that the sheath of mind (''manomaya kosha'') is nourished through sheath of food (''annamaya kosha'') only. Therefore, following proper, pure diet and dietary habits is necessary for preventing psychiatric disorders.  

   

   

The physical ''doshas'' like ''vata, pitta'' and ''kapha'' are assigned certain psychological functions also. Their rise and accumulation takes place at different stage after taking food. Therefore, the type of disease depending upon type of dominant ''dosha,'' evoked due to dominant diet specific to a particular ''dosha''. ''Apasmara'' is also caused due to vitiation of ''dosha'' owing to improper diet. This clarifies link between diet, ''dosha,'' mental functions, memory and consciousness.

The physical ''[[dosha]]s'' like ''[[vata]], [[pitta]]'' and ''[[kapha]]'' are assigned certain psychological functions also. Their rise and accumulation takes place at different stage after taking food. Therefore, the type of disease depending upon type of dominant ''[[dosha]],'' evoked due to dominant diet specific to a particular ''[[dosha]]''. ''Apasmara'' is also caused due to vitiation of ''[[dosha]]'' owing to improper diet. This clarifies link between diet, ''[[dosha]],'' mental functions, memory and consciousness.

=== Memory and consciousness ===

=== Memory and consciousness ===

The profound relation between memory and consciousness is clearly indicated in ''apasmara''. In [[Ayurveda]], memory is termed as fundamental knowledge based upon experiences acquired through sense and motor organs. In psychology, memory is the mental capacity with which information is encoded, stored, and retrieved. Consciousness is the state of awareness of internal events and external environment.<ref>Available from glossary of psychological terms retrived from http://www.apa.org/research/action/glossary.aspx?tab=3 on August 22, 2017</ref> In ''apasmara'', consciousness is affected leading to transient loss of memory.  

The profound relation between memory and consciousness is clearly indicated in ''apasmara''. In [[Ayurveda]], memory is termed as fundamental knowledge based upon experiences acquired through sense and motor organs. In psychology, memory is the mental capacity with which information is encoded, stored, and retrieved. Consciousness is the state of awareness of internal events and external environment.<ref>Available from glossary of psychological terms retrived from http://www.apa.org/research/action/glossary.aspx?tab=3 on August 22, 2017</ref> In ''apasmara'', consciousness is affected leading to transient loss of memory.  

The forbearance of mind is based upon intellect (''dhi'') and pure quality of mind (''sattva''). ''Dhi'' discriminates between right and wrong things. ''Sattva'' is pure quality that might be named as “mental immunity” which protects mind in all adverse conditions. In ''apasmara'', both the intellect and pure quality of mind are afflicted leading to poor forbearance.

The forbearance of mind is based upon intellect (''dhi'') and pure quality of mind (''sattva''). ''Dhi'' discriminates between right and wrong things. ''[[Sattva]]'' is pure quality that might be named as “mental immunity” which protects mind in all adverse conditions. In ''apasmara'', both the intellect and pure quality of mind are afflicted leading to poor forbearance.

=== Brain and heart connection Neurocardiology ===  

=== Brain and heart connection Neurocardiology ===  

Heart (cardiac region) has been considered as site of consciousness and emotions. The heart in context of ''apasmara'' is essentially meant by the abode of consciousness and it doesn’t signify anatomical heart. This is functional heart which is involved in emotions, feelings of the self. Brain (head region) is considered as origin of all sensory and motor organs. The term ''dhamani'' has been used to denote abode of aggravated ''doshas''. This literally means the artery, vein, nerves which carry impulses. This is very important as it channelizes consciousness from site of consciousness i.e. heart to site of intelligence i.e. brain. This canal of heart-brain connection is ''manovaha srotas''. The brain and heart work in co-ordination with each other for maintaining equilibrium between logical intelligence and emotional intelligence. If these are hampered, the consciousness, memory, sensory and motor co-ordination as well as emotional behavior will be affected. This establishes the theory that disturbance in cardiac functions can result into neurological disorders. The heart-brain connection has been authenticated by many researches on neuro-cardiology.<ref>Martin A. Samuels, Contemporary Reviews in Cardiovascular Medicine,The Brain–Heart Connection. Circulation.2007; 116: 77-84 doi: 10.1161/CIRCULATIONAHA.106.678995 </ref>  

Heart (cardiac region) has been considered as site of consciousness and emotions. The heart in context of ''apasmara'' is essentially meant by the abode of consciousness and it doesn’t signify anatomical heart. This is functional heart which is involved in emotions, feelings of the self. Brain (head region) is considered as origin of all sensory and motor organs. The term ''dhamani'' has been used to denote abode of aggravated ''[[dosha]]s''. This literally means the artery, vein, nerves which carry impulses. This is very important as it channelizes consciousness from site of consciousness i.e. heart to site of intelligence i.e. brain. This canal of heart-brain connection is ''manovaha srotas''. The brain and heart work in co-ordination with each other for maintaining equilibrium between logical intelligence and emotional intelligence. If these are hampered, the consciousness, memory, sensory and motor co-ordination as well as emotional behavior will be affected. This establishes the theory that disturbance in cardiac functions can result into neurological disorders. The heart-brain connection has been authenticated by many researches on neuro-cardiology.<ref>Martin A. Samuels, Contemporary Reviews in Cardiovascular Medicine,The Brain–Heart Connection. Circulation.2007; 116: 77-84 doi: 10.1161/CIRCULATIONAHA.106.678995 </ref>  

The theory of heart-brain connection has been well known to [[Ayurveda]] scholars in context of ''apasmara''.

The theory of heart-brain connection has been well known to [[Ayurveda]] scholars in context of ''apasmara''.

=== Signs and symptoms of ''apasmara'' ===

=== Signs and symptoms of ''apasmara'' ===

Transient nervous system collapse of a person which leads to various signs and symptoms enlisted in the verses 7 to 13. The cluster describes features of paroxysmal stage of ''apasmara''. The features include somatic as well as psychological subjective symptoms experienced by patients self. The dreams specific to predominance of ''dosha'' can be important measures for diagnosis of predominance of ''dosha''. The symptomatology has been described elaborately in context of [[Apasmara Nidana]].

Transient nervous system collapse of a person which leads to various signs and symptoms enlisted in the verses 7 to 13. The cluster describes features of paroxysmal stage of ''apasmara''. The features include somatic as well as psychological subjective symptoms experienced by patients self. The dreams specific to predominance of ''[[dosha]]'' can be important measures for diagnosis of predominance of ''[[dosha]]''. The symptomatology has been described elaborately in context of [[Apasmara Nidana]].

=== Gut-brain connection in ''apasmara'' ===

=== Gut-brain connection in ''apasmara'' ===

''Dandaka'' is denoted in the same context as ''stambha'' (stiffness) manifested in ''pani'' (hands), ''pada'' (legs), ''shira'' (head), ''prishtha'' (back) and ''shroni'' (pelvis) making body stiff like wooden log. (verse52)

''Dandaka'' is denoted in the same context as ''stambha'' (stiffness) manifested in ''pani'' (hands), ''pada'' (legs), ''shira'' (head), ''prishtha'' (back) and ''shroni'' (pelvis) making body stiff like wooden log. (verse52)

''Ardita'' caused when ''vayu'' does ''upashoshana'' (dries up) of ''bahu'' (arm), ''pada'' (leg) and ''janu'' (knees), is characterized by ''vakrata'' (curved) of ''mukhardha bhaga'' (half face) and also ''shareerardha'' (torso). The attacks of ''ardita'' do not include convulsions as presenting feature. (Verses 38 to 42)

''Ardita'' caused when ''[[vayu]]'' does ''upashoshana'' (dries up) of ''bahu'' (arm), ''pada'' (leg) and ''janu'' (knees), is characterized by ''vakrata'' (curved) of ''mukhardha bhaga'' (half face) and also ''shareerardha'' (torso). The attacks of ''ardita'' do not include convulsions as presenting feature. (Verses 38 to 42)

''Apatanaka'' is also a disease caused by vitiated ''vata'' either independently or due to ''avarana'' (obstruction) caused by ''kapha'' characteristically manifests with frequent unconsciousness, ''antarayama'' (forward bending of the body) and ''bahirayama'' (backward bending of the body). Because of this bending the disease is otherwise known as ''dhanustambha''. (Verses 43 to 48)  

''Apatanaka'' is also a disease caused by vitiated ''[[vata]]'' either independently or due to ''avarana'' (obstruction) caused by ''[[kapha]]'' characteristically manifests with frequent unconsciousness, ''antarayama'' (forward bending of the body) and ''bahirayama'' (backward bending of the body). Because of this bending the disease is otherwise known as ''dhanustambha''. (Verses 43 to 48)  

''Vepathu'' or ''kampa vata'' are characterized by ''kampa'' (tremor) of either single part/multiple parts/entire body.

''Vepathu'' or ''kampa vata'' are characterized by ''kampa'' (tremor) of either single part/multiple parts/entire body.

In any of the above explained conditions either the involvement of ''hridaya'' (heart) or ''manas''(mind) are not specified. Hence they implicate more of neurological pathology rather than psychological disorder.  

In any of the above explained conditions either the involvement of ''hridaya'' (heart) or ''[[manas]]''(mind) are not specified. Hence they implicate more of neurological pathology rather than psychological disorder.  

''Apatantraka'' , explained in [[Trimarmiya Siddhi]](verses 12 to 15), is very similar to the description of apasmara here in its clinical presentation. ''Avarana'' of ''hridaya'' by ''doshas'' lead to paroxysm of the ''vyadhi'' with pain in ''shira, shankha'' body bending like a bow, ''akshepa'' (convulsions), dyspnea, hoarse expiratory cry like that of a pigeon, unconsciousness, etc. Once the ''avarana'' to ''hridaya'' by the ''doshas'' is clear the person looks healthy.  

''Apatantraka'' , explained in [[Trimarmiya Siddhi]](verses 12 to 15), is very similar to the description of apasmara here in its clinical presentation. ''Avarana'' of ''hridaya'' by ''[[dosha]]s'' lead to paroxysm of the ''vyadhi'' with pain in ''shira, shankha'' body bending like a bow, ''akshepa'' (convulsions), dyspnea, hoarse expiratory cry like that of a pigeon, unconsciousness, etc. Once the ''avarana'' to ''hridaya'' by the ''[[dosha]]s'' is clear the person looks healthy.  

''Apatantraka'' is a ''hridaya marmashrita vyadhi'' which indicates variation in emotional intelligence of the person.The theory of neuro-cardiology differentiates ''apatantraka'' from ''apasmara'' the latter being a disorder of logical intelligence (''smriti budhi sattva samplavat''- ch. Ni. 8/5)

''Apatantraka'' is a ''hridaya marmashrita vyadhi'' which indicates variation in emotional intelligence of the person. The theory of neuro-cardiology differentiates ''apatantraka'' from ''apasmara'' the latter being a disorder of logical intelligence (''smriti budhi sattva samplavat''- ch. Ni. 8/5)

''Apasmara'' is emphasized as ''manasa vikara'' due to loss of ''smriti'' (power of recollection), ''buddhi vyapoha'' (declining of logical and analytical understanding). The person becomes ''moodha'' (stupid). This holds appropriate to say “the loss of logical intelligence in the person”.

''Apasmara'' is emphasized as ''[[manas]]a vikara'' due to loss of ''[[smriti]]'' (power of recollection), ''[[buddhi]] vyapoha'' (declining of logical and analytical understanding). The person becomes ''moodha'' (stupid). This holds appropriate to say “the loss of logical intelligence in the person”.

==== Management of ''apasmara'' ====

==== Management of ''apasmara'' ====

''Apasmara'' is to be treated with strong elimination therapies like [[Panchakarma]].  The strength here directs towards deeper level of penetrability of the therapies to remove the toxins from micro-channels.

''Apasmara'' is to be treated with strong elimination therapies like [[Panchakarma]].  The strength here directs towards deeper level of penetrability of the therapies to remove the toxins from micro-channels.

Important pathological milestone is occlusion of consciousness. Therefore to remove obstruction at heart (site of consciousness), channels of heart-brain connection, and mind is the treatment objective. ''Vata'' dominant ''apasmara'' is to be treated with medicated enema, ''pitta'' dominant with purgation therapies and ''kapha'' dominant with therapeutic emesis.  

Important pathological milestone is occlusion of consciousness. Therefore to remove obstruction at heart (site of consciousness), channels of heart-brain connection, and mind is the treatment objective. ''[[Vata]]'' dominant ''apasmara'' is to be treated with medicated enema, ''[[pitta]]'' dominant with purgation therapies and ''[[kapha]]'' dominant with therapeutic emesis.  

Role of these purification treatments like ''vamana'', etc. in normalizing functioning of heart (consciousness mechanism and emotional intelligence), heart-brain connection, and mental functions is important to be studied. This may prove a major breakthrough in prevention and management of psychiatric disorders. The changes in memory/awareness level, mind functioning, emotional quotient, improvement in forbearance power are bio-markers for the assessment.  

Role of these purification treatments like ''[[vamana]]'', etc. in normalizing functioning of heart (consciousness mechanism and emotional intelligence), heart-brain connection, and mental functions is important to be studied. This may prove a major breakthrough in prevention and management of psychiatric disorders. The changes in memory/awareness level, mind functioning, emotional quotient, improvement in forbearance power are bio-markers for the assessment.  

==== II. Assurance and consolation therapies ====

==== II. Assurance and consolation therapies ====

The episodes of ''apasmara'' occur on exposure of distressful events or psychological trauma due to negative emotions like worries, passion, fright, anger, grief, anxieties etc. This indicates poor emotional quotient.  Affliction of mental ''dosha'' like ''rajas'' and ''tamas'' also need to be corrected basically. Therefore it is important to improve the emotional intelligence through positive training and programming of mind and brain to cope with the adverse situation. If the mental immunity is good, then ''apasmara'' episode will not occur, even if, the bodily ''doshas'' are aggravated. Cognitive Behaviour Therapy (CBT), REBT (Rational Emotive Behaviour Therapy) can be useful supportive treatments for management of ''apasmara'' to reduce frequency of episodes as well as effective management of disorder.   

The episodes of ''apasmara'' occur on exposure of distressful events or psychological trauma due to negative emotions like worries, passion, fright, anger, grief, anxieties etc. This indicates poor emotional quotient.  Affliction of mental ''[[dosha]]'' like ''[[[rajas]]'' and ''[[tamas]]'' also need to be corrected basically. Therefore it is important to improve the emotional intelligence through positive training and programming of mind and brain to cope with the adverse situation. If the mental immunity is good, then ''apasmara'' episode will not occur, even if, the bodily ''[[doshas]]'' are aggravated. Cognitive Behaviour Therapy (CBT), REBT (Rational Emotive Behaviour Therapy) can be useful supportive treatments for management of ''apasmara'' to reduce frequency of episodes as well as effective management of disorder.   

==== III. Pacification (''shamana'') therapy ====

==== III. Pacification (''shamana'') therapy ====

After purification and consolation therapies are done, various formulations useful in treatment of ''apasmara'' have been enlisted. If we see the general medicines prescribed by Charak, all of the formulations are either ghee based or oil based formulations. Ghee is considered as best vehicle for management of ''vata-pitta'' dominant disorders. Oil is the best for ''vata-kapha'' dominant disorders. Ghee has been proved to be effective in treatment of many neurological disorders owing to its capacity of maintaining cellular integrity.  

After purification and consolation therapies are done, various formulations useful in treatment of ''apasmara'' have been enlisted. If we see the general medicines prescribed by Charak, all of the formulations are either ghee based or oil based formulations. Ghee is considered as best vehicle for management of ''[[vata]]-[[pitta]]'' dominant disorders. Oil is the best for ''[[vata]]-[[kapha]]'' dominant disorders. Ghee has been proved to be effective in treatment of many neurological disorders owing to its capacity of maintaining cellular integrity.  

The animal products like ghee, urine, bile are used in most of the formulations. Cow’s ghee and goat’s urine is widely used as processing media for formulations. The route of administration is ''nasya'' (nasal drug delivery), ''anjana'' (for intra-ocular drug delivery through conjunctivae), and ''dhupana'' (fumigation). The properties of drugs used are mainly pungent to ensure higher penetrability in lower dosages. The possibility of crossing blood brain barrier with these routes might be higher for the herbs used in ''apasmara'' treatment.  

The animal products like ghee, urine, bile are used in most of the formulations. Cow’s ghee and goat’s urine is widely used as processing media for formulations. The route of administration is ''[[nasya]]'' (nasal drug delivery), ''anjana'' (for intra-ocular drug delivery through conjunctivae), and ''dhupana'' (fumigation). The properties of drugs used are mainly pungent to ensure higher penetrability in lower dosages. The possibility of crossing blood brain barrier with these routes might be higher for the herbs used in ''apasmara'' treatment.  

The formulations used in treatment are enlisted below:

The formulations used in treatment are enlisted below:

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'''''Vata shlaishma apasmarahara vacha – shampakadi ghrita'''''

'''''[[Vata]] shlaishma apasmarahara vacha – shampakadi ghrita'''''

{| class="wikitable"

{| class="wikitable"

|-

|-

| Milk

| Milk

| rowspan = "2"| 1 "kamsa" in total

| rowspan = "2"| 1 "kamsa" in total

| rowspan = "3"| Instantaneously cures epilepsy caused by ''vayu'' and ''pitta''

| rowspan = "3"| Instantaneously cures epilepsy caused by ''[[vata]]'' and ''[[pitta]]''

|-

|-

| 2

| 2

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'''Different formulations for ''nasya'' (nasal drug delivery) (verse 41)'''

'''Different formulations for ''[[nasya]]'' (nasal drug delivery) (verse 41)'''

{| class="wikitable"

{| class="wikitable"

|-

|-

| Urine of cow having reddish brown (''Kapila'') color  

| Urine of cow having reddish brown (''Kapila'') color  

| QS

| QS

| ''Nasya'' (nasal delivery)- Exceedingly useful for the cure of epilepsy

| ''[[Nasya]]'' (nasal delivery)- Exceedingly useful for the cure of epilepsy

|-

|-

| 2

| 2

| Urine of dog

| Urine of dog

|  

|  

| ''Nasya'' (nasal delivery)

| ''[[Nasya]]'' (nasal delivery)

|-

|-

| 3

| 3

| Urine of Jackal

| Urine of Jackal

|  

|  

| ''Nasya'' (nasal delivery)

| ''[[Nasya]]'' (nasal delivery)

|-

|-

| 4

| 4

| Urine of Cat

| Urine of Cat

|  

|  

| ''Nasya'' (nasal delivery)

| ''[[Nasya]]'' (nasal delivery)

|-

|-

| 5

| 5

| Urine of Lion

| Urine of Lion

|  

|  

| ''Nasya'' (nasal delivery)

| ''[[Nasya]]'' (nasal delivery)

|}

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'''''Nasya'' formulations (verse 42-43)'''

'''''[[Nasya]]'' formulations (verse 42-43)'''

{| class="wikitable"

{| class="wikitable"

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|-

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'''''Nasya'' formulations (verse 43-44)'''

'''''[[Nasya]]'' formulations (verse 43-44)'''

{| class="wikitable"

{| class="wikitable"

|-

|-

| Oil

| Oil

| 1 part

| 1 part

| ''Nasya''

| ''[[Nasya]]''

|-

|-

| 2

| 2

'''''Pradhamana nasya'' formulations (verse 45)'''

'''''Pradhamana [[nasya]]'' formulations (verse 45)'''

{| class="wikitable"

{| class="wikitable"

| Powder of ''Pippali, Vrishchikali, Kushtha, Saindhava Lavana, Sauvarchala lavana, Samudra lavana, Vida lavana, Audbhida lavana'' (vide sutra 1:88-89)  and ''Bhargi''  

| Powder of ''Pippali, Vrishchikali, Kushtha, Saindhava Lavana, Sauvarchala lavana, Samudra lavana, Vida lavana, Audbhida lavana'' (vide sutra 1:88-89)  and ''Bhargi''  

|  

|  

| In the form of ''pradhamana nasya'' (in which powders of drugs are blown into the nostrils of the patient)

| In the form of ''pradhamana [[nasya]]'' (in which powders of drugs are blown into the nostrils of the patient)

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