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Line 1,081: − '''Pathogenesis'''+ − '''Stages of intoxication (mada)'''+ − '''Types and [[dosha]] specific features of intoxication (mada)''' + Line 1,113:
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Vidhishonitiya Adhyaya (view source)
Revision as of 11:14, 22 November 2021
, 11:14, 22 November 2021→Intoxication (mada), Syncope (murchha) and Coma (sanyasa)
====Intoxication (mada)====
====Intoxication (mada)====
=====Pathogenesis=====
If an individual continuously indulges in stale foods and unhealthy/unhygienic habits, the [[dosha]] are vitiated at physical and mental level. His mind gets afflicted with [[raja]] and [[tama]]. The vitiated [[dosha]] obstructs channels carrying nutrient fluid ([[rasa]]), blood ([[rakta]]) and consciousness (sanjna). This causes altered state of consciousness resulting in intoxication (mada), syncope (murchcha) and coma (sanyasa). [Cha.Sa.[[Sutra Sthana]] 24/24-29] Weak minded persons are more susceptible if exposed to vitiation of tri[[dosha]] ([[vata]]/[[pitta]]/[[kapha]]) separately or in combination. [Cha.Sa.[[Sutra Sthana]] 24/28]
If an individual continuously indulges in stale foods and unhealthy/unhygienic habits, the [[dosha]] are vitiated at physical and mental level. His mind gets afflicted with [[raja]] and [[tama]]. The vitiated [[dosha]] obstructs channels carrying nutrient fluid ([[rasa]]), blood ([[rakta]]) and consciousness (sanjna). This causes altered state of consciousness resulting in intoxication (mada), syncope (murchcha) and coma (sanyasa). [Cha.Sa.[[Sutra Sthana]] 24/24-29] Weak minded persons are more susceptible if exposed to vitiation of tri[[dosha]] ([[vata]]/[[pitta]]/[[kapha]]) separately or in combination. [Cha.Sa.[[Sutra Sthana]] 24/28]
=====Stages of intoxication (mada)=====
Three stages of intoxication (mada) are mentioned. In initial stage the person will be over enthusiastic. [Su.Sa.Uttara Sthana. 47/11]<ref name=Susruta/> In the second stage person may talk irrelevantly and will be in delusion stage. In the final stage the person lies unconscious. He may loose his ability to perform any physical action. [Su.Sa.Uttara Sthana. 47/12]<ref name=Susruta/>
Three stages of intoxication (mada) are mentioned. In initial stage the person will be over enthusiastic. [Su.Sa.Uttara Sthana. 47/11]<ref name=Susruta/> In the second stage person may talk irrelevantly and will be in delusion stage. In the final stage the person lies unconscious. He may loose his ability to perform any physical action. [Su.Sa.Uttara Sthana. 47/12]<ref name=Susruta/>
=====Types and [[dosha]] specific features of intoxication (mada)=====
{| class="wikitable"
{| class="wikitable"
[Cha.Sa.[[Sutra Sthana]] 24/30-33]
[Cha.Sa.[[Sutra Sthana]] 24/30-33]
=====Prognosis=====
Intoxication (mada) caused by poison is most difficult to treat among all types. [A.Hr. Nidhana Sthana 6/29]<ref name=Hridaya/> The transient episodes of other types of intoxication (mada) and syncope (murchha) subside without any medical treatment. However, treatment is required to prevent recurrent episodes and progression in all these disorders.
Intoxication (mada) caused by poison is most difficult to treat among all types. [A.Hr. Nidhana Sthana 6/29]<ref name=Hridaya/> The transient episodes of other types of intoxication (mada) and syncope (murchha) subside without any medical treatment. However, treatment is required to prevent recurrent episodes and progression in all these disorders.
The obstruction of channel of consciousness by aggravated [[dosha]] lead to sudden aggravation of [[tamas]]. This results in cessation of feeling of happiness. The person falls down just like a log of wood. [Su.Sa.Uttara Sthana. 46/6]<ref name=Susruta/> This is a transient state of unconsciousness. The person awakes after the episode of aggravation of [[dosha]] is over.
The obstruction of channel of consciousness by aggravated [[dosha]] lead to sudden aggravation of [[tamas]]. This results in cessation of feeling of happiness. The person falls down just like a log of wood. [Su.Sa.Uttara Sthana. 46/6]<ref name=Susruta/> This is a transient state of unconsciousness. The person awakes after the episode of aggravation of [[dosha]] is over.
=====Pathogenesis=====
Weak or emaciated person with excessive vitiation of [[dosha]] are susceptible. If these persons indulge in incompatible food, suppression of natural urges, or if afflicted by injuries; then the excessively aggravated [[dosha]] affect sensory organs and mind. This results in sudden loss of consciousness. [Su.Sa.Uttara Sthana.46/4]<ref name=Susruta/> The predominant [[dosha]] in the pathogenesis of murchha is [[pitta]]. [Su.Sa.Uttara Sthana.46/8]<ref name=Susruta/>
Weak or emaciated person with excessive vitiation of [[dosha]] are susceptible. If these persons indulge in incompatible food, suppression of natural urges, or if afflicted by injuries; then the excessively aggravated [[dosha]] affect sensory organs and mind. This results in sudden loss of consciousness. [Su.Sa.Uttara Sthana.46/4]<ref name=Susruta/> The predominant [[dosha]] in the pathogenesis of murchha is [[pitta]]. [Su.Sa.Uttara Sthana.46/8]<ref name=Susruta/>
=====Premonitory symptoms=====
Pain in chest, excessive yawning, exhaustion, loss of strength and consciousness. [Su.Sa.Uttara Sthana.46/5]<ref name=Susruta/>
Pain in chest, excessive yawning, exhaustion, loss of strength and consciousness. [Su.Sa.Uttara Sthana.46/5]<ref name=Susruta/>
=====Types and Features of Syncope (murchha)=====
{| class="wikitable"
{| class="wikitable"
The excessively aggravated [[dosha]] affect speech, body and mind. They are lodged in heart (hridaya) and result in cessation of all body activities with absolute loss of consciousness. This condition is coma (sanyasa). [Cha.Sa.[[Sutra Sthana]] 24/42] This is a prolonged episode of unconsciousness.
The excessively aggravated [[dosha]] affect speech, body and mind. They are lodged in heart (hridaya) and result in cessation of all body activities with absolute loss of consciousness. This condition is coma (sanyasa). [Cha.Sa.[[Sutra Sthana]] 24/42] This is a prolonged episode of unconsciousness.
=====Diagnostic tests=====
A variety of blood tests like complete blood count, blood smear, blood type, Coombs test, blood culture, mixing study, bone marrow biopsy are available to diagnose the quality of blood tissue. Angiography, computed tomography scan, magnetic resonance imaging techniques are useful to diagnose abnormalities in blood vessels and blood circulation. Utilization of these diagnostic tools is helpful in knowing precise nature of pathological events in syncope and coma.
A variety of blood tests like complete blood count, blood smear, blood type, Coomb's test, blood culture, mixing study, bone marrow biopsy are available to diagnose the quality of blood tissue. Angiography, computed tomography scan, magnetic resonance imaging techniques are useful to diagnose abnormalities in blood vessels and blood circulation. Utilization of these diagnostic tools is helpful in knowing precise nature of pathological events in syncope and coma.
=====Prognosis=====
Immediate medical intervention is needed for coma (sanyasa). [A.Hr. Nidhana Sthana 6/36] Medical treatment is required to prevent recurrent episodes of disease and correct vitiation of blood tissues.
Immediate medical intervention is needed for coma (sanyasa). [A.Hr. Nidhana Sthana 6/36] Medical treatment is required to prevent recurrent episodes of disease and correct vitiation of blood tissues.
Metabolic acidosis and alkalosis should be considered to gain an understanding of blood disorders (raktaja vikara). Electrolyte imbalances should be evaluated for the keen diagnosis of mada, murchcha, and sanyasa. [59-60]
Metabolic acidosis and alkalosis should be considered to gain an understanding of blood disorders (raktaja vikara). Electrolyte imbalances should be evaluated for the keen diagnosis of mada, murchcha, and sanyasa. [59-60]
=====Management=====
The first aim of treatments mentioned are under emergency medical care is regaining consciousness. It includes stimulating and irritant therapies. Sensory stimuli by pricking with needle, applying potent collyrium etc. are used to check the level of consciousness. The drugs used are strong and penetrating in nature.
The first aim of treatments mentioned are under emergency medical care is regaining consciousness. It includes stimulating and irritant therapies. Sensory stimuli by pricking with needle, applying potent collyrium etc. are used to check the level of consciousness. The drugs used are strong and penetrating in nature.
After regaining the consciousness, the treatment should be continued to prevent the remission. This includes purificatory procedures like emesis ([[vamana]]), purgation ([[virechana]]), bloodletting ([[raktamoksha]]) etc. After that rejuvenating therapy ([[rasayana]]) is also advised. Medicated ghee processed with herbs is used for this purpose. The lipoidal nature of ghee (cow’s ghee) makes it an effective vehicle for carrying the active principles of processed drugs and it can easily cross the blood brain barrier.<ref>Karandikar YS, Bansude AS, Angadi EA. Comparison between the Effect of Cow Ghee and Butter on Memory and Lipid Profile of Wistar Rats. J Clin Diagn Res. 2016;10(9):FF11-FF15. doi:10.7860/JCDR/2016/19457.8512</ref>
After regaining the consciousness, the treatment should be continued to prevent the remission. This includes purification procedures like emesis ([[vamana]]), purgation ([[virechana]]), bloodletting ([[raktamoksha]]) etc. After that rejuvenating therapy ([[rasayana]]) is also advised. Medicated ghee processed with herbs is used for this purpose. The lipoidal nature of ghee (cow’s ghee) makes it an effective vehicle for carrying the active principles of processed drugs and it can easily cross the blood brain barrier.<ref>Karandikar YS, Bansude AS, Angadi EA. Comparison between the Effect of Cow Ghee and Butter on Memory and Lipid Profile of Wistar Rats. J Clin Diagn Res. 2016;10(9):FF11-FF15. doi:10.7860/JCDR/2016/19457.8512</ref>
==Case reports==
==Case reports==