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| This chapter emphasizes on quantity of liquor and type of liquor which is suitable for the prakriti (body type) of the individual. The properties of liquor vary with respect to the type of manufacturing process. At lower doses it acts as stimulant, causing euphoria and talkativeness; while with high doses it leads to drowsiness and ultimately unconsciousness. Upon consumption it gets absorbed rapidly by stomach and small intestine 20% and 80% respectively; to feel the effect within 5 to 10 minutes and peak effect by 90 minutes. The feeling of effect usually depends upon the quantity and the food taken before, during, and / or after consumption of the liquor. Presently, the effect is correlated to the Blood Alcohol Levels (BAC) of an individual. The BAC depends upon various factors which are: capacity of liver to metabolize the liquor, food interaction, concentration of the alcoholic beverage, duration of consumption, body type of the consumer-lean or obese, age, gender, ethnicity, and frequency of consumption. All these factors have been discussed methodically and at length in this chapter. | | This chapter emphasizes on quantity of liquor and type of liquor which is suitable for the prakriti (body type) of the individual. The properties of liquor vary with respect to the type of manufacturing process. At lower doses it acts as stimulant, causing euphoria and talkativeness; while with high doses it leads to drowsiness and ultimately unconsciousness. Upon consumption it gets absorbed rapidly by stomach and small intestine 20% and 80% respectively; to feel the effect within 5 to 10 minutes and peak effect by 90 minutes. The feeling of effect usually depends upon the quantity and the food taken before, during, and / or after consumption of the liquor. Presently, the effect is correlated to the Blood Alcohol Levels (BAC) of an individual. The BAC depends upon various factors which are: capacity of liver to metabolize the liquor, food interaction, concentration of the alcoholic beverage, duration of consumption, body type of the consumer-lean or obese, age, gender, ethnicity, and frequency of consumption. All these factors have been discussed methodically and at length in this chapter. |
| The health effects of liquor consumption are observed in two ways as they appear; short term effects or immediate effects and long term effects or late effects. The ojas (the vigor), reflects the short term as well as long term effects, if liquor is consumed beyond the prescribed limit. The ojas is quite dynamic phenomenon of human body, which is said to have similar properties like milk; which indicates the productive benefits to the body. The alcoholic beverages posess exact opposite properties to the ojas, and excess drinking can also cause suppression of ojas leading to intoxication and death with complete obliteration of ojas. The purpose of describing and discussing ojas here indicates the importance to conserve the ojas in the treatment of madatyaya (alcoholism). Most of the formulations prescribed here directly or indirectly lead to enhancement of ojas to achieve conscious state. | | The health effects of liquor consumption are observed in two ways as they appear; short term effects or immediate effects and long term effects or late effects. The ojas (the vigor), reflects the short term as well as long term effects, if liquor is consumed beyond the prescribed limit. The ojas is quite dynamic phenomenon of human body, which is said to have similar properties like milk; which indicates the productive benefits to the body. The alcoholic beverages posess exact opposite properties to the ojas, and excess drinking can also cause suppression of ojas leading to intoxication and death with complete obliteration of ojas. The purpose of describing and discussing ojas here indicates the importance to conserve the ojas in the treatment of madatyaya (alcoholism). Most of the formulations prescribed here directly or indirectly lead to enhancement of ojas to achieve conscious state. |
| The chapter:
| | |
| | === Sanskrit Text, Transliteration and English Translation === |
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| अथातो मदात्ययचिकित्सितं व्याख्यास्यामः ||१|| | | अथातो मदात्ययचिकित्सितं व्याख्यास्यामः ||१|| |
| इति ह स्माह भगवानात्रेयः ||२|| | | इति ह स्माह भगवानात्रेयः ||२|| |
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| pradāya sajalaṁ madyamarthibhyō vasudhātalē||20|| | | pradāya sajalaṁ madyamarthibhyō vasudhātalē||20|| |
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| sharIrakRutasaMskAraH shuciruttamagandhavAn |
| | sharIrakRutasaMskAraH shuciruttamagandhavAn | |
| prAvRuto nirmalairvastrairyathartUddAmagandhibhiH ||11|| | | prAvRuto nirmalairvastrairyathartUddAmagandhibhiH ||11|| |
| vicitravividhasragvI ratnAbharaNabhUShitaH | | | vicitravividhasragvI ratnAbharaNabhUShitaH | |
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| kaphapittādhikēbhyastu mārdvīkaṁ mādhavaṁ ca yat||25|| | | kaphapittādhikēbhyastu mārdvīkaṁ mādhavaṁ ca yat||25|| |
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| abhya~ggotsAdanasnAnavAsodhUpAnulepanaiH |
| | abhya~ggotsAdanasnAnavAsodhUpAnulepanaiH | |
| snigdhoShNairbhAvitashcAnnairvAtiko madyamAcaret ||21|| | | snigdhoShNairbhAvitashcAnnairvAtiko madyamAcaret ||21|| |
| shItopacArairvividhairmadhurasnigdhashItalaiH | | | shItopacArairvividhairmadhurasnigdhashItalaiH | |
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| atipītēna madyēna vihatēnaujasā ca tat| | | atipītēna madyēna vihatēnaujasā ca tat| |
| hr̥dayaṁ yāti vikr̥tiṁ tatrasthā yē ca dhātavaḥ||36|| | | hr̥dayaṁ yāti vikr̥tiṁ tatrasthā yē ca dhātavaḥ||36|| |
| madyaM hRudayamAvishya svaguNairojaso guNAn |
| | madyaM hRudayamAvishya svaguNairojaso guNAn | |
| dashabhirdasha sa~gkShobhya ceto nayati vikriyAm ||29|| | | dashabhirdasha sa~gkShobhya ceto nayati vikriyAm ||29|| |
| laghUShNatIkShNasUkShmAmlavyavAyyAshugameva ca | | | laghUShNatIkShNasUkShmAmlavyavAyyAshugameva ca | |
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| jāyantē mōhanidrāntā madyasyātiniṣēvaṇāt| | | jāyantē mōhanidrāntā madyasyātiniṣēvaṇāt| |
| sa madyavibhramō nāmnā ‘mada’ ityabhidhīyatē||40|| | | sa madyavibhramō nāmnā ‘mada’ ityabhidhīyatē||40|| |
| hRudi madyaguNAviShTe harShastarSho ratiH sukham |
| | hRudi madyaguNAviShTe harShastarSho ratiH sukham | |
| vikArAshca yathAsattvaM citrA rAjasatAmasAH ||39|| | | vikArAshca yathAsattvaM citrA rAjasatAmasAH ||39|| |
| jAyante mohanidrAntA madyasyAtiniShevaNAt | | | jAyante mohanidrAntA madyasyAtiniShevaNAt | |
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| vyasanitvādudarkē ca sa duḥkhaṁ vyādhimaśnutē||51|| | | vyasanitvādudarkē ca sa duḥkhaṁ vyādhimaśnutē||51|| |
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| pIyamAnasya madyasya vij~jAtavyAstrayo madAH |
| | pIyamAnasya madyasya vij~jAtavyAstrayo madAH | |
| prathamo madhyamo~antyashca lakShaNaistAn pracakShmahe ||41|| | | prathamo madhyamo~antyashca lakShaNaistAn pracakShmahe ||41|| |
| praharShaNaH prItikaraH pAnAnnaguNadarshakaH | | | praharShaNaH prItikaraH pAnAnnaguNadarshakaH | |
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| He proceeds to a stage where the identification of right or wrong, happiness or sorrow, desirable or undesirable in the universe is not recognizable. | | He proceeds to a stage where the identification of right or wrong, happiness or sorrow, desirable or undesirable in the universe is not recognizable. |
| He will become hated and non acceptable among the people, and because of addiction will consequently attain a stage of painful diseases afterwards.(41-51) | | He will become hated and non acceptable among the people, and because of addiction will consequently attain a stage of painful diseases afterwards.(41-51) |
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| Overall effects of madya: | | Overall effects of madya: |
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| harShamUrjaM mudaM puShTimArogyaM pauruShaM param [1] | | | harShamUrjaM mudaM puShTimArogyaM pauruShaM param [1] | |
| yuktyA pItaM karotyAshu madyaM sukhamadapradam ||61|| | | yuktyA pItaM karotyAshu madyaM sukhamadapradam ||61|| |
| rocanaM dIpanaM hRudyaM svaravarNaprasAdanam |
| | rocanaM dIpanaM hRudyaM svaravarNaprasAdanam | |
| prINanaM bRuMhaNaM balyaM bhayashokashramApaham ||62|| | | prINanaM bRuMhaNaM balyaM bhayashokashramApaham ||62|| |
| svApanaM naShTanidrANAM mUkAnAM vAgvibodhanam | | | svApanaM naShTanidrANAM mUkAnAM vAgvibodhanam | |
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| svalpēnāpi madaṁ śīghraṁ yānti madyēna mānavāḥ||87|| | | svalpēnāpi madaṁ śīghraṁ yānti madyēna mānavāḥ||87|| |
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| sukhashIlAH susambhAShAH sumukhAH sammatAH satAm |
| | sukhashIlAH susambhAShAH sumukhAH sammatAH satAm | |
| kalAsvabAhyA vishadA viShayapravaNAshca ye ||80|| | | kalAsvabAhyA vishadA viShayapravaNAshca ye ||80|| |
| parasparavidheyA ye yeShAmaikyaM suhRuttayA | | | parasparavidheyA ye yeShAmaikyaM suhRuttayA | |
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| The properties vitiating tridosha as observed in poisons are also observed in the liquor, which are more potent in the former. Some poisons are fatal with immediate effect, while other causes certain diseases. The last stage of intoxication shall be considered as the poisonous state. Therefore, symptoms of tridosha (vitiation) are observed in all types of alcoholism, the difference among them is identity by their specific features.(98-100) | | The properties vitiating tridosha as observed in poisons are also observed in the liquor, which are more potent in the former. Some poisons are fatal with immediate effect, while other causes certain diseases. The last stage of intoxication shall be considered as the poisonous state. Therefore, symptoms of tridosha (vitiation) are observed in all types of alcoholism, the difference among them is identity by their specific features.(98-100) |
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| शरीरदुःखं बलवत् सम्मोहो [१] हृदयव्यथा | | | शरीरदुःखं बलवत् सम्मोहो [१] हृदयव्यथा | |
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| vyākulānāmaśastānāṁ svapnānāṁ darśanāni ca| | | vyākulānāmaśastānāṁ svapnānāṁ darśanāni ca| |
| madātyayasya rūpāṇi sarvāṇyētāni lakṣayēt||106|| | | madātyayasya rūpāṇi sarvāṇyētāni lakṣayēt||106|| |
| sharIraduHkhaM balavat sammoho [1] hRudayavyathA |
| | sharIraduHkhaM balavat sammoho [1] hRudayavyathA | |
| aruciH pratatA [2] tRuShNA jvaraH shItoShNalakShaNaH ||101|| | | aruciH pratatA [2] tRuShNA jvaraH shItoShNalakShaNaH ||101|| |
| shiraHpArshvAsthisandhInAM vidyuttulyA [3] ca vedanA | | | shiraHpArshvAsthisandhInAM vidyuttulyA [3] ca vedanA | |
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| mātuluṅgārdrakōpētaṁ jalayuktaṁ pramāṇavit [1] ||111|| | | mātuluṅgārdrakōpētaṁ jalayuktaṁ pramāṇavit [1] ||111|| |
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| sarvaM madAtyayaM vidyAt tridoShamadhikaM tu yam |
| | sarvaM madAtyayaM vidyAt tridoShamadhikaM tu yam | |
| doShaM madAtyaye pashyet tasyAdau pratikArayet ||107|| | | doShaM madAtyaye pashyet tasyAdau pratikArayet ||107|| |
| kaphasthAnAnupUrvyA ca kriyA kAryA madAtyaye | | | kaphasthAnAnupUrvyA ca kriyA kAryA madAtyaye | |
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| गुणाश्च दश पूर्वोक्तास्तैश्चतुर्दशभिर्गुणैः | | | गुणाश्च दश पूर्वोक्तास्तैश्चतुर्दशभिर्गुणैः | |
| सर्वेषां मद्यमम्लानामुपर्युपरि तिष्ठति ||११६|| | | सर्वेषां मद्यमम्लानामुपर्युपरि तिष्ठति ||११६|| |
| tīkṣōṣṇēnātimātrēṇa pītēnāmlavidāhinā|
| | tīkṣōṣṇēnātimātrēṇa pītēnāmlavidāhinā| |
| madyēnānnarasōtklēdō vidagdhaḥ kṣāratāṁ gataḥ||112|| | | madyēnānnarasōtklēdō vidagdhaḥ kṣāratāṁ gataḥ||112|| |
| antardāhaṁ jvaraṁ tr̥ṣṇāṁ pramōhaṁ vibhramaṁ madam| | | antardāhaṁ jvaraṁ tr̥ṣṇāṁ pramōhaṁ vibhramaṁ madam| |
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| sarvēṣāṁ madyamamlānāmuparyupari tiṣṭhati||116|| | | sarvēṣāṁ madyamamlānāmuparyupari tiṣṭhati||116|| |
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| tIkShoShNenAtimAtreNa pItenAmlavidAhinA |
| | tIkShoShNenAtimAtreNa pItenAmlavidAhinA | |
| madyenAnnarasotkledo vidagdhaH kShAratAM gataH ||112|| | | madyenAnnarasotkledo vidagdhaH kShAratAM gataH ||112|| |
| antardAhaM jvaraM tRuShNAM pramohaM vibhramaM madam | | | antardAhaM jvaraM tRuShNAM pramohaM vibhramaM madam | |
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| mārutaprabalaḥ śīghraṁ praśāmyati madātyayaḥ||135|| | | mārutaprabalaḥ śīghraṁ praśāmyati madātyayaḥ||135|| |
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| madyotkliShTena doSheNa ruddhaH [1] srotaHsu mArutaH |
| | madyotkliShTena doSheNa ruddhaH [1] srotaHsu mArutaH | |
| karoti vedanAM tIvrAM shirasyasthiShu sandhiShu ||117|| | | karoti vedanAM tIvrAM shirasyasthiShu sandhiShu ||117|| |
| doShaviShyandanArthaM hi tasmai [2] madyaM visheShataH | | | doShaviShyandanArthaM hi tasmai [2] madyaM visheShataH | |
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| शस्यते शिशिरं तोयं दाहतृष्णाप्रशान्तये | | | शस्यते शिशिरं तोयं दाहतृष्णाप्रशान्तये | |
| मात्राकालप्रयुक्तेन कर्मणाऽनेन शाम्यति [१०] ||१६३|| | | मात्राकालप्रयुक्तेन कर्मणाऽनेन शाम्यति [१०] ||१६३|| |
| धीमतो वैद्यवश्यस्य शीघ्रं पित्तमदात्ययः |१६४| bhavyakharjūramr̥dvīkāparūṣakarasairyutam [1] |
| | धीमतो वैद्यवश्यस्य शीघ्रं पित्तमदात्ययः |१६४| bhavyakharjūramr̥dvīkāparūṣakarasairyutam [1] | |
| sadāḍimarasaṁ śītaṁ saktubhiścāvacūrṇitam||136|| | | sadāḍimarasaṁ śītaṁ saktubhiścāvacūrṇitam||136|| |
| saśarkaraṁ śārkaraṁ vā mārdvīkamathavā'param| | | saśarkaraṁ śārkaraṁ vā mārdvīkamathavā'param| |
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| yastu dōṣavikalpajñō yaścauṣadhivikalpavit| | | yastu dōṣavikalpajñō yaścauṣadhivikalpavit| |
| sa sādhyānsādhayēdvyādhīn sādhyāsādhyavibhāgavit||190|| | | sa sādhyānsādhayēdvyādhīn sādhyāsādhyavibhāgavit||190|| |
| yadidaM karma nirdiShTaM pRuthagdoShabalaM prati |
| | yadidaM karma nirdiShTaM pRuthagdoShabalaM prati | |
| sannipAte dashavidhe tadvikalpyaM bhiShagvidA ||189|| | | sannipAte dashavidhe tadvikalpyaM bhiShagvidA ||189|| |
| yastu doShavikalpaj~jo yashcauShadhivikalpavit | | | yastu doShavikalpaj~jo yashcauShadhivikalpavit | |
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| With withdrawal of liquor, when kapha is diminished and debility and agility occurs due to fasting, and purifying metabolism of toxins, alleviating measures and vata pitta get dominant in the person wreaked with liquor, the milk acts as a boon like the rains for the tree in intense summer. | | With withdrawal of liquor, when kapha is diminished and debility and agility occurs due to fasting, and purifying metabolism of toxins, alleviating measures and vata pitta get dominant in the person wreaked with liquor, the milk acts as a boon like the rains for the tree in intense summer. |
| When the disease is removed by the use of milk and strength is regained the use of milk shall be discontinued and liquor consumption can be resumed in smaller quantities gradually.(195-198) | | When the disease is removed by the use of milk and strength is regained the use of milk shall be discontinued and liquor consumption can be resumed in smaller quantities gradually.(195-198) |
| Dwansaka and Vikshaya diseases due to madatyaya:
| | Dwansaka and Vikshaya diseases due to madatyaya: |
| विच्छिन्नमद्यः सहसा योऽतिमद्यं निषेवते | | | विच्छिन्नमद्यः सहसा योऽतिमद्यं निषेवते | |
| ध्वंसको [१] विक्षयश्चैव रोगस्तस्योपजायते ||१९९|| | | ध्वंसको [१] विक्षयश्चैव रोगस्तस्योपजायते ||१९९|| |
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| madyaṁ madyōtthitān rōgān hanti yaśca kriyākramaḥ| | | madyaṁ madyōtthitān rōgān hanti yaśca kriyākramaḥ| |
| sarvaṁ taduktamakhilaṁ madātyayacikitsitē||211|| | | sarvaṁ taduktamakhilaṁ madātyayacikitsitē||211|| |
| tatra shlokAH-
| | tatra shlokAH- |
| yatprabhAvA bhagavatI surA peyA yathA ca sA | | | yatprabhAvA bhagavatI surA peyA yathA ca sA | |
| yaddravyA yasya yA ceShTA yogaM cApekShate yathA ||207|| | | yaddravyA yasya yA ceShTA yogaM cApekShate yathA ||207|| |
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| • An individual of kaphaja prakriti shall imbibe madya (the liquor) with warm regimens; drink yava (barley), wheat, meat of wild animals along with black pepper. | | • An individual of kaphaja prakriti shall imbibe madya (the liquor) with warm regimens; drink yava (barley), wheat, meat of wild animals along with black pepper. |
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| Vidhi Vimarsha:
| | === ''Vidhi Vimarsha'' === |
| Sura and its varieties in present era:Sura, is the liquor prepared with shalidhanya which is nutritionally superior type of rice grain. Sura, if consumed as per the standard directives of limited consumption, leads to pleasure; otherwise it leads to the undesirable conditions like hangover, intoxication and the state of unconsciousness.
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| Depending upon the methods of preparation followed alcoholic drinks are of different types like sura, madhu and maitreya. The term sautramani has two meanings in different contexts, the former emphasizes the use of alcohol for the purpose of oblation, while the later as sacrificial Soma2.
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| The advice to use utensils made up of gold and silver for serving liquor is due to their property of being highly non-reactive. In present era metals have been replaced by glass, which is also an inert substance to serve liquor. The principle is to serve liquor in utensils made up of inert substances.
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| Qualities of good liquor:The liquor consumption must be in optimal amount suitable to individual’s body constitution and should not cause vitiation of dosha.
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| Good liquor is prepared from multiple ingredients of varied qualities which have diverse actions to help regulate the three doshas and prevent their vitiation, which may occur in case of use of single ingredient. Sushruta mentioned that the increase or decrease of the dosha is mainly influenced by the ingredients (dravya) of liquor. Therefore, manufacturing liquor with multi-component of varied quality substances will help to maintain state of homoestasis.
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| Features of intoxication:Hangovers are a frequent, though unpleasant, experience among people who drink to intoxication. Multiple possible factors to cause hangover state by liquor have been investigated, and evidence suggests that hangover symptoms depend upon its effects on urine production, the state of gastrointestinal tract, blood sugar concentrations, sleep patterns, and biological rhythms. In addition, researchers postulate that effects related to alcohol withdrawal depend upon, alcohol metabolism, biologically active non alcohol compounds in beverages; the use of other drugs; certain personality traits; and a family history of alcoholism may contribute to the hangover conditionas shown in table 2 below.
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| Table 1: Symptoms of hangover:
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| Class of Symptoms Type
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| Constitutional Fatigue, weakness, and thirst
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| Pain Headache and muscle aches
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| Gastrointestinal Nausea, vomiting, and stomach pain
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| Sleep and biological rhythms Decreased sleep, decreased REM, and increased slow-wave sleep
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| Sensory Vertigo and sensitivity to light and sound
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| Cognitive Decreased attention and concentration
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| Mood Depression, anxiety, and irritability
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| Sympathetic hyperactivity Tremor, sweating, and increased pulse and systolic BP
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| Table 2: Possible Contributing Factors to Hangover3
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| Direct effects of alcohol
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| • Dehydration
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| • Electrolyte imbalance
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| • Gastrointestinal disturbances
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| • Low blood sugar
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| • Sleep and biological rhythm disturbances
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| Alcohol withdrawal
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| Alcohol metabolism (i.e., acetaldehyde toxicity)
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| Non-alcohol effects
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| • Compounds other than alcohol in beverages, especially methanol
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| • Use of other drugs, especially nicotine
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| • Personality type
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| • Family history for alcoholism
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| Table 3: Dubowski’s stages of Alcoholic influence
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| BAC gms/100ml Stages of Alcoholic Influence Clinical Signs /Symptoms
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| 0.01 to 0.05 Subclinical Influence / effects usually not appearent or obvious
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| Behaviour nearly normal by ordinary observation
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| Impairment detectable by special tests
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| 0.03 to 0.12 Euphoria Mild Euphoria, Socialbility, Talkativeness
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| Increased self confidence, Decreased inhibitions
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| Diminished attention, Judgement and control
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| Some sensory motor impairment
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| Slowed information processing
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| Loss of efficiency in critical performance tests
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| 0.09 to 0.25 Excitement Emotional instability, Loss of critical judgement
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| Impairment of perception, memory and comprehension
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| Decreased sensory response, Increased rection time
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| Reduced visual acuty and peripheral vision& slow glare recovery
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| Sensory motor incoordination, Impaired Balance
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| Slurred speech, Vomitting, Drowsiness
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| 0.18 to 0.30 Confusion Disorientation, Confusion, Vertigo, Dysphoria
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| Exagarated emotional states, (fear, rage, grief etc.)
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| Disturbances of vision (Diplopia) & 0f color, form, motion & dimensions
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| Increased pain threeshold
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| Increased muscular incoordination, staggering gait and ataxia
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| Apathy, Lethargy
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| 0.25 to 0.40 Stupor General inertia, approaching loss of motor functions
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| Markedly decreased response to stimuli
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| Marked muscular incoordination, inability to stand or walk
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| Vomiting, incontinence of urine and feces
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| Impaired conciousness, sleep or stupor
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| 0.35 to 0.50 Coma Complete unconciousness, Coma, Anesthesia
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| Depressed or abolished reflexes
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| Subnormal temperature
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| Impairement of circulation and respiration
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| Possible death
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| 0.45 + Death Death from respiratory arrest
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| Role of olfaction in intoxication:
| |
| Alcoholic beverages provoke massive orthonasal and retronasal stimulations (Bragulat et al., 2008) which constitute strong appetitive cues (Bienkowski et al., 2004) and might be involved in causing alcohol-dependence as they rapidly lead to conditioned alcohol-seeking behaviors (Pautassi et al., 2009). Olfactory stimulations elicit strong drinking desires (Schneider et al., 2001), this olfactory craving being even stronger than those provoked by visual–auditory cues, particularly during withdrawal (Kareken et al., 2004; Little et al., 2005) and thus being potentially involved in relapse.
| |
| | |
| The olfactory system relates to cognitive and emotional brain regions, and exploring olfaction might improve the understanding of emotional-cognitive deficits in alcohol- dependence (up to now explore with visio–auditory stimulations). Olfaction is indeed directly connected with limbic (Soudry et al., 2011) and fronto-temporal regions (Rolls, 2004).
| |
| | |
| The orbitofrontal cortex is a crucial area in this perspective, being simultaneously involved in emotional, executive, and olfactory processing (Rolls, 2008). Strong correlations between olfactory and cognitive abilities have been shown (Purdon, 1998; Schu- bert et al., 2008; Sohrabi et al., 2012), underlining their common cerebral basis. Olfaction thus constitutes an interesting way to renew the exploration of emotional-executive deficits in alcohol-dependence.
| |
| In view of the above research; the consumption of liquor in pleasent atmosphere, with perfumes, esscense and garlands has a reason to avoid false stimulation of olfactory nerve and to maintain the consciousness during and after liquor intake.
| |
| The intention of using perfumes etc is based upon the understanding of its effect on olfaction and there by on the cerebral functions; which otherwise termed as gandha-jnyana, meaning knowledge of olfaction. The most preferred aromas will help maintaining the psycho-neuro axis well in control and it prevents the intoxicating effects on human body.
| |
| Factors affecting addictive behaviour: Addictive behavior associated with alcoholism is characterized by compulsive preoccupation with obtaining alcohol, loss of control over consumption, and development of tolerance and dependence, as well as impaired social and occupational functioning. Like other addictive disorders, alcoholism is characterized by chronic vulnerability to relapse after cessation of drinking.
| |
| More recently, increasing attention has been directed toward the understanding of neurobiological and environmental factors in susceptibility to relapse5.
| |
| | |
| The BAC’s showed in the following tables are the maximum attainable concentrations for a specific amount of alcohol consumed.
| |
| Table 4: Factors determining maximum BAC:
| |
| | |
| The calculations are based on Widmark’s Formula:
| |
| A = Amount of alcohol measured in grams
| |
| P = Mass of the individual in kilograms
| |
| C = Blood Alcohol Concentration in gram/100ml
| |
| R = Distribution Factor (f=0.7 =0.6)
| |
| 10 = Conversion Factor from g/1000 ml to g/100ml
| |
| | |
| A = P x C x R x 10
| |
| | |
| | |
| In a fat person the r-factor will be less than in a muscular one. Theoretically a fat person with the same mass as a muscular one will become more intoxicated on the same amount of alcohol consumed over the same period. (alcohol is not fat soluble but water soluble)
| |
| The given blood alcohol concentration is a reflection of the minimum alcohol that was absorbed in the gut.
| |
| | |
| It does not reflect the:
| |
| a) Alcohol remaining in the
| |
| b) Alcohol already metabolized
| |
| c) Alcohol excreted in the urine and still in the bladder
| |
| d) Alcohol perspired
| |
| e) Alcohol exhaled
| |
| | |
| Alcoholism jointly leads to olfactory and memory source impairment and these two categories of deficits are associated. These results strongly support the proposition that olfactory and confabulation measures both index orbitofrontal functioning, and suggests that olfaction could become a reliable cognitive marker in psychiatric disorders6.
| |
| Table 5: ICD classification
| |
| | |
| ICD 11 – Alcohol
| |
| | |
| Y91 categories in ICD-10:
| |
| Evidence of alcohol involvement determined by level of intoxication
| |
| | |
| Y91.0
| |
| Mild alcohol intoxication
| |
| Smell of alcohol on breath, slight behavioural disturbance in functions and responses, or slight difficulty in coordination
| |
| | |
| Y91.1
| |
| Moderate alcohol intoxication
| |
| Smell of alcohol on breath, moderate behavioural disturbance in functions and responses, or
| |
| Moderate difficulty in coordination
| |
| | |
| Y91.2
| |
| Severe alcohol intoxication
| |
| Severe disturbances in functions and responses, severe difficulty in coordination, or impaired ability to cooperate
| |
| | |
| Y91.3
| |
| Very severe alcohol intoxication
| |
| Very severe disturbance in functions and responses, very severe difficulty in coordination, or loss of ability to cooperate
| |
| | |
| Y91.4
| |
| Alcohol involvement, not otherwise specified
| |
| Suspected alcohol involvemen
| |
| | |
| Effects of alcohol:
| |
| Alcohol consumption can interfere with the function of all parts of the gastrointestinal tract. Acute alcohol ingestion induces changes in the motility of the esophagus and stomach that favor gastro-esophageal reflux and, probably, the development of reflux esophagitis.
| |
| | |
| Alcohol abuse may lead to damage of the gastric mucosa, including hemorrhagic lesions. Beverages with low alcohol content stimulate gastric acid secretion, whereas beverages with high alcohol content do not. In the small intestine, alcohol inhibits the absorption of numerous nutrients. The importance of these absorption disorders for the development of nutritional disturbances in alcoholics, however, is unclear. In alcoholics with other digestive disorders (e.g., advanced liver disease or impaired pancreatic function), impaired digestion likely is more significant. Acute alcohol consumption also damages the mucosa in the upper region of the small intestine and may even lead to the destruction of the tips of the villi.
| |
| Qualities of different types of liquors and uses:
| |
| The Ashtang Hridaya has elaborated peculiarities of liquor prepared by various sources. The superiority though has been mentioned; the liquor prepared by respective components have specific qualities, which can be considered therapeutically important.
| |
| Table 6: Types of liquors Name of liquor Main Quality Indication Correlation
| |
| Sura Snehani (Unctous) Gulma, Udara, Arsha, Grahani, Lactating, Diuretic Tumor, Ascitis, Hemorrhoids, Colitis and digestive disorders
| |
| Varuni Agile, Sharp, Hridya Shool, Kasa, Vomitting, Asthma, Vibandha, Adhmana, Peenasa Gasric erosions, Cough, Bloating, Rhinitis,
| |
| Baibhitaki Agile, Pathya Wounds, Anemia, Skin diseases
| |
| Yava-sura Guru, Arid, Vishtambhi
| |
| Mardwika Sweet, Sara, Lekhana, not to hot Anemia, Meha, Worms All types of Urine disorders
| |
| Kharjura Vatala, Guru
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| Sharkara Sweet, Hridya, Agile
| |
| Gaudika Tarpana, Deepana Diuresis, Laxative
| |
| Seedhu Stimulates Vata, Pitta Obesity, Anasarca, Ascitis, Hemorrhoids
| |
| Madhwasava Chhedana Meha, Peenas, Kasa Urinary disorders, Rhinitis, Cough
| |
| Shuktam Utkledi, Hot, sharp, Sour, Palatable, Laxative, Cool on touch Anemia, Visual disorders, Worms
| |
| | |
| | |
| | |
| Time needed to absorb and metabolize different amounts of alcohol:
| |
| | |
| Factors such as food intake and its constituent profile, gender and age have been reported to influence the kinetics of alcohol absorption and metabolism.
| |
| | |
| It is widely accepted that the rate of alcohol absorption can be decreased by consuming food along with the alcoholic drink. The rate at which alcohol is absorbed depends on how quickly the stomach empties its contents into the intestine.
| |
| | |
| The higher the dietary fat content, the more time this emptying will require and the longer the process of absorption will take.
| |
| | |
| One study found that subjects who drank alcohol after a meal that included fat, protein, and carbohydrates, absorbed the alcohol about three times more slowly than when they consumed alcohol on an empty stomach. Ref???
| |
| | |
| Role of fructose and carbohydrates in alcohol absorption:
| |
| Rogers et al, showed that carbohydrates significantly increased the rate of alcohol metabolism in fasting humans while protein and fat failed to show the same effect. In this context it is interesting to mention that for a long time (prior to controlled scientific interventions) a common nonscientific experience existed claiming that consumption of honey may shorten the period of alcohol intoxication (honey is an excellent rich source of nutritional fructose). The honey significantly increased blood alcohol disappearance and elimination rates by 32.4 and 28.6 percent, respectively, and reduced the intoxication time (that is, the time taken to attain zero blood alcohol level) and its degree (the peak blood alcohol level) by 30 and 4.4 percent.
| |
| | |
| Fructose, also known as “fruit Sugar”, is naturally-occurring, is characterized by “clean” non-lingering sweet taste. Fructose is highly soluble, and is characterized by a Relative Sweetening Value (RSV) of 1.1-1.7 (where sucrose = 1.0), depending on temperature and pH.
| |
| With regards to the possible mechanism by which fructose accelerates ethanol metabolism, a literature review indicates a possible shift in the metabolism of fructose in the presence of alcohol. This shift has been linked to the production in the liver of NAD+ which facilitates alcohol oxidation. Therefore, in the presence of alcohol, the metabolism of fructose in the liver is diverted from NAD+ to NADH requiring pathways, which in turn generates the NAD+ needed for alcohol oxidation9.
| |
| | |
| Treatment of acute alcoholism: ??
| |
| Treatment of chronic alcoholism: ??
| |
| Refrences:
| |
| 1. Charaka Samhita; Chaukhamba, Bhagwan Das, R K Sharma
| |
| 2. Charaka Samhita; Chaukhamba, Bhagwan Das, Sharma
| |
| 3. Alcohol Health and Research World; Mechanisms and Mediators; Robert swift, Dena Davidson; page 54-60
| |
| 4. Frontiers in Psychology; Olfaction in alcohol dependence: a neglected yet promising research field; Maurage et al; Jan 2014, Vol.4. Article 1007
| |
| 5. Journal of Neurosciences, May 1, 2002, 22(9), 3332-3337; Behavioural Neurobiology of Alcohol addiction; Weiss and Porrino
| |
| 6. Journal of Plosone; August 2011, Vol.6, Issue 8; Olfactory Impairment Is Correlated with Confabulation in Alcoholism: Towards a Multimodal Testing of Orbito-frontal Cortex
| |
| Pierre Maurage et al
| |
| 7. Alcohol Health and Research World; Alcohol’s role in Gastrointestinal disorders; Chirstian Bode & J. Christian Bode
| |
| 8. Biological Psychology, Vol. 88, Issue 1; Sep 2011. 28-36; Chemosensory event-related potentials in alcoholism: A specific impairment for olfactory function; Maurage et al
| |
| 9. Agro Food Industry hi tech Sep-Oct2009, Vol. 20 No.5; Fructose and its effect on alcohol elimination from blood following alcohol consumption; Fernando Schved
| |
| 10. Charak Sutrasthana 1/ 44.
| |
| 11. Sushrut sutrasthana 2:
| |
| Gunaha ye ukta dravyeshu sharireshu api te tathaI
| |
| sthana vriddhi kshayah tasmad dehino dravyahetukaII
| |
| 12. Ashtang Hridaya Sutrasthana 11/37-38 commentary by Arundatta
| |
| 13. Ashtang Hridaya Chilitsasthana 7 Madatyayachikitsa – Hemadri & Arundatta
| |
| 14. Alcohol, the body and health effects; The Alcohol Advisory Council, NZ
| |
| Index 1:
| |
| Verse no. Name as per Charaka Lattin name Useful Part Rasa
| |
| 23 Yava
| |
| 23 Godhum Triticum sativum Phal
| |
| 23 Marich Piper nigrum Phal
| |
| 111 Matulung Celastrus paniculatus Willd Beeja
| |
| 111 Aadrak Zingiber officinale Swaras
| |
| 121 Bijpurak Citrus medica Linn Phal
| |
| 121 Vrukshamla Garcinia indica Chois Phal
| |
| 121 Kol Zizyphus jujuba Lam Phal
| |
| 121 Dadim Punica granatum Linn Phal-Twak, Moola-twak
| |
| 121 Yawani Hyoscyamus niger Linn Beeja
| |
| 121 Hapusha Juniperus communis Linn Phal
| |
| 121 Ajjaji Cuminum cyminum Linn Phal
| |
| 121 Shrungwer
| |
| 125 Godhum
| |
| 126 Mash Phaseolus mungo Linn Phal
| |
| 127 Marich
| |
| 127 Adrak
| |
| 127 Dadim
| |
| 128 Marich
| |
| 128 Adrak
| |
| 129 Dadim
| |
| 129 Panchmul
| |
| 130 Dhanya Coriandrum sativum Linn Phal
| |
| 130 Nagar Zingiber officinale Roscoe Moola
| |
| 136 Kharjur Phoenix sylvestris Roxb Phal
| |
| 136 Mrudhwika Vitis vinifera Linn Phal
| |
| 136 Parushak Grewia asiatica Linn Phal
| |
| 137 Mardik
| |
| 138 Shalishashtik Oryza sativa Linn Phal
| |
| 139 Patol Trichosanthes dioics Roxb Patra, Mool
| |
| 139 Mudag Phaseolus aureus Roxb Beej, phal
| |
| 139 Dadim
| |
| 139 Aamlak Phyllanthus emblica Linn Phal
| |
| 140 Draksha
| |
| 140 Aamlak
| |
| 140 Kharjur
| |
| 140 Parushak
| |
| 145 Guduchi Tinosphora cardifolia Panchang
| |
| 145 Bhadramusta Cyperus rotundus Linn Kand
| |
| 145 Patol
| |
| 145 Nagar
| |
| 146 Draksha
| |
| 149 Parushak
| |
| 149 Pilu Salvadora persica Linn patra, beeja, Moola
| |
| 150 Musta Cyperus scariosus R.Br kanda
| |
| 150 Dadim
| |
| 150 Laja
| |
| 151 Kol
| |
| 151 Dadim
| |
| 151 Vrukshamla
| |
| 151 Churika Tamarindus indica Linn phal, beeja, patra, pushpa
| |
| 153 Padam Prunus puddum Roxb Kashtha
| |
| 153 Utpal Saussurea lappa, Mool Katu, madhur, tikta
| |
| 153 Chandan Santalum album, Linn Kashthasar Tikta
| |
| 155 Chandan
| |
| 156 Kumud Nymphaea alba, Linn moola, pushap
| |
| 156 Utpal
| |
| 156 Chandan
| |
| 159 Phalini Callicarpa macrophylla vahl phul, patra
| |
| 159 Sevya Andropogon muricatus Retz Moola Tikta, madhur
| |
| 159 Lodhra Symplocos racemosa, Roxb Twaka Kashay
| |
| 159 Ambu
| |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
| | |
|
| |
|
| Index 2:
| | Work in Progress |
| (www.alcoholservices-ateam.org)
| |