Changes

The tenth chapter deals with specific features of types of ''apasmara'' and its management. In continuation with the earlier explanation about causative factors, patho-physiology and clinical features have been described in [[Apasmara Nidana]], with another definition provided here in this chapter in greater detail.

The tenth chapter deals with specific features of types of ''apasmara'' and its management. In continuation with the earlier explanation about causative factors, patho-physiology and clinical features have been described in [[Apasmara Nidana]], with another definition provided here in this chapter in greater detail.

    

    

Specific features of dominance of ''vata, pitta'' and ''kapha doshas'' are explained and involvement of exogenous factors is mentioned. Management of ''apasmara'' depending on the predominance of ''doshas'', influence of ''agantu'' (exogenous) factors are explained. Special preparations like ''panchagavya ghrita, mahapanchagavya ghrita, jeevaneeya ghrita,'' various preparations for nasal administrations etc are given.

Specific features of dominance of ''[[vata]], [[pitta]]'' and ''[[kapha]] [[dosha]]s'' are explained and involvement of exogenous factors is mentioned. Management of ''apasmara'' depending on the predominance of ''[[dosha]]s'', influence of ''agantu'' (exogenous) factors are explained. Special preparations like ''panchagavya ghrita, mahapanchagavya ghrita, jeevaneeya ghrita,'' various preparations for nasal administrations etc are given.

Etiological factors, pathogenesis, features and management of an important disease called ''atattvabhinivesha'' (a disease of perversion of intellect) are narrated. Importance of ''rasayana'' (rejuvenation) and protection of patient of ''unmada'' and ''apasmara'' are also emphasized.  

Etiological factors, pathogenesis, features and management of an important disease called ''atattvabhinivesha'' (a disease of perversion of intellect) are narrated. Importance of ''[[rasayana]]'' (rejuvenation) and protection of patient of ''unmada'' and ''apasmara'' are also emphasized.  

'''Keywords''': ''Apasmara'', memory, consciousness, epilepsy, ''atattvabhinivesha, unmada'', seizure disorders. </div>

'''Keywords''': ''Apasmara'', memory, consciousness, epilepsy, ''atattvabhinivesha, unmada'', seizure disorders. </div>

== Introduction ==

== Introduction ==

<div style="text-align:justify;">

<div style="text-align:justify;">

All psychiatric and psycho-somatic diseases find their roots in the two chapters of ''unmada'' and ''apasmara''. These diseases are caused by similar etiological factors and both manifest as ''manasika vikara'' (psychiatric diseases). Therefore these two chapters are placed in succession. ''Mana'' (mind), ''buddhi'' (intellect), and ''smriti'' (memory) are integral parts combined with ''atma'' (self) in understanding Ayurvedic psychiatry. The series of pathological events that take place to occlude consciousness in heart and loss of memory is distinctive feature of ''apasmara''. As mentioned earlier in [[Apasmara Nidana]], first the aggravation of ''doshas'' at somatic level occurs by improper and impure/foul food and excess affliction of negative emotions like worries, passion, fright, anger, grief etc at psychic level. The disease precipitates in the form of paroxysmal attack, then the negative psychological emotions occlude the consciousness at heart and thereafter leading to loss of memory.

All psychiatric and psycho-somatic diseases find their roots in the two chapters of ''unmada'' and ''apasmara''. These diseases are caused by similar etiological factors and both manifest as ''manasika vikara'' (psychiatric diseases). Therefore these two chapters are placed in succession. ''[[Manas]]'' (mind), ''[[buddhi]]'' (intellect), and ''[[smriti]]'' (memory) are integral parts combined with ''[[atma]]'' (self) in understanding Ayurvedic psychiatry. The series of pathological events that take place to occlude consciousness in heart and loss of memory is distinctive feature of ''apasmara''. As mentioned earlier in [[Apasmara Nidana]], first the aggravation of ''[[dosha]]s'' at somatic level occurs by improper and impure/foul food and excess affliction of negative emotions like worries, passion, fright, anger, grief etc at psychic level. The disease precipitates in the form of paroxysmal attack, then the negative psychological emotions occlude the consciousness at heart and thereafter leading to loss of memory.

   

   

There is always a possibility of food contamination as a causative factor for epilepsy. A case in point is of endrin-laced taquitos causing seizures in the United States<ref>

There is always a possibility of food contamination as a causative factor for epilepsy. A case in point is of endrin-laced taquitos causing seizures in the United States<ref>

Waller K, Prendergast TJ, Slagle A, Jackson RJ. Seizures after eating a snack food contaminated with the pesticide endrin. The tale of the toxic taquitos. Western Journal of Medicine. 1992;157(6):648-651.</ref>. Balance between ''sattva, rajas'' and ''tamas'' is important by avoiding the stressors that precipitate the episode of ''apasmara''. Various animal products like ghee processed with medicinal herbs are utilized for medicine preparation.  

Waller K, Prendergast TJ, Slagle A, Jackson RJ. Seizures after eating a snack food contaminated with the pesticide endrin. The tale of the toxic taquitos. Western Journal of Medicine. 1992;157(6):648-651.</ref>. Balance between ''[[sattva]], [[rajas]]'' and ''[[tamas]]'' is important by avoiding the stressors that precipitate the episode of ''apasmara''. Various animal products like ghee processed with medicinal herbs are utilized for medicine preparation.  

''Atattvabhinivesha'' is another disease specially mentioned in this chapter. It is termed as the single major disease ,i.e., ''mahagada,'' leading to affliction of mind and intellect. Its management is also mentioned in this context.

''Atattvabhinivesha'' is another disease specially mentioned in this chapter. It is termed as the single major disease ,i.e., ''mahagada,'' leading to affliction of mind and intellect. Its management is also mentioned in this context.

''Apasmara'' occurs in those persons, in whom:

''Apasmara'' occurs in those persons, in whom:

#The ''doshas'' are excessively aggravated and have spread to other sites (''vibhranta'') due to (habitual) intake of improper/harmful and impure/contaminated food.   

#The ''[[dosha]]s'' are excessively aggravated and have spread to other sites (''vibhranta'') due to (habitual) intake of improper/harmful and impure/contaminated food.   

#In whom, the ''sattva'' (one of the attributes of mind representing purity and consciousness) is suppressed by ''rajas'' (attribute of the mind representing energy and dynamism) and ''tamas'' (attribute of the mind representing passivity and ignorance) ;  

#In whom, the ''[[sattva]]'' (one of the attributes of mind representing purity and consciousness) is suppressed by ''[[rajas]]'' (attribute of the mind representing energy and dynamism) and ''[[tamas]]'' (attribute of the mind representing passivity and ignorance) ;  

#The heart (site of consciousness) is obscured by aggravated ''doshas''; and

#The heart (site of consciousness) is obscured by aggravated ''[[dosha]]s''; and

#Mind is distressed or annihilated by (affliction of negative emotions like) worry, passion, fright, anger, grief, anxiety etc.  [4-5]

#Mind is distressed or annihilated by (affliction of negative emotions like) worry, passion, fright, anger, grief, anxiety etc.  [4-5]

</div></div>

</div></div>

(By the above mentioned factors) ''doshas'' located in the vessels (or ''dhamani'', channels that carry nutrients) afflict the heart. Thus person suffers due to bewildered mind.[6]

(By the above mentioned factors) ''[[dosha]]s'' located in the vessels (or ''dhamani'', channels that carry nutrients) afflict the heart. Thus person suffers due to bewildered mind.[6]

He visualizes non-existent forms (visual hallucinations), falls down, his tongue, eyes and eyebrows become tremulous, saliva discharges from his mouth, his hands and legs are extended / bent.[7]

He visualizes non-existent forms (visual hallucinations), falls down, his tongue, eyes and eyebrows become tremulous, saliva discharges from his mouth, his hands and legs are extended / bent.[7]

</div></div>

</div></div>

When the surge of ''doshas'' is over, he wakes up as if he is getting up from sleep (regains consciousness). [8]

When the surge of ''[[dosha]]s'' is over, he wakes up as if he is getting up from sleep (regains consciousness). [8]

=== Types of ''apasmara'' ===

=== Types of ''apasmara'' ===

</div></div>

</div></div>

''Apasmara'' is of four types including those due to separate ''doshas'' (''vata, pitta'' and ''kapha'') and due to combination of all (''sannipatika''). [8]

''Apasmara'' is of four types including those due to separate ''[[dosha]]s'' (''[[vata]], [[pitta]]'' and ''[[kapha]]'') and due to combination of all (''sannipatika''). [8]

=== Features (Ictal phase) ===

=== Features (Ictal phase) ===

==== ''Apasmara'' with ''vata'' dominance ====

==== ''Apasmara'' with ''[[vata]]'' dominance ====

<div class="mw-collapsible mw-collapsed">

<div class="mw-collapsible mw-collapsed">