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Line 55: − + − ==== Specifications of Punarvasu ==== + Line 76:
Line 76: − ==== Causes of ''unmada'' ====+ Line 92:
Line 92: − ==== Pathogenesis of ''unmada'' ====+ Line 108:
Line 108: − ==== Clinical features ====+ Line 135:
Line 135: − ==== Types of ''unmada'' ====+ Line 151:
Line 151: − ==== ''Vata'' dominant ''unmada'' ====+ Line 178:
Line 178: − ==== ''Pitta'' dominant ''unmada'' ====+ Line 205:
Line 205: − ==== ''Kapha'' dominant ''unmada'' ====+ Line 231:
Line 231: − ==== ''Sannipata unmada'' (due to vitiation of all ''doshas'') ====+ Line 247:
Line 247: − ==== ''Agantu unmada'' (exogenous type) ====+ Line 263:
Line 263: − ==== Signs of ''bhutonmada'' (affliction of evil spirits) ====+ Line 304:
Line 304: − ==== Various types of ''agantu unmada'' ====+ − ===== Affliction by God =====+ Line 325:
Line 325: − ===== Affliction by ''unmada'' due to affliction of guru etc. =====+ Line 338:
Line 338: − ===== ''Unmada'' due to affliction of ancestors or forefathers =====+ Line 351:
Line 351: − ===== ''Unmada'' due to affliction of ''gandharva'' (celestial musicians) =====+ Line 370:
Line 370: − ===== ''Unmada'' due to affliction of ''yaksha'' =====+ Line 383:
Line 383: − ===== ''Unmada'' due to affliction of ''rakshasa'' (demons) =====+ Line 396:
Line 396: − ===== ''Unmada'' due to affliction of ''brahma-rakshasa'' (a class of evil demons) =====+ Line 409:
Line 409: − ===== ''Unmada'' due to affliction of ''pishacha'' =====+ Line 422:
Line 422: − ==== Days, time and susceptible persons for affliction ====+ Line 447:
Line 447: − ==== Untreatable ''unmada'' ====+ Line 460:
Line 460: − ==== Management principles ====+ Line 581:
Line 581: − ==== Various formulations ====+ − ===== ''Hingvadi ghee'' =====+ Line 608:
Line 608: − ===== ''Kalyanaka'' ghee =====+ Line 688:
Line 688: − ===== ''Mahakalyanaka ghee'' =====+ Line 725:
Line 725: − ===== ''Mahapaishachika ghee'' =====+ Line 774:
Line 774: − ===== ''Lashunadya ghee'' =====+ Line 859:
Line 859: − ===== Second formulation of ''lashunadya ghrita'' =====+ − ===== Different useful recipes of medicated ghee =====+ Line 933:
Line 933: − ==== Therapeutic utility of old ghee ====+ Line 939:
Line 939: − ==== External applications in ''vata-kapha'' dominant ''unmada'' ====+ Line 1,074:
Line 1,074: − ===== ''Siddharthakadi Agada'' =====+ Line 1,084:
Line 1,084: − ==== Treatment of ''pitta'' dominant ''unmada'' ====+ Line 1,112:
Line 1,112: − ==== Isolation of ''unmada'' patients ====+ Line 1,128:
Line 1,128: − ==== Psychotherapy and other therapies ====+ Line 1,199:
Line 1,199: − ==== Therapies in mental trauma patients ====+ Line 1,226:
Line 1,226: − ==== Spriritual therapies in exogenous type of ''unmada'' ====+ Line 1,338:
Line 1,338: − ==== Signs of complete cure of ''unmada'' ====+ Line 1,354:
Line 1,354: − ==== Summary ====+ Line 1,395:
Line 1,395: − ==== Similar conditions observed in contemporary psychiatry ====+ − ===== ''Nija unmada'' (endogenous psychoses) =====+ Line 1,405:
Line 1,405: − ===== ''Agantuja unmada'' (exogenous psychoses)=====+ − ==== Management of ''unmada'' ====+ − ===== ''Yuktivyapashraya Chikitsa'' (rational treatment) =====+ Line 1,422:
Line 1,422: − ===== Concept and rationale of ''ghrita-pana/ shamana sneha pana'' =====+ − ===== Recommended therapies for ''dosha'' dominant ''unmada'' =====+ Line 1,451:
Line 1,451: − ===== Specific therapies by ''dosha'' dominant ''unmada'' , and prescribed medicines=====+ + Line 1,460:
Line 1,461: − ====== Useful single drugs mentioned in unmada ======+ − + − ====== Compound Formulations ======+ + + Line 1,536:
Line 1,539: − ==== ''Pathya Apathya'' (Dietary Indications and contraindications)====+ − ===== ''Pathya'' =====+ Line 1,549:
Line 1,552: − ===== ''Satvavajaya'' =====+ Line 1,568:
Line 1,571: − ==== Summary ====+
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Now (I) shall expound the chapter on the treatment of ''unmada''. Thus said Lord Atreya. [1-2]
Now we shall expound the chapter "Unmada Chikitsa" (Management of psychosis disorders). Thus said Lord Atreya. [1-2]
=== Specifications of Punarvasu ===
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Punarvasu, the abode of intellect, [[memory]], knowledge, penance and saviour of living beings, timely described the etiology, symptoms and treatment of ''unmada'' to Agnivesha as queried. [3]
Punarvasu, the abode of intellect, [[memory]], knowledge, penance and saviour of living beings, timely described the etiology, symptoms and treatment of ''unmada'' to Agnivesha as queried. [3]
=== Causes of ''unmada'' ===
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Food with incompatible, contaminated and unclean properties; possession by spirits like gods, teachers and ''brahmanas''; mental trauma due to recurrent exposure to fear or exhilaration and adopting difficult posture are the general causes of ''unmada''.[4]
Food with incompatible, contaminated and unclean properties; possession by spirits like gods, teachers and ''brahmanas''; mental trauma due to recurrent exposure to fear or exhilaration and adopting difficult posture are the general causes of ''unmada''.[4]
=== Pathogenesis of ''unmada'' ===
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By the above causative factors, the ''doshas'' get vitiated in the person possessing low level of ''sattva guna'' (weak minded people) in turn vitiate ''hridaya'' (mind), which is the seat of intellect. There from the channels carrying mental factors (''mano-vaha srotasas''), quickly delude the mind of the person. [5]
By the above causative factors, the ''doshas'' get vitiated in the person possessing low level of ''sattva guna'' (weak minded people) in turn vitiate ''hridaya'' (mind), which is the seat of intellect. There from the channels carrying mental factors (''mano-vaha srotasas''), quickly delude the mind of the person. [5]
=== Clinical features ===
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Thus, the person with deranged mind does not know pleasures, pain, ethics and eternal duties and does not get peace anywhere. Therefore, he lets the mind wander here and there due to loss of memory, intellect and perceptions. [6-7]
Thus, the person with deranged mind does not know pleasures, pain, ethics and eternal duties and does not get peace anywhere. Therefore, he lets the mind wander here and there due to loss of memory, intellect and perceptions. [6-7]
=== Types of ''unmada'' ===
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''Unmada'' refers to excessive affliction of intellect, mind and memory. This is of two types – ''nija'' (endogenous) and ''agantuja'' (exogenous). According to origin, it is of five types.(I) will describe their symptoms and treatment separately.[8]
''Unmada'' refers to excessive affliction of intellect, mind and memory. This is of two types – ''nija'' (endogenous) and ''agantuja'' (exogenous). According to origin, it is of five types.(I) will describe their symptoms and treatment separately.[8]
=== ''Vata'' dominant ''unmada'' ===
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Laughing, smiling, dancing, singing, speaking, abnormal movement of body parts, weeping at improper places and improper time, roughness, emaciation, reddish discoloration of body parts and aggravation of the disease after digestion of food; are the clinical features of the ''vata'' dominant ''unmada'' .[9-10]
Laughing, smiling, dancing, singing, speaking, abnormal movement of body parts, weeping at improper places and improper time, roughness, emaciation, reddish discoloration of body parts and aggravation of the disease after digestion of food; are the clinical features of the ''vata'' dominant ''unmada'' .[9-10]
=== ''Pitta'' dominant ''unmada'' ===
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Intolerance, agitation, nakedness, terrorizing, excessive movements, (running), heat, wrath (anger), yellowish luster and desire for dense shady places, cold food - are the clinical features of pitta dominant ''unmada''. [11-12]
Intolerance, agitation, nakedness, terrorizing, excessive movements, (running), heat, wrath (anger), yellowish luster and desire for dense shady places, cold food - are the clinical features of pitta dominant ''unmada''. [11-12]
=== ''Kapha'' dominant ''unmada'' ===
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Slow speech and movements, anorexia, and liking for women and loneliness, excessive sleep, vomiting, salivation, aggravation of the disease after taking meals and whiteness of nails etc.– these are the clinical features of the ''kapha'' dominant ''unmada''. [13-14]
Slow speech and movements, anorexia, and liking for women and loneliness, excessive sleep, vomiting, salivation, aggravation of the disease after taking meals and whiteness of nails etc.– these are the clinical features of the ''kapha'' dominant ''unmada''. [13-14]
=== ''Sannipata unmada'' (due to vitiation of all ''doshas'') ===
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The severe type of ''unmada'' arising from ''sannipata'' (aggravation of all three ''doshas'') is caused by all the above etiological factors. It presents with all the above characters in mixed form and because of antagonistic therapeutic principles, it is difficult to treat and therefore should be rejected. [15]
The severe type of ''unmada'' arising from ''sannipata'' (aggravation of all three ''doshas'') is caused by all the above etiological factors. It presents with all the above characters in mixed form and because of antagonistic therapeutic principles, it is difficult to treat and therefore should be rejected. [15]
=== ''Agantu unmada'' (exogenous type) ===
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Possession by the gods, sages, ''gandharvas'' (celestial choristers), ''pishachas'' (devils), ''yakshas'' (living supernatural being/spiritual apparition), ''rakshasas'' (demons) and ''pitru''(forefathers/ancestors spirits); unmethodical performance of spiritual rituals and vows etc. and the deeds of past life are the causes of the exogenous type of ''unmada''. [16]
Possession by the gods, sages, ''gandharvas'' (celestial choristers), ''pishachas'' (devils), ''yakshas'' (living supernatural being/spiritual apparition), ''rakshasas'' (demons) and ''pitru''(forefathers/ancestors spirits); unmethodical performance of spiritual rituals and vows etc. and the deeds of past life are the causes of the exogenous type of ''unmada''. [16]
=== Signs of ''bhutonmada'' (affliction of evil spirits) ===
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As said earlier in the diagnosis -section, prodromal features coincide with the entry of celestial beings. Now listen about the symptoms of various types separately, time of affliction and susceptible person. [19]
As said earlier in the diagnosis -section, prodromal features coincide with the entry of celestial beings. Now listen about the symptoms of various types separately, time of affliction and susceptible person. [19]
=== Various types of ''agantu unmada'' ===
==== Affliction by God ====
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Gentle look, serious, unassailable, unwrathful, having no desire for sleep and food, with decreased sweat, urine, stool and flatus, auspicious smell and face like blossomed lotus flower- are the characters of unmada caused due to affliction by gods.
Gentle look, serious, unassailable, unwrathful, having no desire for sleep and food, with decreased sweat, urine, stool and flatus, auspicious smell and face like blossomed lotus flower- are the characters of unmada caused due to affliction by gods.
==== Affliction by ''unmada'' due to affliction of guru etc. ====
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One having movements, diet and speech corresponding to type of ''abhishapa'' (curse), ''abhichara'' (magical spell) or ''abhidhyana'' (desire to transform by willpower), meditation of teacher, elders, accomplished person (''siddhas'') and sages should be known as ''unmada'' caused due to affliction by them (''rishis'' etc.) respectively.
One having movements, diet and speech corresponding to type of ''abhishapa'' (curse), ''abhichara'' (magical spell) or ''abhidhyana'' (desire to transform by willpower), meditation of teacher, elders, accomplished person (''siddhas'') and sages should be known as ''unmada'' caused due to affliction by them (''rishis'' etc.) respectively.
==== ''Unmada'' due to affliction of ancestors or forefathers ====
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Unhappy look, inability to see, drowsiness, interrupted speech, lack of desire for food, anorexia and indigestion are the characteristics of the person suffering from ''unmada'' caused due to affliction by ''pitris''(manes).
Unhappy look, inability to see, drowsiness, interrupted speech, lack of desire for food, anorexia and indigestion are the characteristics of the person suffering from ''unmada'' caused due to affliction by ''pitris''(manes).
==== ''Unmada'' due to affliction of ''gandharva'' (celestial musicians) ====
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Violent acts, over courageousness, sharpness, seriousness, invincibility, liking for vocal music, instrumental music played by mouth, dancing, singing, good food and drinks, garlands, incense, perfume, red apparels, ''bali'' (offerings of sacrifices), laughing, humorous talks and pleasant aroma from the body are the features of the patients suffering from ''unmada'' caused due to affliction by ''gandharvas'' (celestial musicians).
Violent acts, over courageousness, sharpness, seriousness, invincibility, liking for vocal music, instrumental music played by mouth, dancing, singing, good food and drinks, garlands, incense, perfume, red apparels, ''bali'' (offerings of sacrifices), laughing, humorous talks and pleasant aroma from the body are the features of the patients suffering from ''unmada'' caused due to affliction by ''gandharvas'' (celestial musicians).
==== ''Unmada'' due to affliction of ''yaksha'' ====
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Frequent sleep, cry and laugh, liking for dancing, singing, playing instruments, reciting sacred scriptures, liking for stories, good food and drinks, garlands, incense, perfume, red & tearful eyes ,despising ''dvijas'' (persons of families of ''brahmana, kshatriya'' and ''vaishyas''.) and physicians, disclosing the secrets are the features of the patients suffering from ''unmada'' caused due to affliction by ''yakshas'' (demigods, semi-divine celestial beings, attendants of ''Kubera'', the celestial physician).
Frequent sleep, cry and laugh, liking for dancing, singing, playing instruments, reciting sacred scriptures, liking for stories, good food and drinks, garlands, incense, perfume, red & tearful eyes ,despising ''dvijas'' (persons of families of ''brahmana, kshatriya'' and ''vaishyas''.) and physicians, disclosing the secrets are the features of the patients suffering from ''unmada'' caused due to affliction by ''yakshas'' (demigods, semi-divine celestial beings, attendants of ''Kubera'', the celestial physician).
==== ''Unmada'' due to affliction of ''rakshasa'' (demons) ====
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Sleeplessness, hatred for food and drinks, and excessive strength in spite of aversion for food, liking for weapons, blood, meat and red garlands and ferociousness are the features of the patients suffering from ''unmada'' caused due to affliction by ''rakshasas'' (demons).
Sleeplessness, hatred for food and drinks, and excessive strength in spite of aversion for food, liking for weapons, blood, meat and red garlands and ferociousness are the features of the patients suffering from ''unmada'' caused due to affliction by ''rakshasas'' (demons).
==== ''Unmada'' due to affliction of ''brahma-rakshasa'' (a class of evil demons) ====
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Excessive laughter, dance, hatred and disobedience to Gods, ''brahmins'' and physicians, reciting sacred scriptures and illustrations from hymns, the ''Vedas'' and ''mantras'' (incantations), injuring himself by pieces of wood etc. are the features of the patients suffering from ''unmada'' caused due to affliction by ''brahma-rakshasas'' (a class of evil demons).
Excessive laughter, dance, hatred and disobedience to Gods, ''brahmins'' and physicians, reciting sacred scriptures and illustrations from hymns, the ''Vedas'' and ''mantras'' (incantations), injuring himself by pieces of wood etc. are the features of the patients suffering from ''unmada'' caused due to affliction by ''brahma-rakshasas'' (a class of evil demons).
==== ''Unmada'' due to affliction of ''pishacha'' ====
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One who has impaired mind (fickle minded), does not find peace anywhere, dances, sings and laughs frequently, delirious with coherent or incoherent speech, fond of climbing on garbage, dirty lanes, cloth, grass, stone and wood, has hoarse and rough voice, remains naked, running and not standing at a place, always complaining of his miseries and sorrows before others and has lost his memory should be known as ''unmada'' caused due to affliction by ''pishacha'' (a class of demons). [20]
One who has impaired mind (fickle minded), does not find peace anywhere, dances, sings and laughs frequently, delirious with coherent or incoherent speech, fond of climbing on garbage, dirty lanes, cloth, grass, stone and wood, has hoarse and rough voice, remains naked, running and not standing at a place, always complaining of his miseries and sorrows before others and has lost his memory should be known as ''unmada'' caused due to affliction by ''pishacha'' (a class of demons). [20]
=== Days, time and susceptible persons for affliction ===
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''Rakshasa'' (demons) and ''pishachas'' (a class of evil demons) attack the person who has inferior psyche (devoid of will power), has back- biting tendency, fond of women, thief, greedy and wicked often on the second, third and eighth day of the fortnight. These are the eight prominent ones among innumerable ''grahas'' (seizures), which are described. [21]
''Rakshasa'' (demons) and ''pishachas'' (a class of evil demons) attack the person who has inferior psyche (devoid of will power), has back- biting tendency, fond of women, thief, greedy and wicked often on the second, third and eighth day of the fortnight. These are the eight prominent ones among innumerable ''grahas'' (seizures), which are described. [21]
=== Untreatable ''unmada'' ===
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Of the above varieties of ''unmadas,'' he who strikes at others or himself, without hesitation raising his hands with wrath and agitation should be considered as incurable. He who has tearful eyes, hemorrhage from penis, wounded tongue, running nose, a bruised skin, uninteractable hands, constantly groaning, deranged complexion, excessive thirst and foul smell should be known as maddened by a violent type of spirits (grahas) and should not be treated. [22]
Of the above varieties of ''unmadas,'' he who strikes at others or himself, without hesitation raising his hands with wrath and agitation should be considered as incurable. He who has tearful eyes, hemorrhage from penis, wounded tongue, running nose, a bruised skin, uninteractable hands, constantly groaning, deranged complexion, excessive thirst and foul smell should be known as maddened by a violent type of spirits (grahas) and should not be treated. [22]
=== Management principles ===
रत्यर्चनाकामोन्मादिनौ तु भिषगभिप्रायाचाराभ्यां बुद्ध्वा तदङ्गोपहारबलिमिश्रेण| <br />
रत्यर्चनाकामोन्मादिनौ तु भिषगभिप्रायाचाराभ्यां बुद्ध्वा तदङ्गोपहारबलिमिश्रेण| <br />
In exogenous type of ''unmada'', intake of ghee (''sarpih pana'') etc. along with chanting of hymns (mantras) is recommended for the benefit of the patient. [24-32]
In exogenous type of ''unmada'', intake of ghee (''sarpih pana'') etc. along with chanting of hymns (mantras) is recommended for the benefit of the patient. [24-32]
=== Various formulations ===
==== ''Hingvadi ghee'' ====
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''Hingu, sauvarchala'' and ''trikatu'' (''shunthi , maricha'' and ''pippali'' ) each 80 gm (two ''palas'') should be made to paste and cooked with one ''adhaka'' of ghee (2.56 kg ) and four times cow’s urine is a tested destroyer of ''unmada''.[33-34]
''Hingu, sauvarchala'' and ''trikatu'' (''shunthi , maricha'' and ''pippali'' ) each 80 gm (two ''palas'') should be made to paste and cooked with one ''adhaka'' of ghee (2.56 kg ) and four times cow’s urine is a tested destroyer of ''unmada''.[33-34]
==== ''Kalyanaka'' ghee ====
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This ghee is useful in epilepsy, fever, cough, poor digestion, wasting, ''vatarakta,'' coryza, tertian and quaternary fever, vomiting, piles, dysuria, erysipelas, itching, anemia, ''unmada,'' poisoning, ''prameha'', mental affection by supernatural beings (evil spirits), stammering voice, loss of consciousness and female sterility. It promotes life span, wealth and strength. It alleviates inauspiciousness, sins and micro-organism including all the ''grahas'' (seizures). This ''kalyanaka ghrita'' is also excellent for ''punsavana'' (''samskara'' for formation of fetus). [35-41,1/2]
This ghee is useful in epilepsy, fever, cough, poor digestion, wasting, ''vatarakta,'' coryza, tertian and quaternary fever, vomiting, piles, dysuria, erysipelas, itching, anemia, ''unmada,'' poisoning, ''prameha'', mental affection by supernatural beings (evil spirits), stammering voice, loss of consciousness and female sterility. It promotes life span, wealth and strength. It alleviates inauspiciousness, sins and micro-organism including all the ''grahas'' (seizures). This ''kalyanaka ghrita'' is also excellent for ''punsavana'' (''samskara'' for formation of fetus). [35-41,1/2]
==== ''Mahakalyanaka ghee'' ====
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In the same way, the twenty one drugs beginning with ''sthira'' (''shalparni'') are boiled in water. With this decoction ghee is cooked adding four times milk of ''primi para'' cow (milk collected from the cow after its first delivery) and paste of vira, two types of ''masha'' (''masha'' and ''rajmasha'') , ''kakoli, kapikacchu, rishabhaka'' and ''riddhi''. This ''mahakalyanaka ghrita'' is particularly nourishing (bulk promoting) and an excellent alleviator of ''sannipata'' (simultaneous vitiation of all three ''doshas''). [42 1/2-44]
In the same way, the twenty one drugs beginning with ''sthira'' (''shalparni'') are boiled in water. With this decoction ghee is cooked adding four times milk of ''primi para'' cow (milk collected from the cow after its first delivery) and paste of vira, two types of ''masha'' (''masha'' and ''rajmasha'') , ''kakoli, kapikacchu, rishabhaka'' and ''riddhi''. This ''mahakalyanaka ghrita'' is particularly nourishing (bulk promoting) and an excellent alleviator of ''sannipata'' (simultaneous vitiation of all three ''doshas''). [42 1/2-44]
==== ''Mahapaishachika ghee'' ====
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Ghee processed with drugs like ''jatamansi, haritaki, bhutkeshi, charati, kapikacchu, vacha, trayamana, jaya'' (''jayanti''), ''vira''(''kshirakakoli''), ''choraka, katurohini, vayastha, varahi, chhatra, atichhatra, palankasha, shatavari, kayastha,'' two types of ''nakuli'' (''nakuli'' and ''gandha nakuli''), ''katabhi'' and ''shalaparni'', is known as ''mahapaishachika ghrita''. It is like ambrosia and alleviates quartan fever, ''unmada'', epilepsy. It also promotes intellect and memory and help in development of children. This is ''mahapaishachika ghrita''. [45-48]
Ghee processed with drugs like ''jatamansi, haritaki, bhutkeshi, charati, kapikacchu, vacha, trayamana, jaya'' (''jayanti''), ''vira''(''kshirakakoli''), ''choraka, katurohini, vayastha, varahi, chhatra, atichhatra, palankasha, shatavari, kayastha,'' two types of ''nakuli'' (''nakuli'' and ''gandha nakuli''), ''katabhi'' and ''shalaparni'', is known as ''mahapaishachika ghrita''. It is like ambrosia and alleviates quartan fever, ''unmada'', epilepsy. It also promotes intellect and memory and help in development of children. This is ''mahapaishachika ghrita''. [45-48]
==== ''Lashunadya ghee'' ====
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One hundred dehusked bulbs of garlic, 30 fruits of ''haritaki, trikatu'' 40 gm ,ash of cow leather 640 gm, cow milk and cow urine 5.12kg should be well cooked with ten year old cow ghee 640 gm .After it is well cooked and cooled, 40 gms of powder of ''hingu''(asafoetida) and honey 320gm should be added .This ''lashunadya ghrita'' applied in the form of intake, massage and snuffing alleviates quickly all types of ''unmada'', both endogenous and exogenous, intermittent fever and epilepsy. [49-51]
One hundred dehusked bulbs of garlic, 30 fruits of ''haritaki, trikatu'' 40 gm ,ash of cow leather 640 gm, cow milk and cow urine 5.12kg should be well cooked with ten year old cow ghee 640 gm .After it is well cooked and cooled, 40 gms of powder of ''hingu''(asafoetida) and honey 320gm should be added .This ''lashunadya ghrita'' applied in the form of intake, massage and snuffing alleviates quickly all types of ''unmada'', both endogenous and exogenous, intermittent fever and epilepsy. [49-51]
==== Second formulation of ''lashunadya ghrita'' ====
Undamaged garlic decorticated -200gm, ''dashamula'' -100gm should be boiled in 5.12 liters of water and reduced to one fourth. Thereafter ghee -640 gm garlic juice -640 gm along with the juice of ''kola'' (jujube), radish, ''vrikshamla, matulunga'' and fresh ginger, pomegranate, ''sura'', curd water and sour gruel -each 320 ml and the past of ''triphala, devadaru,'' rocksalt, ''trikatu, ajamoda, yavani, chavya, hingu'' and ''amlavetasa'' -each 20 gm should be cooked. This medicated ghee by intake alleviates colic, ''gulma'', piles, ''udara'', inguinal hernia, anemia, spleen enlargement, female genital disorders, fever, worms, disorder of ''vata, kapha'' and all types of ''unmada''. [52-56]
Undamaged garlic decorticated -200gm, ''dashamula'' -100gm should be boiled in 5.12 liters of water and reduced to one fourth. Thereafter ghee -640 gm garlic juice -640 gm along with the juice of ''kola'' (jujube), radish, ''vrikshamla, matulunga'' and fresh ginger, pomegranate, ''sura'', curd water and sour gruel -each 320 ml and the past of ''triphala, devadaru,'' rocksalt, ''trikatu, ajamoda, yavani, chavya, hingu'' and ''amlavetasa'' -each 20 gm should be cooked. This medicated ghee by intake alleviates colic, ''gulma'', piles, ''udara'', inguinal hernia, anemia, spleen enlargement, female genital disorders, fever, worms, disorder of ''vata, kapha'' and all types of ''unmada''. [52-56]
==== Different useful recipes of medicated ghee ====
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After administrating the maximum dose the patient should be kept in isolation in some underground ditch or room. Particularly old ghee should be administrated to the patients of ''unmada''. [57-58]
After administrating the maximum dose the patient should be kept in isolation in some underground ditch or room. Particularly old ghee should be administrated to the patients of ''unmada''. [57-58]
=== Therapeutic utility of old ghee ===
Old ghee alleviates ''tridosha'', particularly destroys demonic seizures because of being pure/sacred nature, by intake is more potent in properties and is pungent- bitter in taste. The ghee stored for ten years is taken as old (''puraana ghrita''). It is irritant in smell. In color it is like solution of lacquer in appearance, cold and destroys all ''grahas''. It promotes intellect and is an excellent purgative.
Old ghee alleviates ''tridosha'', particularly destroys demonic seizures because of being pure/sacred nature, by intake is more potent in properties and is pungent- bitter in taste. The ghee stored for ten years is taken as old (''puraana ghrita''). It is irritant in smell. In color it is like solution of lacquer in appearance, cold and destroys all ''grahas''. It promotes intellect and is an excellent purgative.
Ghee kept beyond ten years is called as ''pra-purana'' (extremely old). There is no disease, which is incurable for the ghee which is old by one hundred years. It destroys all the ''grahas'' by seeing, touching, inhaling and is particularly recommended for those suffering from epilepsy (''apasmara''), ''grahas'' (demonic seizures) and ''unmada'' . [59-62]
Ghee kept beyond ten years is called as ''pra-purana'' (extremely old). There is no disease, which is incurable for the ghee which is old by one hundred years. It destroys all the ''grahas'' by seeing, touching, inhaling and is particularly recommended for those suffering from epilepsy (''apasmara''), ''grahas'' (demonic seizures) and ''unmada'' . [59-62]
=== External applications in ''vata-kapha'' dominant ''unmada'' ===
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''Maricha'' impregnated with (the above) bile and kept in the sun for a month makes a collyrium which is useful in defects of vision and loss of memory caused by vitiated ''doshas'' and demonic seizures. [681/2-1/2 69]
''Maricha'' impregnated with (the above) bile and kept in the sun for a month makes a collyrium which is useful in defects of vision and loss of memory caused by vitiated ''doshas'' and demonic seizures. [681/2-1/2 69]
==== ''Siddharthakadi Agada'' ====
White mustard, ''vacha, hingu, karanja, devadaru, manjishtha, triphala, shveta, katabhi'' (bark), ''trikatu, priyangu, shirisha'' and two types of ''haridra'' – all taken in equal quantity are powdered with goat’s urine. This is an anti-poison formulation and used as intake, collyrium, snuff, paste, bath and anointing. It alleviates epilepsy, poisoning, ''unmada,'' magical spells, inauspiciousness and fever. It averts fear from the spirits and also protects in royal place.
White mustard, ''vacha, hingu, karanja, devadaru, manjishtha, triphala, shveta, katabhi'' (bark), ''trikatu, priyangu, shirisha'' and two types of ''haridra'' – all taken in equal quantity are powdered with goat’s urine. This is an anti-poison formulation and used as intake, collyrium, snuff, paste, bath and anointing. It alleviates epilepsy, poisoning, ''unmada,'' magical spells, inauspiciousness and fever. It averts fear from the spirits and also protects in royal place.
*In the ''unmada'' caused by ''vata'' and ''kapha'', sprinkling collyrium(''anjana''), blowing(''pradhamana''), snuffing(''nasya'') and smoking(fumigation) should be done with application of urine, bile, feces, skin, hairs, nails and hide of porcupine (''shallaka''), owl (''uluka''), cat (''marjara''), jackal (''jambuka''), wolf (''vrika'') and goat (''basta''). [741/2-1/2 76]
*In the ''unmada'' caused by ''vata'' and ''kapha'', sprinkling collyrium(''anjana''), blowing(''pradhamana''), snuffing(''nasya'') and smoking(fumigation) should be done with application of urine, bile, feces, skin, hairs, nails and hide of porcupine (''shallaka''), owl (''uluka''), cat (''marjara''), jackal (''jambuka''), wolf (''vrika'') and goat (''basta''). [741/2-1/2 76]
=== Treatment of ''pitta'' dominant ''unmada'' ===
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In ''pitta'' dominant type of ''unmada'', the patients should be given ''tikta'', and ''jivaniya ghrita'' (ghee cooked with bitter and vitalisers e.g. ''maha tiktaka ghrita'' ([[Chikitsa Sthana]] chapter 7 ) and ''jivaniya ghrita'' ([[Chikitsa Sthana]] chapter 29) and ''mishraka sneha'' ([[Chikitsa Sthana]] chapter 5) are efficacious. Moreover, the patient should be given cold, sweet and soft food and drinks or the physician should perform blood-letting vein situated at the joining place of temple and the end of hair line in ''unmada'', irregular fever and epilepsy. [76-77]
In ''pitta'' dominant type of ''unmada'', the patients should be given ''tikta'', and ''jivaniya ghrita'' (ghee cooked with bitter and vitalisers e.g. ''maha tiktaka ghrita'' ([[Chikitsa Sthana]] chapter 7 ) and ''jivaniya ghrita'' ([[Chikitsa Sthana]] chapter 29) and ''mishraka sneha'' ([[Chikitsa Sthana]] chapter 5) are efficacious. Moreover, the patient should be given cold, sweet and soft food and drinks or the physician should perform blood-letting vein situated at the joining place of temple and the end of hair line in ''unmada'', irregular fever and epilepsy. [76-77]
=== Isolation of ''unmada'' patients ===
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The patient should be restricted to wind-free place after taking meat and ghee in his diet to his satisfaction as a result, the patient overcomes the loss of intellect and memory and regains sense and consciousness. Thus, he becomes free from disease. [78]
The patient should be restricted to wind-free place after taking meat and ghee in his diet to his satisfaction as a result, the patient overcomes the loss of intellect and memory and regains sense and consciousness. Thus, he becomes free from disease. [78]
=== Psychotherapy and other therapies ===
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The danger to the life is above that of the fear of injury to the body. Therefore, the perverted mind of the patient as such gets distracted from all directions and gets pacification and regains normalcy through the above mentioned measures. [84]
The danger to the life is above that of the fear of injury to the body. Therefore, the perverted mind of the patient as such gets distracted from all directions and gets pacification and regains normalcy through the above mentioned measures. [84]
=== Therapies in mental trauma patients ===
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If the mental derangement is due to the passion (''kama''), grief (''shoka''), fear (''bhaya''), anger (''krodha''), exhilaration (''harsha''), envy (''irshya''), and greed (''lobha''), they should be pacified by their mutually antagonizing and contradictory factors . [85-86]
If the mental derangement is due to the passion (''kama''), grief (''shoka''), fear (''bhaya''), anger (''krodha''), exhilaration (''harsha''), envy (''irshya''), and greed (''lobha''), they should be pacified by their mutually antagonizing and contradictory factors . [85-86]
=== Spriritual therapies in exogenous type of ''unmada'' ===
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The person having preponderance of ''sattva'' (strong mental strength), abstaining from meat and wine, taking wholesome diet, sincere and disciplined and observing purity of mind and body is not affected by either endogenous or exogenous type of ''unmada''. [96]
The person having preponderance of ''sattva'' (strong mental strength), abstaining from meat and wine, taking wholesome diet, sincere and disciplined and observing purity of mind and body is not affected by either endogenous or exogenous type of ''unmada''. [96]
=== Signs of complete cure of ''unmada'' ===
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Blissful feeling (in perception) of sense objects and also of intellect, self and mind along with normalcy of tissue elements (''dhatus'') are the signs of having recovered from ''unmada''. [97]
Blissful feeling (in perception) of sense objects and also of intellect, self and mind along with normalcy of tissue elements (''dhatus'') are the signs of having recovered from ''unmada''. [97]
=== Summary ===
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== Vidhi Vimarsha (Applied Inferences ) ==
== Vidhi Vimarsha (Applied Inferences ) ==
=== Similar conditions observed in contemporary psychiatry ===
==== ''Nija unmada'' (endogenous psychoses) ====
#''Vata'' dominant ''unmada'' is similar to excited catatonic type of schizophrenia and is acute form of schizophrenia. These patients present with the symptoms of catatonic excitement with general symptoms of ''unmada''. It is produced due to vitiation of ''vata'' along with ''rajas'' and ''tamas doshas''. Due to excess of ''rajas'' and ''vata'', catatonic excitement occurs.
#''Vata'' dominant ''unmada'' is similar to excited catatonic type of schizophrenia and is acute form of schizophrenia. These patients present with the symptoms of catatonic excitement with general symptoms of ''unmada''. It is produced due to vitiation of ''vata'' along with ''rajas'' and ''tamas doshas''. Due to excess of ''rajas'' and ''vata'', catatonic excitement occurs.
#All types of chronic, incapacitating psychotic conditions are included under the category of ''sannipatika / tridoshaja unmada''. Hebephrenic schizophrenia, chronic schizophrenia and residual schizophrenia come under this category, again the difference being predominance of the ''doshas'' involved in the psychopathogenesis.
#All types of chronic, incapacitating psychotic conditions are included under the category of ''sannipatika / tridoshaja unmada''. Hebephrenic schizophrenia, chronic schizophrenia and residual schizophrenia come under this category, again the difference being predominance of the ''doshas'' involved in the psychopathogenesis.
==== ''Agantuja unmada'' (exogenous psychoses)====
#Various psychoses due to possession of ''grahas'' and ''bhutas'' (supernatural beings) are included under ''agantuja unmada'', which should be regarded as suffering from paranoid schizophrenia, paranoia and various other paranoid states. Paranoid schizophrenia is characterized by predominance of delusions.
#Various psychoses due to possession of ''grahas'' and ''bhutas'' (supernatural beings) are included under ''agantuja unmada'', which should be regarded as suffering from paranoid schizophrenia, paranoia and various other paranoid states. Paranoid schizophrenia is characterized by predominance of delusions.
#It is important to mention that ''grahas'' have been christened only on the basis of the resemblance of the clinical features of the afflicted individual with the activities of those grahas e.g. gods, gandharvas etc. It is not that these have entered into the the body of the afflicted individual. This is just the way of presentation and the writing style in [[Ayurveda]] to personify an event/process. This form of presentation is somewhat similar to syndromic classification in conventional modern medicine. Because of similarity of clinical symptoms, the patients are said to be suffering from some ''graha.'' These individual syndromes can also be correlated to a single disease entity from modern perspective.
#It is important to mention that ''grahas'' have been christened only on the basis of the resemblance of the clinical features of the afflicted individual with the activities of those grahas e.g. gods, gandharvas etc. It is not that these have entered into the the body of the afflicted individual. This is just the way of presentation and the writing style in [[Ayurveda]] to personify an event/process. This form of presentation is somewhat similar to syndromic classification in conventional modern medicine. Because of similarity of clinical symptoms, the patients are said to be suffering from some ''graha.'' These individual syndromes can also be correlated to a single disease entity from modern perspective.
=== Management of ''unmada'' ===
==== ''Yuktivyapashraya Chikitsa'' (rational treatment) ====
The purification procedures prescribed in ''unmada'' are :(1) ''Nasya'' (2) ''Vamana'' (3) ''Virechana'' (4) ''Niruha basti'' (5) ''Anuvasana basti''. Besides these five chief ''karmas'', two other preparatory and axillary ''karmas'' are indicated i.e. ''snehana karma'' and ''swedana karmas''. ''Snehana karmas'' are also carried out as ''shamana'' (pacification) therapy with low dose ''sneha''. Especially in major psychiatric illness it is considered as a separate therapy. The other measures like ''pradeha, utsadana, abhyanga, dhuma, snehapana,'' etc. are also administered which stimulates the mind, intellect, memory and consciousness of the patient.
The purification procedures prescribed in ''unmada'' are :(1) ''Nasya'' (2) ''Vamana'' (3) ''Virechana'' (4) ''Niruha basti'' (5) ''Anuvasana basti''. Besides these five chief ''karmas'', two other preparatory and axillary ''karmas'' are indicated i.e. ''snehana karma'' and ''swedana karmas''. ''Snehana karmas'' are also carried out as ''shamana'' (pacification) therapy with low dose ''sneha''. Especially in major psychiatric illness it is considered as a separate therapy. The other measures like ''pradeha, utsadana, abhyanga, dhuma, snehapana,'' etc. are also administered which stimulates the mind, intellect, memory and consciousness of the patient.
Even after the body is cleansed, if the patient exhibits perversion of conduct, he should be given strong ''navanam, anjanam, taadanam.''
Even after the body is cleansed, if the patient exhibits perversion of conduct, he should be given strong ''navanam, anjanam, taadanam.''
==== Concept and rationale of ''ghrita-pana/ shamana sneha pana'' ====
''Snehapana'' is specially indicated in ''unmada. Shamana sneha'' includes the measures that bring down the increased ''doshas'' to normal stage without expelling them out and without disturbing balance of other normal ''doshas''. The properties like ''sukshma, snigdha, picchila'' and ''manda'' operate pharmacologically to pacify ''unmada''.
''Snehapana'' is specially indicated in ''unmada. Shamana sneha'' includes the measures that bring down the increased ''doshas'' to normal stage without expelling them out and without disturbing balance of other normal ''doshas''. The properties like ''sukshma, snigdha, picchila'' and ''manda'' operate pharmacologically to pacify ''unmada''.
==== Recommended therapies for ''dosha'' dominant ''unmada'' ====
#''Snehana'' (oleation)
#''Snehana'' (oleation)
#''sira vedha'' (venesection) .
#''sira vedha'' (venesection) .
==== Specific therapies by ''dosha'' dominant ''unmada'' , and prescribed medicines====
#'''''Vata'' dominance''': ''Snehapana, mrudu shodhana, Samsarjana, swedana, niruha, shirovirechana, dhupana, anjana, dhuma, lepana, snana.''
#'''''Vata'' dominance''': ''Snehapana, mrudu shodhana, Samsarjana, swedana, niruha, shirovirechana, dhupana, anjana, dhuma, lepana, snana.''
##'''Medicines''': ''Kalyanaghrita, mahakalyanghrita, phalaghrita, hinguvadi ghrita, mahapaishachakaghrita, lasunadighrita, vyosadivarti, sirishadivarti, apamargadi varti, marichadivarti, siddharthakadyagada, shallakyadyagada, srugaladiyoga, brahmyadivarti.''
##'''Medicines''': ''Kalyanaghrita, mahakalyanghrita, phalaghrita, hinguvadi ghrita, mahapaishachakaghrita, lasunadighrita, vyosadivarti, sirishadivarti, apamargadi varti, marichadivarti, siddharthakadyagada, shallakyadyagada, srugaladiyoga, brahmyadivarti.''
#'''Daivavyapashraya Chikitsa''': One who worships Lord shiva, the supreme controller of all the ''bhutas'', and the omnipotent master of whole universe regularly with devotion becomes free from attack of ''unmada''. Worshipping ''pramathas'', attendants of Rudra also cures ''unmada''. ''Bali, mangala'' (recitation of mantras), ''homa, aushadha agadadhaarana,'' observing truth fullness, maintaining good conduct, ''tapas'', charity, offering prayers to gods, cows, ''brahmins,'' and teachers and by using ''siddha mantras'' and ''aushadhis'' one can cure ''unmada''.
#'''Daivavyapashraya Chikitsa''': One who worships Lord shiva, the supreme controller of all the ''bhutas'', and the omnipotent master of whole universe regularly with devotion becomes free from attack of ''unmada''. Worshipping ''pramathas'', attendants of Rudra also cures ''unmada''. ''Bali, mangala'' (recitation of mantras), ''homa, aushadha agadadhaarana,'' observing truth fullness, maintaining good conduct, ''tapas'', charity, offering prayers to gods, cows, ''brahmins,'' and teachers and by using ''siddha mantras'' and ''aushadhis'' one can cure ''unmada''.
==== Useful single drugs mentioned in unmada ====
''Shankapushpi, Amalaki, . Mandukaparni , Sarpagandha, Brahmi , Rasona, Vacha, Devadaru, Jyotishmati, Jatiphala, Jatamansi, Mochaka, Kushtha, Karpura, Tagara ,Haritaki ,Parasikyavani, Vibhitaki, Palandu, Ashwagandha, Hingu, Kushmanda, Shatavari, Hema'' (gold),
''Shankapushpi, Amalaki, . Mandukaparni , Sarpagandha, Brahmi , Rasona, Vacha, Devadaru, Jyotishmati, Jatiphala, Jatamansi, Mochaka, Kushtha, Karpura, Tagara ,Haritaki ,Parasikyavani, Vibhitaki, Palandu, Ashwagandha, Hingu, Kushmanda, Shatavari, Hema'' (gold)
==== Compound Formulations ====
#Ghrita- Medicated ghee preparations:
#Ghrita- Medicated ghee preparations:
##Kalyanakaghrita
##Kalyanakaghrita
##Marichadyanjana
##Marichadyanjana
=== ''Pathya Apathya'' (Dietary Indications and contraindications)===
==== ''Pathya'' ====
It is said that he who suffers from unmada should maintain cleanliness and consume food and drink, that are relishing and easily digestible, the following articles have been recommended in unmada:
It is said that he who suffers from unmada should maintain cleanliness and consume food and drink, that are relishing and easily digestible, the following articles have been recommended in unmada:
#Paniyavarga - drink/beverages gangambu (rain water) madya (alcohol) rasala (Sugar cane) Kulmasatarpana (gruel of kulmasa)
#Paniyavarga - drink/beverages gangambu (rain water) madya (alcohol) rasala (Sugar cane) Kulmasatarpana (gruel of kulmasa)
==== ''Satvavajaya'' ====
The methods of yuktivyapasraya treatment have been prescribed in the treatment of mental diseases. But in the derailment of manasika doshas, it is essential that the line of treatment of mental diseases should be specific and based on the theory of balancing the mental doshas (rajas and tamas). Taking into consideration all these factors, most probably in [[Ayurveda]] a separate classification of satvavajaya treatment has been specially mentioned. Charak defines it as a mind control therapy in which stress will be laid on restraining the mind from unwholesome arthas (objects). Certain techniques have been mentioned for this therapy.
The methods of yuktivyapasraya treatment have been prescribed in the treatment of mental diseases. But in the derailment of manasika doshas, it is essential that the line of treatment of mental diseases should be specific and based on the theory of balancing the mental doshas (rajas and tamas). Taking into consideration all these factors, most probably in [[Ayurveda]] a separate classification of satvavajaya treatment has been specially mentioned. Charak defines it as a mind control therapy in which stress will be laid on restraining the mind from unwholesome arthas (objects). Certain techniques have been mentioned for this therapy.
#Kula-kala, desha, bala jnana: The knowledge about ones own self, country, family, age, vitality and ability.
#Kula-kala, desha, bala jnana: The knowledge about ones own self, country, family, age, vitality and ability.
=== Summary ===
Manovahasrotas can be understood as the channels conducting various factors that regulate behavior. Vitiation of these srotas at different levels produce abnormal behavioral patterns thereby bringing about the psychological & behavioural symptoms of unmada vis-à-vis psychosis. A number of formulations, treatment modalities, procedures and therapeutic techniques have been described with predominance of lipid predominant dosage forms esp. ghritas & tailas, which seems to be so formulated as to exert maximum effect on neural tissue by increasing bio-availability of formulation by increased ability to cross blood –brain barrier. All the preventive measures mentioned by Acaryas are aimed at bestowing relaxation and mental balance, which are the basic prerequisites of a sound mind. It may be mentioned here that sharira shuddhi is needed before attaining manasika shuddhi.
Manovahasrotas can be understood as the channels conducting various factors that regulate behavior. Vitiation of these srotas at different levels produce abnormal behavioral patterns thereby bringing about the psychological & behavioural symptoms of unmada vis-à-vis psychosis. A number of formulations, treatment modalities, procedures and therapeutic techniques have been described with predominance of lipid predominant dosage forms esp. ghritas & tailas, which seems to be so formulated as to exert maximum effect on neural tissue by increasing bio-availability of formulation by increased ability to cross blood –brain barrier. All the preventive measures mentioned by Acaryas are aimed at bestowing relaxation and mental balance, which are the basic prerequisites of a sound mind. It may be mentioned here that sharira shuddhi is needed before attaining manasika shuddhi.