Charak Samhita

Difference between revisions of "Stambhana"

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<p style="text-align:justify;">The word ‘stambhana’ literally means to stop or to stiffen, making it rigid or immovable. It denotes the actions of blocking, arresting, checking, restraining etc.<ref>Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Stambhana, Page 1258.</ref> It is one of six important therapies. [Cha.Sa.[[Sutra Sthana]] 22/04] This therapy is indicated to stop excess discharges of body fluids. </p>
  
−
The word stambhana literally means stiffening, making rigid or immovable. It also represents stopping, arresting, checking, restraining etc. In Ayurveda stambhana denotes a symptom and as a treatment method also. This article deals with stambhana as a treatment.  
+
{{Infobox
 +
 
 +
|title =  Contributors
 +
 
 +
|label1 = Section/Chapter/topic
 +
|data1 = [[Chikitsa]] / [[Stambhana]]
 +
 
 +
|label2 = Authors
 +
|data2 = Aneesh E.G., [[Yogesh Deole|Deole Yogesh S.]]
 +
 
 +
|label3 = Reviewed and Edited by
 +
|data3 = [[Gopal Basisht|Basisht G.]]
 +
 
 +
|label4 = Affiliations
 +
|data4 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India,
 +
 +
 
 +
|label5 = Correspondence email:
 +
|data5 = draneesheg@gmail.com,
 +
dryogeshdeole@gmail.com,
 +
carakasamhita@gmail.com
 +
 
 +
|label6 = Publisher
 +
|data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India
 +
 
 +
|label7 = Date of first publication:
 +
|data7 = April 30, 2021
 +
 
 +
|label8 = DOI
 +
|data8 = 10.47468/CSNE.2021.e01.s09.053
 +
}}
 +
 
 +
<div style='text-align:justify;'>
  
 
==Etymology and derivation==
 
==Etymology and derivation==
  
−
Stambhana is derived from the root word ‘stambha’ by adding ‘lyut’ suffix, which means ‘to make stiff’ or ‘to stop’. [Vachaspatyam]   
+
‘Stambhana’ is derived from the root word ‘stambha’ by adding ‘lyut’ suffix, which means ‘to make stiff’ or ‘to stop’. [Vachaspatyam]   
  
 
==Definition==
 
==Definition==
  
−
The therapy which causes inhibition of mobility, flow of bodily substances and stabilizes is called stambhana. [Cha.Sa.[[Sutra Sthana]] 22/12]
+
The therapy which inhibits or stops mobile, flowing body constituents and stabilizes them is called ‘stambhana’. [Cha.Sa.[[Sutra Sthana]] 22/12]
  
 
==Synonyms==
 
==Synonyms==
  
−
Stambhana, upastambhana, grahi [Arunadatta on A.Hr Sutrasthana 27/48]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>
+
Stambhana, upastambhana, grahi [Arunadatta on A.Hr Sutra Sthana 27/48]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>
  
 
==Contextual meanings==
 
==Contextual meanings==
  
−
The term stambhana represents the following meanings in different contexts  
+
The term ‘stambhana’ denotes the following meanings in different contexts:
−
*To restrict the flow of blood (styptic/haemostatic)
+
*To check the bleeding  e.g.raktastambhana (styptic/hemostatic)
−
*To restrict the flow of stools (constipating)  
+
*To restrict the flow of stools (constipating) e.g.malavashtambha (constipation)  
−
*Stiffness/restrictions in movement of a particular body part
+
*Stiffness/restrictions in movement of a particular body part e.g.urustambha (stiffness of thigh)
  
−
==Methods to arrest bleeding==
+
==Stambhana therapy==
 +
 +
The therapy is done by use of food or medicines having sweet, bitter, and astringent tastes. Those with liquid, thin, stable and cold properties are also applied in stambhana therapy.[Cha.Sa.[[Sutra Sthana]] 22/32]
  
−
4 procedures are mentioned to arrest the excessive bleeding.
+
==Properties==
−
#Sandana
 
−
#Skandana
 
−
#Pachana
 
−
#Dahana
 
−
Sandana: By using decoctions which have predominance of astringent taste
 
−
Skandana: By the application of cold
 
−
Pachana: By powdering over the bleeding site
 
−
Dahana: By constricting the blood vessel through cauterization [Su.Sa.Sutra Sthana 14/39-40]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>
 
  
−
==Methods for stambhana==
+
The substance having cooling effect, slow acting, softness, smoothness, dryness, minuteness (subtleness), liquid state, stability and lightness qualities can produce stambhana effect. [Cha.Sa.[[Sutra Sthana]] 22/17]
  
−
*Use of substances having sweet, bitter and astringent tastes
+
Dryness (ruksha guna), cold potency (shita virya), astringent taste (kashayaa rasa) and light in digestion (laghu paka) are essential properties for stambhana effect. [Sha.Purvakhanda 04/12]<ref name= Shargadara> Sharangadhara. Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.</ref>
−
*Use of drugs with liquid, thin, stable and cold properties.[Cha.Sa.[[Sutra Sthana]] 22/32]
 
  
−
==Properties of stambhana drugs==
+
==Food and medicines==
 +
*Water is the best for stambhana effect [Cha.Sa.[[Sutra Sthana]] 25/40]
 +
*Alkali [Su.Sa.Sutra Sthana 11/5]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>
 +
*Lodhradigana [Su.Sa.Sutra Sthana 38/15]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref>
 +
*Kutaja (Holarrhena pubescens)[Sha.Purvakhanda 04/12]<ref name=Shargadara/>
 +
*Shyonaka (Oroxylum indicum)[Sha.Purvakhanda 04/12]<ref name=Shargadara/>
  
−
The drugs which possess cold, sluggish, soft, smooth, dry, minute (subtle), liquid, stable and light qualities can produce stambhana. [Cha.Sa.[[Sutra Sthana]] 22/17]
+
==Indications==
  
−
The drug which increases the vata dosha due to its dry property (ruksha), cold potency (shita virya), astringent taste (kashaya rasa) and light in digestion (laghu paka) is called stambhana drug. [Sha.Pu.04/12]<ref name= Shargadara> Sharangadhara. Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.</ref>
+
*Persons afflicted with corrosive actions of [[pitta]][[dosha]], alkali and fire
 +
*Vomiting and diarrhea
 +
*Poisoning
 +
*Complications of excessive sudation ([[swedana]])[Cha.Sa.[[Sutra Sthana]] 22/33]
 +
*Weak individuals [A.S.Chikitsa Sthana 10/26]<ref name= Sangraha> Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.</ref>
  
−
The taste (rasa) with stambhana property : Astringent (kashaya) [Cha.Sa.[[Sutra Sthana]] 26/43]
+
==Assessment of therapy==
 +
 +
===Clinical features of optimum stambhana===
  
−
Stambhana action is attributed to these drugs
+
The optimal effect of stambhana is assessed based on clinical observations as below:
−
*The best stambhana material is water. [Cha.Sa.[[Sutra Sthana]] 25/40]
+
*Pacification of diseases like vomiting, diarrhea etc.
−
*Alkali [Su.Sa.Sutra Sthana 11/5]<ref name=Susruta/>
+
*Regaining strength and normal state of body tissues [Cha.Sa.[[Sutra Sthana]] 22/39]
−
*Lodradigana [Su.Sa.Sutra Sthana 38/15]<ref name=Susruta/>
 
−
*Holarrhena pubescens(kutaja)[Sha.Pu.04/12]<ref name=Shargadara/>
 
−
*Shyonaka (Oroxylum indicum)[Sha.Pu.04/12]<ref name=Shargadara/>
 
  
−
==Indications==
+
===Clinical features of excessive stambhana===
  
−
*Patients afflicted with [[pitta]], alkali and fire
+
Following are clinical features of excessive administration of stambhana:
−
*Those who are afflicted with vomiting and diarrhea
+
*Blackish discoloration
−
*Those who are afflicted with poison
+
*Stiffness of body parts including jaw
−
*During excessive fomentation.[Cha.Sa.[[Sutra Sthana]] 22/33]
+
*Congestion in chest or bradycardia
−
*If the patient is having less strength [A.S Chikitsa Sthana 10/26]<ref name= Sangraha> Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.</ref>
+
*Feeling of uneasiness
 +
*Constipation [Cha.Sa.[[Sutra Sthana]] 22/40]
  
−
==Signs and symptoms of optimum stambhana==
+
The stambhana therapy is stopped immediately after observing above untoward effects.
  
−
By proper stambhana therapy the diseases like excessive vomiting, diarrhea etc gets cured and patient regains the strength of the body. [Cha.Sa.[[Sutra Sthana]] 22/39]
+
==Importance of Stambhana==
  
−
==Signs and symptoms of excessive administration of stambhana==
+
Stambhana acts as a regulator or controller of various processes and activities. It increases [[kapha]][[dosha]] and pacifies [[vata]] and [[pitta]] [[dosha]]. It is indicated in the treatment of disorders due to excess mobility of [[vata]][[dosha]] for stability. It soothes the excess heat or acute effects of [[pitta]] [[dosha]]. Moreover, the astringent and dryness help to bind the tissues.
 
   
 
   
−
Excessive administration of stambhana may lead to the appearance of blackish discoloration, stiffness of body parts including jaw, catching type of pain in cardiac region, feeling of uneasiness and constipation.[Cha.Sa.[[Sutra Sthana]] 22/40]
+
Stambhana is a type of expressed nasal medication (avapida [[nasya]]). [Cha.Sa.[[Siddhi Sthana]] 9/90] It is one of the sixty types of treatment (shastiupakrama) mentioned for the wound. [Su.Sa.Chikitsa Sthana 1/48]<ref name=Susruta/> It is one of the ten types of topical applications (alepa). [A.S. Uttara Sthana 30/08]<ref name=Sangraha/>
  
−
==Importance of Stambhana==
+
===Importance in management of disease===
  
−
===Stambhana as different treatment modalities===
+
Whenever there is an excessive discharge of body fluids, stambhana is the prime treatment.
  
−
Stambhana is one among the major six therapies in Ayurveda.[Cha.Sa.[[Sutra Sthana]] 22/04]
+
====Management of acute conditions====
 +
 +
*Excessive bleeding from a wound
 +
*Bleeding hemorrhoids with [[pitta]] [[dosha]] dominance and in summer season [Cha.Sa.[[Chikitsa Sthana]] 14/184]
 +
*Vomiting or diarrhea or bleeding in weak persons.
  
−
It is a type of expressed nasal medication (avapida nasya). [Cha.Sa.[[Siddhi Sthana]] 9/90] 
+
====Management of chronic conditions====
−
 
−
It is one among the sixty types of treatment (shasti upakrama) mentioned for the wound. [Su.Sa.Chikitsa Sthana 1/48]
 
  
−
It is one among the ten types of topical applications (alepa). [A.S. Uttara Sthana 30/08]
+
*In chronic diarrhea without the presence of [[ama]] (undigested food or metabolic wastes) [Su.Sa.Uttara sthana 40/68]<ref name=Susruta/>
 +
*In chronic vomiting, depleted state of body tissues [Cha.Sa.[[Chikitsa Sthana]] 20/46]  
  
−
===Importance in management of disease===
+
====Management of iatrogenic complications====
 +
 +
*If there is depletion of patient strength after excessive administration of therapeutic vomiting, purgation, sudation [A.S. Sutra Sthana 26/19]<ref name=Sangraha/> and bloodletting, stambhana is the treatment of choice.
  
−
Whenever there is excessive expulsion of body fluids stambhana can be used mainly in the following conditions
+
==Contemporary views and current researches==
  
−
As an emergency management:
+
The medicines that stop, block, or inhibit any biological activities can be viewed from the stambhana effect perspective. Thus, the medicines given as anti-diarrheal, anti-emetics, styptic medicines can be included in the stambhana category. The mechanism of action involves blocking the respective receptor at the site and reducing the motility. The coagulating factors or agents can also be included. The stambhana medicines may cause vasoconstriction due to astringent and cold properties. The delayed or extended medicine response can be related to the slow-acting (manda) and stable (sthira) properties of stambhana medicine.  
−
 
−
*If there is excessive bleeding from a wound it should be arrested immediately.  
 
−
*Bleeding due to hemorrhoids with [[pitta]] [[dosha]] in summer season should be arrested immediately. [Cha.Sa.[[Chikitsa Sthana]] 14/184]
 
−
*If vomiting or diarrhea happens to an extremely weak person then also irrespective of stage of disease stambhana should be done to protect that person.
 
  
−
As final line of treatment:
+
'''Antidiarrheal action'''
−
*If the evacuation of fecal matter happens without the association of toxic waste materials ([[ama]]), stambhana can be adopted as treatment. [Su.Sa.Uttara sthana 40/68]<ref name=Susruta/>
 
  
−
*In chronic vomiting stambhana medications should be used [Cha.Sa.[[Chikitsa Sthana]] 20/46] otherwise it may results in depletion of body tissues ([[dhatu]]) and may leads to the increase of [[vata]] [[dosha]].
+
The anti-diarrheal activity is achieved either by altering the intestinal motility or by increasing the absorption of fluid by the intestinal mucosa.<ref>Lawrence r. Schiller, Carol a. Santa Ana et al. Mechanism of the Antidiarrheal Effect of Loperamide, GASTROENTEROLOGY 1984;86;1475-80 Available from https://www.gastrojournal.org/article/S0016-5085(84)80161-4/pdf</ref>  Change in motor function and reduced intestinal motility results in delay in passage of fluid through the intestine.<ref>Schiller LR, Santa Ana CA, Morawski SG, Fordtran JS. Mechanism of the antidiarrheal effect of loperamide. Gastroenterology. 1984;86(6):1475-1480</ref> Decoction prepared out of Guava leaves is reported to be effective in treating infectious diarrhea. The anti-infective and anti-virulent activity along with gut microflora modulation capability might be the cause for anti-diarrheal action.<ref>Tannaz Bardi, G. Geetha K et al. A randomized open label efficacy clinical trial of guava leaf decoction in patients with acute infectious diarrhoea. Journal of Ayurveda and Integrative Medicine 11 (2020) 163e172</ref>
  
−
As a measure to manage complications arising out of other treatments:
+
'''Bleeding disorders'''
−
 
−
*In excessive vomiting, purgation, sudation [A.S. Sutra Sthana 26/19] and bloodletting stambhana is the treatment of choice.
 
  
−
==Current researches==
+
Various methods are used to check bleeding. Application of cold (skandana) and cautery (dahana) arrests the bleeding by constriction of the blood vessels by cold and heat stimulus respectively. Gelatin is a hemostatic agent which can be used in various forms including the powder form. It is believed to act as a physical inhibitor than chemically.<ref>Pereira BM, Bortoto JB, Fraga GP. Topical hemostatic agents in surgery: review and prospects. Agentes hemostáticos tópicos em cirurgia: revisão e perspectivas. Rev Col Bras Cir. 2018;45(5):e1900. Published 2018 Oct 18. doi:10.1590/0100-6991e-20181900</ref>  This type of physical barrier action might be provided through the application of topical powders as in case of pachana.
  
−
Even though stambhana is the term used commonly for the treatment of diarrhea (atisara), vomiting (chchardi), bleeding, hyperhydrosis etc. the mode of action is different in each pathological condition. Since in every above mentioned condition the treatment principle is to stop the excessive flow of fluid, stambhana is considered as a treatment of choice.
+
'''Other disorders:'''
  
−
The anti-diarrheal activity can be achieved either by altering the motor function of the intestine or by increasing the absorption of fluid by the intestinal mucosa.<ref>Lawrence r. Schiller, Carol a. Santa Ana et al. Mechanism of the Antidiarrheal Effect of Loperamide, GASTROENTEROLOGY 1984;86;1475-80 Available from https://www.gastrojournal.org/article/S0016-5085(84)80161-4/pdf</ref>  Change in motor function of intestine results in increased capacitance of the gut and delay in passage of fluid through the intestine.<ref>Schiller LR, Santa Ana CA, Morawski SG, Fordtran JS. Mechanism of the antidiarrheal effect of loperamide. Gastroenterology. 1984;86(6):1475-1480</ref>  Decoction prepared out of Guava leaves is reported to be effective in treating infectious diarrhea. The anti infective and anti virulent activity along with gut microflora modulation capability might be the cause for anti diarrheal action.<ref>Tannaz Bardi, G. Geetha K et al. A randomized open label efficacy clinical trial of guava leaf decoction in patients with acute infectious diarrhoea. Journal of Ayurveda and Integrative Medicine 11 (2020) 163e172</ref>
+
The stambhana therapy is used in acid peptic disorders, ulcers, esophageal varices, menorrhagia, diabetes insipidus, urethral bleeding, hematemesis, per rectal bleeding. Stambhana activity of Terminalia arjuna is used to treat cardio-vascular disorders, hypertension and tachycardia. The stable property of Bacopa helps to reduce excessive thoughts and calm mind. Thus, stambhana therapy is applied to treat psychiatric disorders caused due to excess mental activities like anxiety, insomnia.  
 
   
 
   
−
Among the four methods mentioned for treating the bleeding, application of cold (skandana) and cautery (dahana) may arrest the bleeding by constriction of the blood vessels by cold and heat stimulus respectively. Gelatin is a hemostatic agent which can be used in various forms including powder form. It is believed to act as a physical inhibitor than chemically.<ref>Pereira BM, Bortoto JB, Fraga GP. Topical hemostatic agents in surgery: review and prospects. Agentes hemostáticos tópicos em cirurgia: revisão e perspectivas. Rev Col Bras Cir. 2018;45(5):e1900. Published 2018 Oct 18. doi:10.1590/0100-6991e-20181900</ref>  This type of physical barrier action might be provided through the application of topical powders as in case of pachana.
+
The exact mechanism of action of various stambhana drugs need to be studied. More research works are required to explore the beneficial effects of stambhana therapy.
−
 
 
−
The mode of action of various stambhana drugs are still unknown. More research works are needed to explore the concept of stambhana.
 
  
 
==List of theses done==
 
==List of theses done==
  
 
#Gunsai Kishangiri Kirtigiri (2017): An experimental evaluation of medohara (Hypolipidemic) and raktapratiskandana (Anticoagulant) activity of Kusha (Desmostachya Bipinnata Stapf.) and Darbha (Imperata Cylindrica Beauv.). Department of Dravyaguna Vigyan. IPGT&RA Jamnagar
 
#Gunsai Kishangiri Kirtigiri (2017): An experimental evaluation of medohara (Hypolipidemic) and raktapratiskandana (Anticoagulant) activity of Kusha (Desmostachya Bipinnata Stapf.) and Darbha (Imperata Cylindrica Beauv.). Department of Dravyaguna Vigyan. IPGT&RA Jamnagar
−
#Prasad Kulkarni (2012): A clinical study on Shukragata vata w.s.r premature ejaculation and its management by stambanakarak yoga. Department of Kayachikitsa. IPGT&RA Jamnagar.
+
#Prasad Kulkarni (2012): A clinical study on Shukragatavata w.s.r premature ejaculation and its management by stambanakarak yoga. Department of Kayachikitsa. IPGT&RA Jamnagar.
  
 
==More information==
 
==More information==
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[[Langhanabrimhaniya Adhyaya]]
 
[[Langhanabrimhaniya Adhyaya]]
  
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==References==
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== Abbreviations ==
 +
 
 +
Cha. = Charak, Su. = Sushruta, A. = Ashtanga, S. = Sangraha, Hr. = Hridayam, Sha = Sharangadara, Sa. = Samhita.
 +
 
 +
== List of references ==
 +
 
 +
The list of references for stambhana in Charak Samhita can be seen [[Media:List_of_references_for_the_word_Stambana.pdf|here]]
 +
 
 +
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
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==References==  
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</div>
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Latest revision as of 09:49, 24 February 2024

Cite.png

The word ‘stambhana’ literally means to stop or to stiffen, making it rigid or immovable. It denotes the actions of blocking, arresting, checking, restraining etc.[1] It is one of six important therapies. [Cha.Sa.Sutra Sthana 22/04] This therapy is indicated to stop excess discharges of body fluids.

Contributors
Section/Chapter/topic Chikitsa / Stambhana
Authors Aneesh E.G., Deole Yogesh S.
Reviewed and Edited by Basisht G.
Affiliations Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India,
Correspondence email:

draneesheg@gmail.com, dryogeshdeole@gmail.com,

carakasamhita@gmail.com
Publisher Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of first publication: April 30, 2021
DOI 10.47468/CSNE.2021.e01.s09.053

Etymology and derivation

‘Stambhana’ is derived from the root word ‘stambha’ by adding ‘lyut’ suffix, which means ‘to make stiff’ or ‘to stop’. [Vachaspatyam]

Definition

The therapy which inhibits or stops mobile, flowing body constituents and stabilizes them is called ‘stambhana’. [Cha.Sa.Sutra Sthana 22/12]

Synonyms

Stambhana, upastambhana, grahi [Arunadatta on A.Hr Sutra Sthana 27/48][2]

Contextual meanings

The term ‘stambhana’ denotes the following meanings in different contexts:

  • To check the bleeding e.g.raktastambhana (styptic/hemostatic)
  • To restrict the flow of stools (constipating) e.g.malavashtambha (constipation)
  • Stiffness/restrictions in movement of a particular body part e.g.urustambha (stiffness of thigh)

Stambhana therapy

The therapy is done by use of food or medicines having sweet, bitter, and astringent tastes. Those with liquid, thin, stable and cold properties are also applied in stambhana therapy.[Cha.Sa.Sutra Sthana 22/32]

Properties

The substance having cooling effect, slow acting, softness, smoothness, dryness, minuteness (subtleness), liquid state, stability and lightness qualities can produce stambhana effect. [Cha.Sa.Sutra Sthana 22/17]

Dryness (ruksha guna), cold potency (shita virya), astringent taste (kashayaa rasa) and light in digestion (laghu paka) are essential properties for stambhana effect. [Sha.Purvakhanda 04/12][3]

Food and medicines

  • Water is the best for stambhana effect [Cha.Sa.Sutra Sthana 25/40]
  • Alkali [Su.Sa.Sutra Sthana 11/5][4]
  • Lodhradigana [Su.Sa.Sutra Sthana 38/15][4]
  • Kutaja (Holarrhena pubescens)[Sha.Purvakhanda 04/12][3]
  • Shyonaka (Oroxylum indicum)[Sha.Purvakhanda 04/12][3]

Indications

  • Persons afflicted with corrosive actions of pittadosha, alkali and fire
  • Vomiting and diarrhea
  • Poisoning
  • Complications of excessive sudation (swedana)[Cha.Sa.Sutra Sthana 22/33]
  • Weak individuals [A.S.Chikitsa Sthana 10/26][5]

Assessment of therapy

Clinical features of optimum stambhana

The optimal effect of stambhana is assessed based on clinical observations as below:

  • Pacification of diseases like vomiting, diarrhea etc.
  • Regaining strength and normal state of body tissues [Cha.Sa.Sutra Sthana 22/39]

Clinical features of excessive stambhana

Following are clinical features of excessive administration of stambhana:

  • Blackish discoloration
  • Stiffness of body parts including jaw
  • Congestion in chest or bradycardia
  • Feeling of uneasiness
  • Constipation [Cha.Sa.Sutra Sthana 22/40]

The stambhana therapy is stopped immediately after observing above untoward effects.

Importance of Stambhana

Stambhana acts as a regulator or controller of various processes and activities. It increases kaphadosha and pacifies vata and pitta dosha. It is indicated in the treatment of disorders due to excess mobility of vatadosha for stability. It soothes the excess heat or acute effects of pitta dosha. Moreover, the astringent and dryness help to bind the tissues.

Stambhana is a type of expressed nasal medication (avapida nasya). [Cha.Sa.Siddhi Sthana 9/90] It is one of the sixty types of treatment (shastiupakrama) mentioned for the wound. [Su.Sa.Chikitsa Sthana 1/48][4] It is one of the ten types of topical applications (alepa). [A.S. Uttara Sthana 30/08][5]

Importance in management of disease

Whenever there is an excessive discharge of body fluids, stambhana is the prime treatment.

Management of acute conditions

  • Excessive bleeding from a wound
  • Bleeding hemorrhoids with pitta dosha dominance and in summer season [Cha.Sa.Chikitsa Sthana 14/184]
  • Vomiting or diarrhea or bleeding in weak persons.

Management of chronic conditions

  • In chronic diarrhea without the presence of ama (undigested food or metabolic wastes) [Su.Sa.Uttara sthana 40/68][4]
  • In chronic vomiting, depleted state of body tissues [Cha.Sa.Chikitsa Sthana 20/46]

Management of iatrogenic complications

  • If there is depletion of patient strength after excessive administration of therapeutic vomiting, purgation, sudation [A.S. Sutra Sthana 26/19][5] and bloodletting, stambhana is the treatment of choice.

Contemporary views and current researches

The medicines that stop, block, or inhibit any biological activities can be viewed from the stambhana effect perspective. Thus, the medicines given as anti-diarrheal, anti-emetics, styptic medicines can be included in the stambhana category. The mechanism of action involves blocking the respective receptor at the site and reducing the motility. The coagulating factors or agents can also be included. The stambhana medicines may cause vasoconstriction due to astringent and cold properties. The delayed or extended medicine response can be related to the slow-acting (manda) and stable (sthira) properties of stambhana medicine.

Antidiarrheal action

The anti-diarrheal activity is achieved either by altering the intestinal motility or by increasing the absorption of fluid by the intestinal mucosa.[6] Change in motor function and reduced intestinal motility results in delay in passage of fluid through the intestine.[7] Decoction prepared out of Guava leaves is reported to be effective in treating infectious diarrhea. The anti-infective and anti-virulent activity along with gut microflora modulation capability might be the cause for anti-diarrheal action.[8]

Bleeding disorders

Various methods are used to check bleeding. Application of cold (skandana) and cautery (dahana) arrests the bleeding by constriction of the blood vessels by cold and heat stimulus respectively. Gelatin is a hemostatic agent which can be used in various forms including the powder form. It is believed to act as a physical inhibitor than chemically.[9] This type of physical barrier action might be provided through the application of topical powders as in case of pachana.

Other disorders:

The stambhana therapy is used in acid peptic disorders, ulcers, esophageal varices, menorrhagia, diabetes insipidus, urethral bleeding, hematemesis, per rectal bleeding. Stambhana activity of Terminalia arjuna is used to treat cardio-vascular disorders, hypertension and tachycardia. The stable property of Bacopa helps to reduce excessive thoughts and calm mind. Thus, stambhana therapy is applied to treat psychiatric disorders caused due to excess mental activities like anxiety, insomnia.

The exact mechanism of action of various stambhana drugs need to be studied. More research works are required to explore the beneficial effects of stambhana therapy.

List of theses done

  1. Gunsai Kishangiri Kirtigiri (2017): An experimental evaluation of medohara (Hypolipidemic) and raktapratiskandana (Anticoagulant) activity of Kusha (Desmostachya Bipinnata Stapf.) and Darbha (Imperata Cylindrica Beauv.). Department of Dravyaguna Vigyan. IPGT&RA Jamnagar
  2. Prasad Kulkarni (2012): A clinical study on Shukragatavata w.s.r premature ejaculation and its management by stambanakarak yoga. Department of Kayachikitsa. IPGT&RA Jamnagar.

More information

Langhanabrimhaniya Adhyaya

Abbreviations

Cha. = Charak, Su. = Sushruta, A. = Ashtanga, S. = Sangraha, Hr. = Hridayam, Sha = Sharangadara, Sa. = Samhita.

List of references

The list of references for stambhana in Charak Samhita can be seen here

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References

  1. ↑ Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Stambhana, Page 1258.
  2. ↑ Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.
  3. ↑ 3.0 3.1 3.2 Sharangadhara. Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.
  4. ↑ 4.0 4.1 4.2 4.3 Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.
  5. ↑ 5.0 5.1 5.2 Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.
  6. ↑ Lawrence r. Schiller, Carol a. Santa Ana et al. Mechanism of the Antidiarrheal Effect of Loperamide, GASTROENTEROLOGY 1984;86;1475-80 Available from https://www.gastrojournal.org/article/S0016-5085(84)80161-4/pdf
  7. ↑ Schiller LR, Santa Ana CA, Morawski SG, Fordtran JS. Mechanism of the antidiarrheal effect of loperamide. Gastroenterology. 1984;86(6):1475-1480
  8. ↑ Tannaz Bardi, G. Geetha K et al. A randomized open label efficacy clinical trial of guava leaf decoction in patients with acute infectious diarrhoea. Journal of Ayurveda and Integrative Medicine 11 (2020) 163e172
  9. ↑ Pereira BM, Bortoto JB, Fraga GP. Topical hemostatic agents in surgery: review and prospects. Agentes hemostáticos tópicos em cirurgia: revisão e perspectivas. Rev Col Bras Cir. 2018;45(5):e1900. Published 2018 Oct 18. doi:10.1590/0100-6991e-20181900
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