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Line 35: − === Introduction ===+ − ===Sanskrit text, Transliteration and English Translation===+ + + Line 42:
Line 54: + − “Now I shall expound the chapter on properly formed blood”, said Lord Atreya. [1-2]+ − ==== Formation of pure blood ====+ + + Line 58:
Line 73: + − ==== Effects of pure blood on body ====+ + + Line 74:
Line 92: + − ==== Causes of blood vitiation ====+ + Line 102:
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Line 171: + + − + + + + − ==== Diseases due to vitiation of blood ====+ + Line 183:
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Line 267: + + − ==== Management of blood vitiation disorders ====+ + + Line 256:
Line 288: + − ==== Extent of bloodletting ====+ + + Line 272:
Line 307: + − ==== ''Dosha''-specific features of vitiated blood ====+ + Line 284:
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Line 338: + + − ==== Characteristics of pure blood ====+ + + Line 317:
Line 359: + − ==== Diet after bloodletting ====+ + + Line 333:
Line 378: + + − ==== Characteristics of a person with pure blood ====+ + + Line 350:
Line 399: + − ==== Causative factors and pathogenesis of ''mada'' (intoxication), ''murchcha'' (syncope) and ''sanyasa''(coma) ====+ + Line 374:
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Line 466: + + − ==== ''Dosha'' specific features of ''mada'' (intoxication) ====+ + Line 433:
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Line 547: + − ==== Specific features of ''dosha'' dominant ''murchcha'' (syncope) ====+ + Line 515:
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Line 649: − ==== Sanyasa (coma) ====+ + Line 629:
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Line 806: − ==== Various treatments of ''mada'' and ''murchcha'' ====+ + Line 754:
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Line 877: − ==== Summary ====+ + Line 811:
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Line 960: − − === References === − <references/> − − === Glossary === − − #aukasātmyā (aukasAtmyA; अकसात्म्य)– Acquired homologation/adaptation − #ādhyaśana (Adhyashana; अध्यशनै ) - Eating before the complete digestion of the previous food. − #ajīrṇā (ajIrNA ; अजीर्णा) – Indigestion. − #virēka (virekam; विरेक ) - Purgative action. − #tantu (tantu; तन्तु ) – Thread-like. − #dīpanīya (dIpanIya; दीपनीयं) – To increase appetite or digestive power. − #viśadaṁ (vishadaM ; द्विशदं ) – Nonslimy. − #agnisāda (agnisAda; अग्निसाद) – loss of appetite or decreased digestive power. − #gurugātratā (gurugAtratA; गुरुगात्रता) – Heaviness of body. − #santāpa (santApa; सन्ताप) – Pyrexia. − #klamaḥ (klamaḥ; क्लमः) – Feeling of exhaustion. − #buddhēḥ sammōhō (buddheH sammoho ; बुद्धेः सम्मोहो ) – Confusion of mind. − #svarakṣayaḥ (svarakShayaH; स्वरक्षयः) – Weakness of voice. − #tandrā (tandrA; तन्द्रा) – Excessive drowsiness. − #kōṭha (koTha; कोठ) –Patches on skin. − #Prasahanam (प्रसहानां)- Animals and birds that take in their food by snatching. − #Prameelakah (प्रमीलकाः)- It is a state of almost falling asleep. − #Pradhyantatparam (प्रध्यानतत्परम्)- A person who is continuous in a state of anxiety. + + + +
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{{#seo:
|title=Vidhishonitiya Adhyaya
|titlemode=append
|keywords=Rakta, rakta visravana, sanyasa sangyavahi srotas, vegetative state, shonita, sadyaphala kriya, sangyaprabodhanam, pure blood, blood vitiating factors, coma, syncope, intoxication, drug addiction, blood, charak samhita, ayurveda
|description=Sutra Sthana Chapter 24. Characteristics of Shonita (Blood), its vitiation and disorders
|image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg
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<big>'''Sutra Sthana Chapter 24. Characteristics of Shonita (Blood), its vitiation and disorders '''</big>
<big>'''Sutra Sthana Chapter 24. Characteristics of Shonita (Blood), its vitiation and disorders '''</big>
}}
}}
== Introduction ==
<div style="text-align:justify;">
<div style="text-align:justify;">
In the previous chapters of ''Yojana Chatushka'' (tetrad on management protocol), procedures for the management of disorders caused due to vitiation of three ''doshas'' were described. In continuation, the present chapter describes the management principles of disorders due to ''shonita'' (blood) vitiation. Formation of pure blood is very important for survival because blood is vital for sustaining life [1,2]. Origin, development, and survival of the body depend on blood [3]. Various etiological factors for vitiation of ''rakta'' have been explained in this chapter. Vitiated ''rakta'' causes various diseases e.g. stomatitis, redness in the eye, etc. If cold (or hot) and rough (or unctuous) ''dravyas'' are used for treatment without response, ''raktaja vikara'' (blood disorder) should be the reason. The line of treatment for ''raktaja vikara'' constitutes courses of treatment for ''raktapitta'' (i.e., prescribed for cases of vitiated ''pitta'' such as purgation and fasting, along with bloodletting). The physical appearance of pure blood has been described to be of golden colors, like red lotus, firefly, ''lakh'' (''laksha''), the fruit of ''gunja'' (Abrus precatorius Linn.). Any deviation from these could be explained to be due to ''vikaras'' or disorders. Some of the prominent blood-related disorders such as ''mada'' (intoxication), ''murchcha'' (syncope) and ''sanyasa'' (coma) have therefore been described in this chapter. Their etiopathogenesis, types, symptoms and grades of severity - in this sequence - have been explained, along with some suggested courses of treatment. In the case of ''mada'' and ''murchcha'', purificatory measures ([[Panchakarma]]) have been suggested, while for ''sanyasa'', an emergency treatment (''attyaika chikitsa'') should be followed.
In the previous chapters of ''Yojana Chatushka'' (tetrad on management protocol), procedures for the management of disorders caused due to vitiation of three ''doshas'' were described. In continuation, the present chapter describes the management principles of disorders due to ''shonita'' (blood) vitiation. Formation of pure blood is very important for survival because blood is vital for sustaining life [1,2]. Origin, development, and survival of the body depend on blood [3]. Various etiological factors for vitiation of ''rakta'' have been explained in this chapter. Vitiated ''rakta'' causes various diseases e.g. stomatitis, redness in the eye, etc. If cold (or hot) and rough (or unctuous) ''dravyas'' are used for treatment without response, ''raktaja vikara'' (blood disorder) should be the reason. The line of treatment for ''raktaja vikara'' constitutes courses of treatment for ''raktapitta'' (i.e., prescribed for cases of vitiated ''pitta'' such as purgation and fasting, along with bloodletting). The physical appearance of pure blood has been described to be of golden colors, like red lotus, firefly, ''lakh'' (''laksha''), the fruit of ''gunja'' (Abrus precatorius Linn.). Any deviation from these could be explained to be due to ''vikaras'' or disorders. Some of the prominent blood-related disorders such as ''mada'' (intoxication), ''murchcha'' (syncope) and ''sanyasa'' (coma) have therefore been described in this chapter. Their etiopathogenesis, types, symptoms and grades of severity - in this sequence - have been explained, along with some suggested courses of treatment. In the case of ''mada'' and ''murchcha'', purificatory measures ([[Panchakarma]]) have been suggested, while for ''sanyasa'', an emergency treatment (''attyaika chikitsa'') should be followed.
</div>
</div>
==Sanskrit text, Transliteration and English Translation==
<div class="mw-collapsible mw-collapsed">
अथातो विधिशोणितीयमध्यायं व्याख्यास्यामः ||१||
अथातो विधिशोणितीयमध्यायं व्याख्यास्यामः ||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
<div class="mw-collapsible-content">
athātō vidhiśōṇitīyamadhyāyaṁ vyākhyāsyāmaḥ ||1||
athātō vidhiśōṇitīyamadhyāyaṁ vyākhyāsyāmaḥ ||1||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
</div></div>
Now we shall expound the chapter "Vidhishonitiya" (Characteristics of Shonita (Blood), its vitiation and disorders). Thus said Lord Atreya. [1-2]
=== Formation of pure blood ===
<div class="mw-collapsible mw-collapsed">
विधिना शोणितं जातं शुद्धं भवति देहिनाम्|
विधिना शोणितं जातं शुद्धं भवति देहिनाम्|
देशकालौकसात्म्यानां विधिर्यः सम्प्रकाशितः||३||
देशकालौकसात्म्यानां विधिर्यः सम्प्रकाशितः||३||
<div class="mw-collapsible-content">
vidhinā śōṇitaṁ jātaṁ śuddhaṁ bhavati dēhinām|
vidhinā śōṇitaṁ jātaṁ śuddhaṁ bhavati dēhinām|
deshakAlaukasAtmyAnAM vidhiryaH samprakAshitaH||3||
deshakAlaukasAtmyAnAM vidhiryaH samprakAshitaH||3||
</div></div>
Pure blood is formed in harmony with place, time, and adaptation, as said earlier. (C.Su.6) [3]
Pure blood is formed in harmony with place, time, and adaptation, as said earlier. (C.Su.6) [3]
=== Effects of pure blood on body ===
<div class="mw-collapsible mw-collapsed">
तद्विशुद्धं हि रुधिरं बलवर्णसुखायुषा|
तद्विशुद्धं हि रुधिरं बलवर्णसुखायुषा|
युनक्ति प्राणिनं प्राणः शोणितं ह्यनुवर्तते||४||
युनक्ति प्राणिनं प्राणः शोणितं ह्यनुवर्तते||४||
<div class="mw-collapsible-content">
tadviśuddhaṁ hi rudhiraṁ balavarṇasukhāyuṣā|
tadviśuddhaṁ hi rudhiraṁ balavarṇasukhāyuṣā|
yunakti prANinaM prANaH shoNitaM hyanuvartate||4||
yunakti prANinaM prANaH shoNitaM hyanuvartate||4||
</div></div>
That pure blood provides the individual with strength, complexion, happiness, and life. Because vitality of life depends on blood. [4]
That pure blood provides the individual with strength, complexion, happiness, and life. Because vitality of life depends on blood. [4]
=== Causes of blood vitiation ===
<div class="mw-collapsible mw-collapsed">
प्रदुष्टबहुतीक्ष्णोष्णैर्मद्यैरन्यैश्च तद्विधैः|
प्रदुष्टबहुतीक्ष्णोष्णैर्मद्यैरन्यैश्च तद्विधैः|
शरत्कालस्वभावाच्च शोणितं सम्प्रदुष्यति||१०||
शरत्कालस्वभावाच्च शोणितं सम्प्रदुष्यति||१०||
<div class="mw-collapsible-content">
praduṣṭabahutīkṣṇōṣṇairmadyairanyaiśca tadvidhaiḥ|
praduṣṭabahutīkṣṇōṣṇairmadyairanyaiśca tadvidhaiḥ|
sharatkAlasvabhAvAcca shoNitaM sampraduShyati||10||
sharatkAlasvabhAvAcca shoNitaM sampraduShyati||10||
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
By habitual intake of spoiled food and/or liquids, overeating, imbibing hard liquor and other similar drinks, too much salt, alkaline substances, sour and pungent food, ''kulatha'' (Dolichos biflorus Linn.), ''masha'' (Phaseolus mungo Linn.), ''nishpava'' (Dolichos lablab Linn.), ''tila taila'' (Sesamum indicum Linn. oils), ''pindalu'' (Randia uliginosa DC.), radish and all green (leafy) vegetables, meat of aquatic and marshy animals, burrowing animals and those that snatch birds, excessive intake of curd, sour whey (curd-water), vinegars and other sour fermented liquids, consuming decomposed, putrid food with opposite properties excessive sleeping during the day especially after taking liquids, unctuous and heavy food, excessive anger, excessive exposure to the sun and the wind, suppression of the natural urges like vomiting, avoidance of blood-letting in prescribed time (autumn), too much exertion, injury, heat, indigestion, taking meal during indigestion and in the autumn season naturally vitiates ''rakta'' (blood).[5-10]
The blood is vitiated due to the following causes:
By habitual intake of spoiled or unsuitable food and/or liquids, overeating, acidic or pungent liquor and other similar drinks, too much salty, alkaline substances, sour and pungent food, ''kulatha'' (Dolichos biflorus Linn.), ''masha'' (Phaseolus mungo Linn.), ''nishpava'' (Dolichos lablab Linn.), ''tila taila'' (Sesamum indicum Linn. oils), ''pindalu'' (Randia uliginosa DC.), radish and all green (leafy) vegetables, meat of aquatic and marshy animals, burrowing animals and those that snatch birds, excessive intake of curd, sour whey (curd-water), vinegars and other sour fermented liquids, consuming decomposed, putrid food with opposite properties excessive sleeping during the day especially after taking liquids, unctuous and heavy food, excessive anger, excessive exposure to the sun and the wind, suppression of the natural urges like vomiting, avoidance of blood-letting in prescribed time (autumn), too much exertion, injury, heat, indigestion, taking meal during indigestion and due to natural pattern in autumn season.[5-10]
</div>
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=== Diseases due to vitiation of blood ===
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ततः शोणितजा रोगाः प्रजायन्ते पृथग्विधाः|
ततः शोणितजा रोगाः प्रजायन्ते पृथग्विधाः|
सम्यक् साध्या न सिध्यन्ति रक्तजांस्तान् विभावयेत्||१७||
सम्यक् साध्या न सिध्यन्ति रक्तजांस्तान् विभावयेत्||१७||
<div class="mw-collapsible-content">
tataḥ śōṇitajā rōgāḥ prajāyantē pr̥thagvidhāḥ|
tataḥ śōṇitajā rōgāḥ prajāyantē pr̥thagvidhāḥ|
samyak sAdhyA na sidhyanti raktajAMstAn vibhAvayet||17||
samyak sAdhyA na sidhyanti raktajAMstAn vibhAvayet||17||
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
The above mentioned dietary habits or lifestyle choices cause various diseases that should be considered blood disorders, such as stomatitis, redness in eyes, foul smell in nose and mouth, ''gulma'' (lump abdomen), ''upakusha'' (inflammation of gum leads to falling of teeth), erysipelas, bleeding disorder, sleepiness, abscess, hematuria, menorrhagia, ''vatarakta'', discoloration of skin, loss of digestive power, thirst, heaviness in body, pyrexia, extreme debility, anorexia, headache, burning sensation after meals, bitter and sour eructation, physical and mental exhaustion, excessive anger, state of confusion, saline taste in mouth, sweating, fetid odor in body, narcosis, tremors, decreased voice, drowsiness, excessive sleep and feeling of darkness, itching, pustules, patches, boils, leprosy, thick skin, etc. The diseases, which, in spite of being curable, are not alleviated after treatment with any of six therapies like cold-hot, unctuous-rough etc. should be considered as caused by (impure) blood. [11-17]
The above mentioned dietary habits or lifestyle choices cause various diseases that should be considered blood disorders, such as stomatitis, redness in eyes, foul smell in nose and mouth, ''gulma'' (lump abdomen), ''upakusha'' (inflammation of gum leads to falling of teeth), erysipelas, bleeding disorder, sleepiness, abscess, hematuria, menorrhagia, ''vatarakta'', discoloration of skin, loss of digestive power, thirst, heaviness in body, pyrexia, extreme debility, anorexia, headache, burning sensation after meals, bitter and sour eructation, physical and mental exhaustion, excessive anger, state of confusion, saline taste in mouth, sweating, fetid odor in body, narcosis, tremors, decreased voice, drowsiness, excessive sleep and feeling of darkness, itching, pustules, patches, boils, leprosy, thick skin, etc. The diseases, which, in spite of being curable, are not alleviated after treatment with any of six therapies like cold-hot, unctuous-rough etc. should be considered as caused by (impure) blood. [11-17]
</div>
</div>
=== Management of blood vitiation disorders ===
<div class="mw-collapsible mw-collapsed">
कुर्याच्छोणितरोगेषु रक्तपित्तहरीं क्रियाम्|
कुर्याच्छोणितरोगेषु रक्तपित्तहरीं क्रियाम्|
विरेकमुपवासं च स्रावणं शोणितस्य च||१८||
विरेकमुपवासं च स्रावणं शोणितस्य च||१८||
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kuryācchōṇitarōgēṣu raktapittaharīṁ kriyām|
kuryācchōṇitarōgēṣu raktapittaharīṁ kriyām|
virekamupavAsaM ca srAvaNaM shoNitasya ca||18||
virekamupavAsaM ca srAvaNaM shoNitasya ca||18||
</div></div>
Treatment for blood disorder is as per ''raktapitta'' with therapeutic purgation, fasting and bloodletting. [18]
Treatment for blood disorder is as per ''raktapitta'' with therapeutic purgation, fasting and bloodletting. [18]
=== Extent of bloodletting ===
<div class="mw-collapsible mw-collapsed">
बलदोषप्रमाणाद्वा विशुद्ध्या रुधिरस्य वा|
बलदोषप्रमाणाद्वा विशुद्ध्या रुधिरस्य वा|
रुधिरं स्रावयेज्जन्तोराशयं प्रसमीक्ष्य वा||१९||
रुधिरं स्रावयेज्जन्तोराशयं प्रसमीक्ष्य वा||१९||
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baladōṣapramāṇādvā viśuddhyā rudhirasya vā|
baladōṣapramāṇādvā viśuddhyā rudhirasya vā|
rudhiraM srAvayejjantorAshayaM prasamIkShya vA||19||
rudhiraM srAvayejjantorAshayaM prasamIkShya vA||19||
</div></div>
Bloodletting should be done considering the strength of the person, ''dosha'',location of the disease, and until pure blood starts to flow out.[19]
Bloodletting should be done considering the strength of the person, ''dosha'',location of the disease, and until pure blood starts to flow out.[19]
=== ''Dosha''-specific features of vitiated blood ===
<div class="mw-collapsible mw-collapsed">
अरुणाभं भवेद्वाताद्विशदं फेनिलं तनु|
अरुणाभं भवेद्वाताद्विशदं फेनिलं तनु|
संसृष्टलिङ्गं संसर्गात्त्रिलिङ्गं ||२१||
संसृष्टलिङ्गं संसर्गात्त्रिलिङ्गं ||२१||
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aruṇābhaṁ bhavēdvātādviśadaṁ phēnilaṁ tanu|
aruṇābhaṁ bhavēdvātādviśadaṁ phēnilaṁ tanu|
saMsRuShTali~ggaM saMsargAttrili~ggaM sAnnipAtikam||21||
saMsRuShTali~ggaM saMsargAttrili~ggaM sAnnipAtikam||21||
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
Due to vitiated ''vata,'' blood becomes arunabham (reddish), non-slimy, frothy and thin. Due to vitiated ''pitta'', it becomes yellow or blackish, with delayed coagulation because of heat. Due to vitiated ''kapha'' it is slightly pale, slimy, fibrous and more viscous. In the case of combination of vitiated ''doshas'', it acquires mixed characters and in ''sannipata'', has symptoms of all the three ''doshas''.[20-21]
Due to vitiated ''vata,'' blood becomes arunabham (reddish), non-slimy, frothy and thin. Due to vitiated ''pitta'', it becomes yellow or blackish, with delayed coagulation because of heat. Due to vitiated ''kapha'' it is slightly pale, slimy, fibrous and more viscous. In the case of combination of vitiated ''doshas'', it acquires mixed characters and in ''sannipata'', has symptoms of all the three ''doshas''.[20-21]
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=== Characteristics of pure blood ===
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तपनीयेन्द्रगोपाभं पद्मालक्तकसन्निभम्|
तपनीयेन्द्रगोपाभं पद्मालक्तकसन्निभम्|
गुञ्जाफलसवर्णं च विशुद्धं विद्धि शोणितम्||२२||
गुञ्जाफलसवर्णं च विशुद्धं विद्धि शोणितम्||२२||
<div class="mw-collapsible-content">
tapanīyēndragōpābhaṁ padmālaktakasannibham|
tapanīyēndragōpābhaṁ padmālaktakasannibham|
gu~jjAphalasavarNaM ca vishuddhaM viddhi shoNitam||22||
gu~jjAphalasavarNaM ca vishuddhaM viddhi shoNitam||22||
</div></div>
Blood should be regarded as pure when its color resembles red-gold, firefly, red lotus, ''laksha'' (lac-resinous material) and ''gunja'' fruit (Abrus precatorius Linn.).[22]
Blood should be regarded as pure when its color resembles red-gold, firefly, red lotus, ''laksha'' (lac-resinous material) and ''gunja'' fruit (Abrus precatorius Linn.).[22]
=== Diet after bloodletting ===
<div class="mw-collapsible mw-collapsed">
नात्युष्णशीतं लघु दीपनीयं रक्तेऽपनीते हितमन्नपानम्|
नात्युष्णशीतं लघु दीपनीयं रक्तेऽपनीते हितमन्नपानम्|
तदा शरीरं ह्यनवस्थितासृगग्निर्विशेषेण च रक्षितव्यः||२३||
तदा शरीरं ह्यनवस्थितासृगग्निर्विशेषेण च रक्षितव्यः||२३||
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nātyuṣṇaśītaṁ laghu dīpanīyaṁ raktē'panītē hitamannapānam|
nātyuṣṇaśītaṁ laghu dīpanīyaṁ raktē'panītē hitamannapānam|
tadA sharIraM hyanavasthitAsRugagnirvisheSheNa ca rakShitavyaH||23||
tadA sharIraM hyanavasthitAsRugagnirvisheSheNa ca rakShitavyaH||23||
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
After bloodletting, it is beneficial to take diet that is neither too hot nor cold, is light (to digest), and is appetizing. During this period, the body is vulnerable to relapse of various other forms of blood-related diseases, so the ''agni'' (digestive power) should be protected with care. [23]
After bloodletting, it is beneficial to take diet that is neither too hot nor cold, is light (to digest), and is appetizing. During this period, the body is vulnerable to relapse of various other forms of blood-related diseases, so the ''agni'' (digestive power) should be protected with care. [23]
</div>
</div>
=== Characteristics of a person with pure blood ===
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प्रसन्नवर्णेन्द्रियमिन्द्रियार्थानिच्छन्तमव्याहतपक्तृवेगम्|
प्रसन्नवर्णेन्द्रियमिन्द्रियार्थानिच्छन्तमव्याहतपक्तृवेगम्|
सुखान्वितं तु(पु)ष्टिबलोपपन्नं विशुद्धरक्तं पुरुषं वदन्ति||२४||
सुखान्वितं तु(पु)ष्टिबलोपपन्नं विशुद्धरक्तं पुरुषं वदन्ति||२४||
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prasannavarṇēndriyamindriyārthānicchantamavyāhatapaktr̥vēgam|
prasannavarṇēndriyamindriyārthānicchantamavyāhatapaktr̥vēgam|
sukhAnvitaM tu(pu)ShTibalopapannaM vishuddharaktaM puruShaM vadanti||24||
sukhAnvitaM tu(pu)ShTibalopapannaM vishuddharaktaM puruShaM vadanti||24||
</div></div>
A person should be considered as having pure blood if he has glowing complexion, well-functioning sense organs, and is cheerful. A person with unvitiated blood has normal digestion and unobstructed natural urges, is happy and is endowed with saturation and strength. [24]
A person should be considered as having pure blood if he has glowing complexion, well-functioning sense organs, and is cheerful. A person with unvitiated blood has normal digestion and unobstructed natural urges, is happy and is endowed with saturation and strength. [24]
=== Causative factors and pathogenesis of ''mada'' (intoxication), ''murchcha'' (syncope) and ''sanyasa''(coma) ===
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यदा तु रक्तवाहीनि रससञ्ज्ञावहानि च|
यदा तु रक्तवाहीनि रससञ्ज्ञावहानि च|
सञ्ज्ञां नयत्याकुलतां विशेषश्चात्र वक्ष्यते||२९||
सञ्ज्ञां नयत्याकुलतां विशेषश्चात्र वक्ष्यते||२९||
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yadā tu raktavāhīni rasasañjñāvahāni ca|
yadā tu raktavāhīni rasasañjñāvahāni ca|
sa~jj~jAM nayatyAkulatAM visheShashcAtra vakShyate||29||
sa~jj~jAM nayatyAkulatAM visheShashcAtra vakShyate||29||
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
When a person indulges in spoiled food and unhealthy habits, he develops a clouded sensorium with ''rajas'' and ''tamas'' qualities. The vitiated ''doshas'', singly or in combination, reside and obstruct the channels that carry ''rakta, rasa'' (plasma), and consciousness. This leads to various diseases such as ''mada'' (intoxication), ''murchcha'' (syncope), and ''sanyasa'' (coma) which are etiologically, symptomatically and therapeutically progressive. Vitiated ''doshas'' distress the mind and alter the sensorium leading to further impairment of consciousness. [25-29]
When a person indulges in spoiled food and unhealthy habits, he develops a clouded sensorium with ''rajas'' and ''tamas'' qualities. The vitiated ''doshas'', singly or in combination, reside and obstruct the channels that carry ''rakta, rasa'' (plasma), and consciousness. This leads to various diseases such as ''mada'' (intoxication), ''murchcha'' (syncope), and ''sanyasa'' (coma) which are etiologically, symptomatically and therapeutically progressive. Vitiated ''doshas'' distress the mind and alter the sensorium leading to further impairment of consciousness. [25-29]
</div>
</div>
=== ''Dosha'' specific features of ''mada'' (intoxication) ===
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सक्तानल्पद्रुताभाषं चलस्खलितचेष्टितम्|
सक्तानल्पद्रुताभाषं चलस्खलितचेष्टितम्|
सर्वाण्येतानि रूपाणि सन्निपातकृते मदे|३३|
सर्वाण्येतानि रूपाणि सन्निपातकृते मदे|३३|
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saktānalpadrutābhāṣaṁ calaskhalitacēṣṭitam |
saktānalpadrutābhāṣaṁ calaskhalitacēṣṭitam |
sarvANyetAni rUpANi sannipAtakRute made|33|
sarvANyetAni rUpANi sannipAtakRute made|33|
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
The person should be diagnosed as suffering from ''vatika mada'', if his speech is excessive and fast, movement is unstable, and face is rough, reddish or blackish. A person with angry and harsh tongue, quarrelsome, tends to be physical with a red, yellow and black face should be known to be suffering from ''paittika mada''. The one affected with ''kaphaja mada'' speaks less with incoherence, seems drowsy and lethargic, is pale and is continuously in a state of anxiety. In ''sannipataja mada'', all these features are found in combination. [30-33]
The person should be diagnosed as suffering from ''vatika mada'', if his speech is excessive and fast, movement is unstable, and face is rough, reddish or blackish. A person with angry and harsh tongue, quarrelsome, tends to be physical with a red, yellow and black face should be known to be suffering from ''paittika mada''. The one affected with ''kaphaja mada'' speaks less with incoherence, seems drowsy and lethargic, is pale and is continuously in a state of anxiety. In ''sannipataja mada'', all these features are found in combination. [30-33]
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</div>
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जायते शाम्यति क्षिप्रं मदो मद्यमदाकृतिः||३३||
जायते शाम्यति क्षिप्रं मदो मद्यमदाकृतिः||३३||
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jāyatē śāmyati kṣipraṁ madō madyamadākr̥tiḥ||33||
jāyatē śāmyati kṣipraṁ madō madyamadākr̥tiḥ||33||
jAyate shAmyati kShipraM mado madyamadAkRutiH||33||
jAyate shAmyati kShipraM mado madyamadAkRutiH||33||
''
</div></div>
Sannipataja mada'' (a type of narcosis) arises and subsides quickly like alcoholic narcosis. [33]
''Sannipataja mada'' (a type of narcosis) arises and subsides quickly like alcoholic narcosis. [33]
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यश्च मद्यकृतः प्रोक्तो विषजो रौधिरश्च यः|
यश्च मद्यकृतः प्रोक्तो विषजो रौधिरश्च यः|
सर्व एते मदा नर्ते वातपित्तकफत्रयात्||३४||
सर्व एते मदा नर्ते वातपित्तकफत्रयात्||३४||
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yaśca madyakr̥taḥ prōktō viṣajō raudhiraśca yaḥ|
yaśca madyakr̥taḥ prōktō viṣajō raudhiraśca yaḥ|
sarva ete madA narte vAtapittakaphatrayAt||34||
sarva ete madA narte vAtapittakaphatrayAt||34||
</div></div>
All types of narcosis are caused by alcoholic drinks, poisons or by vitiation of blood. It can be concluded that all types of narcosis are caused by nothing but the vitiation of the three ''doshas'' viz. ''vata, pitta'' and ''kapha''. [34]
All types of narcosis are caused by alcoholic drinks, poisons or by vitiation of blood. It can be concluded that all types of narcosis are caused by nothing but the vitiation of the three ''doshas'' viz. ''vata, pitta'' and ''kapha''. [34]
=== Specific features of ''dosha'' dominant ''murchcha'' (syncope) ===
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नीलं वा यदि वा कृष्णमाकाशमथवाऽरुणम्|
नीलं वा यदि वा कृष्णमाकाशमथवाऽरुणम्|
स जन्तुं पातयत्याशु विना बीभत्सचेष्टितैः||४१||
स जन्तुं पातयत्याशु विना बीभत्सचेष्टितैः||४१||
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nīlaṁ vā yadi vā kr̥ṣṇamākāśamathavā'ruṇam|
nīlaṁ vā yadi vā kr̥ṣṇamākāśamathavā'ruṇam|
sa jantuM pAtayatyAshu vinA bIbhatsaceShTitaiH||41||
sa jantuM pAtayatyAshu vinA bIbhatsaceShTitaiH||41||
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
In ''vatika murchcha'', the patient becomes unconscious after seeing the sky as blue, black or reddish and regains consciousness quickly. Other symptoms include trembling, body-ache, excessive pain in the cardiac region, emaciation, and blackish and reddish luster.
In ''vatika murchcha'', the patient becomes unconscious after seeing the sky as blue, black or reddish and regains consciousness quickly. Other symptoms include trembling, body-ache, excessive pain in the cardiac region, emaciation, and blackish and reddish luster.
</div>
</div>
=== Sanyasa (coma) ===
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दोषेषु मदमूर्च्छायाः कृतवेगेषु देहिनाम्|
दोषेषु मदमूर्च्छायाः कृतवेगेषु देहिनाम्|
तस्य संरक्षितव्यं हि मनः प्रलयहेतुतः||५३||
तस्य संरक्षितव्यं हि मनः प्रलयहेतुतः||५३||
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dōṣēṣu madamūrcchāyāḥ kr̥tavēgēṣu dēhinām|
dōṣēṣu madamūrcchāyāḥ kr̥tavēgēṣu dēhinām|
tasya saMrakShitavyaM hi manaH pralayahetutaH||53||
tasya saMrakShitavyaM hi manaH pralayahetutaH||53||
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
''Mada'' and ''murchcha'' subside on their own when the vitiated ''doshas'' subside. However, ''sanyasa'' (coma) does not subside without medical treatment. In weak patients, when vitiated ''doshas'' move into a vital organ (i.e. brain and heart) and start affecting speech, physical movement, and the mind, coma ensues. A person affected with coma appears to be in a vegetative state or seems dead. Death can occur if prompt and effective treatment is not given. The physician should manage a comatose patient just as a wise person recovers a utensil sinking in deep water quickly before it settles down in the bottom.
''Mada'' and ''murchcha'' subside on their own when the vitiated ''doshas'' subside. However, ''sanyasa'' (coma) does not subside without medical treatment. In weak patients, when vitiated ''doshas'' move into a vital organ (i.e. brain and heart) and start affecting speech, physical movement, and the mind, coma ensues. A person affected with coma appears to be in a vegetative state or seems dead. Death can occur if prompt and effective treatment is not given. The physician should manage a comatose patient just as a wise person recovers a utensil sinking in deep water quickly before it settles down in the bottom.
</div>
</div>
=== Various treatments of ''mada'' and ''murchcha'' ===
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स्नेहस्वेदोपपन्नानां यथादोषं यथाबलम्|
स्नेहस्वेदोपपन्नानां यथादोषं यथाबलम्|
सेवनान्मदमूर्च्छायाः प्रशाम्यन्ति शरीरिणाम्||५८||
सेवनान्मदमूर्च्छायाः प्रशाम्यन्ति शरीरिणाम्||५८||
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snēhasvēdōpapannānāṁ yathādōṣaṁ yathābalam|
snēhasvēdōpapannānāṁ yathādōṣaṁ yathābalam|
sevanAnmadamUrcchAyAH prashAmyanti sharIriNAm||58||
sevanAnmadamUrcchAyAH prashAmyanti sharIriNAm||58||
</div></div>
<div style="text-align:justify;">
<div style="text-align:justify;">
In the cases of ''mada'' and ''murchcha'', patients should be subjected to five (evacuative) measures, after proper oleation and fomentation, according to the ''dosha'' and strength of the person and the disease. Likewise, the administration of ''paniya-kalyana ghrita'', ''tiktashatpala ghrita'' or ''mahatikta ghrita'' is recommended. The use of ''triphala'' with ''ghrita'', honey and sugar, ''shilajatu,'' milk, ''pippali'' (Piper longum) or ''chitraka'' (Plumbago zeylanica Linn.) with milk, ''rasayana,'' and ''kaumbha'' (ten year old) ''ghrita'' are also beneficial.
In the cases of ''mada'' and ''murchcha'', patients should be subjected to five (evacuative) measures, after proper oleation and fomentation, according to the ''dosha'' and strength of the person and the disease. Likewise, the administration of ''paniya-kalyana ghrita'', ''tiktashatpala ghrita'' or ''mahatikta ghrita'' is recommended. The use of ''triphala'' with ''ghrita'', honey and sugar, ''shilajatu,'' milk, ''pippali'' (Piper longum) or ''chitraka'' (Plumbago zeylanica Linn.) with milk, ''rasayana,'' and ''kaumbha'' (ten year old) ''ghrita'' are also beneficial.
</div>
</div>
=== Summary ===
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तत्र श्लोकौ-
तत्र श्लोकौ-
विधिशोणितकेऽध्याये सर्वमेतत् प्रकाशितम्||६०||
विधिशोणितकेऽध्याये सर्वमेतत् प्रकाशितम्||६०||
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tatra ślōkau-
tatra ślōkau-
vidhishoNitake~adhyAye sarvametat prakAshitam||60||
vidhishoNitake~adhyAye sarvametat prakAshitam||60||
</div></div>
Now the (summing up) verses-
Now the (summing up) verses-
Diseases with variable state of consciousness, from confusion to coma have been described in this chapter. [59-60]
Diseases with variable state of consciousness, from confusion to coma have been described in this chapter. [59-60]
=== ''Tattva Vimarsha'' / Fundamental Principles ===
== Tattva Vimarsha (Fundamental Principles) ==
*Formation of pure blood depends upon the place, time, diet, and lifestyle. [3]
*Formation of pure blood depends upon the place, time, diet, and lifestyle. [3]
*Purification of channels through [[Panchakarma]] is indicated before administration of drugs.[54-58]
*Purification of channels through [[Panchakarma]] is indicated before administration of drugs.[54-58]
=== ''Vidhi Vimarsha'' / Applied Inferences===
== Vidhi Vimarsha (Applied Inferences) ==
A person who is following a regimen or conduct suitable to a location (''desha-satmya''), time (''kala-satmya''), and habit or lifestyle (''oka-satmya''), when he takes food according to ''ahara vidhi visheshayatana'' (as described in the first chapter of Charak [[Vimana Sthana]] <ref>Pandit Kashi Nath Shastri, Dr. Gorakhanath Chaturvedi, Charak Samhita, 2nd part, Chikitsa sthana, Chap 15, shlok no.28 ,Reprint 2005, Chaukhambha Bharati Academy, Varanasi, pp 457. </ref>) - food having six ''rasaja'', taken at proper time, proper place, in proper quantity, and that which is wholesome in nature, will have pure (or healthy) blood. Pure blood formed after proper digestion of food is full of nutritional values necessary for life. Formation of pure blood takes place due to extrinsic and intrinsic factors. Extrinsic factors are obtained from dietary sources. On the other hand, intrinsic factors are generated inside the body, such as ''Ranjaka pitta'' and ''majjagata'' substances (bone marrow). The importance of pure blood is described in ''Sushruta Sutra'' <ref>Pandit Kashi Nath Shastri, Dr. Gorakhanath Chaturvedi, Charak Samhita, Ist part, Vimana sthana, Chap 1, shlok no.21 ,Reprint 2005, Chaukhambha Bharati Academy, Varanasi, pp 680.</ref>15/7 and ''Charak Chikitsa'' <ref>Kaviraja Ambikadutta Shastri, Sushruta Samhita, Ist part, Sutra sthana Chap 15, shlok no.7 ,Reprint 2013, Chaukhambha Sanskrit Sansthan, Varanasi, pp 75. </ref>15/28.[3]
A person who is following a regimen or conduct suitable to a location (''desha-satmya''), time (''kala-satmya''), and habit or lifestyle (''oka-satmya''), when he takes food according to ''ahara vidhi visheshayatana'' (as described in the first chapter of Charak [[Vimana Sthana]]) - food having six ''rasaja'', taken at proper time, proper place, in proper quantity, and that which is wholesome in nature, will have pure (or healthy) blood. Pure blood formed after proper digestion of food is full of nutritional values necessary for life. Formation of pure blood takes place due to extrinsic and intrinsic factors. Extrinsic factors are obtained from dietary sources. On the other hand, intrinsic factors are generated inside the body, such as ''Ranjaka pitta'' and ''majjagata'' substances (bone marrow). The importance of pure blood is described in Sushruta Samhita Vidhishonitiya adhyaya (Sutra Sthana Chapter 14). [3]
Pure-blood is the basis of life as it nourishes ''dasha pranayatna'' (ten important “life areas” of the body: two temples, heart, head, bladder, throat, blood, semen, ''ojas'' and rectum <ref>Pandit Kashi Nath Shastri, Dr. Gorakhanath Chaturvedi, Charak Samhita, 2nd part, Chikitsa sthana, Chap 15, shlok no.28 ,Reprint 2005, Chaukhambha Bharati Academy, Varanasi, pp 457. </ref>, (Ch. Sha. 7/9) <ref>Pandit Kashi Nath Shastri, Dr. Gorakhanath Chaturvedi, Charak Samhita, Ist part, Sutrasthana, Chap 29, shlok no.3 ,Reprint 2005, Chaukhambha Bharati Academy, Varanasi, pp 576. </ref>. ''Rakta'' increases the physical strength, complexion, immunity, and vitality of life (Su.Su. 15/7)<ref>Pandit Kashi Nath Shastri, Dr. Gorakhanath Chaturvedi, Charak Samhita, Ist part, Sharira sthana, Chap 7, shlok no. 9 ,Reprint 2005, Chaukhambha Bharati Academy, Varanasi, pp 913. </ref>. [4]
Pure-blood is the basis of life as it nourishes ''dasha pranayatana'' (ten important “life areas” of the body: two temples, heart, head, bladder, throat, blood, semen, ''ojas'' and rectum, (Cha.Sa.[[Sharira Sthana]] 7/9). ''Rakta'' increases the physical strength, complexion, immunity, and vitality of life. [4]
Severe indigestion, eating leftover foods, and suppression of urge of vomiting can form vasoactive intestinal peptides and in turn lead to allergic diathesis. [5-10]
Severe indigestion, eating leftover foods, and suppression of urge of vomiting can form vasoactive intestinal peptides and in turn lead to allergic diathesis. [5-10]
The recommended therapies for the treatment of vitiated blood disorders – such as bloodletting - are not to be administered or applied in all diseases. Like in the case of any disease, treatment measures are to be selected according to the nature of the disease and condition of the patient. Bloodletting should be administered till the vitiated ''dosha'' are eliminated from blood. [18]
The recommended therapies for the treatment of vitiated blood disorders – such as bloodletting - are not to be administered or applied in all diseases. Like in the case of any disease, treatment measures are to be selected according to the nature of the disease and condition of the patient. Bloodletting should be administered till the vitiated ''dosha'' are eliminated from blood. [18]
Any line of treatment should be planned keeping in mind the basic principles of blood coagulation as described in Ayurvedic texts. [20-21]
Any line of treatment should be planned to keep in mind the basic principles of blood coagulation as described in Ayurvedic texts. [20-21]
After bloodletting is administered, the patient should be prescribed a nourishing diet and regimen that rejuvenates his blood, and thus, vitalizes his life. The diet shall not interfere with the coagulation process or vitiate his blood but should aid in the bodily processes to replenish blood.[23]
After bloodletting is administered, the patient should be prescribed a nourishing diet and regimen that rejuvenates his blood, and thus, vitalizes his life. The diet shall not interfere with the coagulation process or vitiate his blood but should aid in the bodily processes to replenish blood.[23]
Metabolic acidosis and alkalosis should be considered to gain an understanding of ''raktaja vikara''. Electrolyte imbalances should be evaluated for the keen diagnosis of ''mada, murchcha,'' and ''sanyasa''. [59-60]
Metabolic acidosis and alkalosis should be considered to gain an understanding of ''raktaja vikara''. Electrolyte imbalances should be evaluated for the keen diagnosis of ''mada, murchcha,'' and ''sanyasa''. [59-60]
=== Related Chapters ===
=== Related Chapters ===
* [[ Raktapitta Nidana ]]
* [[ Raktapitta Nidana ]]
* [[ Raktapitta Chikitsa ]]
* [[ Raktapitta Chikitsa ]]
== References ==
<references/>
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