Administrators, Editors, Bots, Bureaucrats, Charaksamhita, Moderators (CommentStreams), Interface administrators, Administrators
10,113
edits
Changes
Jump to navigation
Jump to search
Line 1:
Line 1: + Line 8:
Line 9: − Line 29:
Line 29: − + Line 39:
Line 39: − + − − − + Line 1,065:
Line 1,063: − Line 1,081:
Line 1,078: − '''Pathogenesis'''+ − '''Stages of intoxication (mada)'''+ − '''Types and [[dosha]] specific features of intoxication (mada)''' + − + Line 1,113:
Line 1,110: − '''Prognosis:''' + − + Line 1,121:
Line 1,118: − '''Pathogenesis'''+ − '''Premonitory symptoms'''+ − '''Types and Features of Syncope (murchha)'''+ Line 1,156:
Line 1,153: − '''Diagnostic tests:'''+ − + − '''Prognosis'''+ Line 1,166:
Line 1,163: − '''Management''' + − + − + Line 1,198:
Line 1,195: − + − + Line 1,208:
Line 1,205: − + − +
no edit summary
{{CiteButton}}
{{#seo:
{{#seo:
|title=Vidhishonitiya Adhyaya
|title=Vidhishonitiya Adhyaya
|type=article
|type=article
}}
}}
<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>
{{Infobox
{{Infobox
|data7 = Byadgi P.S.
|data7 = Byadgi P.S.
|label8 = Editors
|label8 = Editors
|data8 = Dwivedi R.B., Deole Y.S., Basisht G.
|data8 = Dwivedi R.B., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
|label9 = Year of publication
|label9 = Year of publication
|data9 = 2020
|data9 = 2020
<big>'''Abstract'''</big>
<big>'''Abstract'''</big>
<p style="text-align:justify;">Blood is important for maintaining vitality of individuals. It is also the most important factor in patho-physiology of any disease as it carries vitiated [[dosha] leading to disease. This chapter focuses on [[rakta dhatu]] (blood tissue), delineating the characteristic features of pure blood as well as the factors influencing the formation of blood. Pure blood (Shuddha rakta) is formed by following proper dietary habits. Therefore, characteristics of pure blood, the causative factors for vitiation of blood, [[dosha]] specific features of vitiated blood, their treatment and procedure of bloodletting are described in this chapter. Since blood plays an important role in the treatment of cerebrovascular diseases, a description of ailments such as mada (intoxication/confusion), murchha (syncope), and sanyasa (coma), their pathology and courses of treatment, and mind’s role in the pathogenesis of some of these diseases have also been provided. </br>
<div style="text-align:justify;">Blood is important for maintaining vitality of individuals. It is also the most important factor in patho-physiology of any disease as it carries vitiated [[dosha] leading to disease. This chapter focuses on [[rakta dhatu]] (blood tissue), delineating the characteristic features of pure blood as well as the factors influencing the formation of blood. Pure blood (Shuddha rakta) is formed by following proper dietary habits. Therefore, characteristics of pure blood, the causative factors for vitiation of blood, [[dosha]] specific features of vitiated blood, their treatment and procedure of bloodletting are described in this chapter. Since blood plays an important role in the treatment of cerebrovascular diseases, a description of ailments such as mada (intoxication/confusion), murchha (syncope), and sanyasa (coma), their pathology and courses of treatment, and mind’s role in the pathogenesis of some of these diseases have also been provided. </div>
'''Keywords''': [[Rakta]], rakta visravana, sanyasa sangyavahi srotas, vegetative state, shonita, sadyaphala kriya, sangyaprabodhanam, pure blood, blood vitiating factors, coma, syncope, intoxication, drug addiction.
'''Keywords''': [[Rakta]], rakta visravana, sanyasa sangyavahi srotas, vegetative state, shonita, sadyaphala kriya, sangyaprabodhanam, pure blood, blood vitiating factors, coma, syncope, intoxication, drug addiction.
</div>
</p>
*Thick skin as in scleroderma and ichthyosis vulgaris
*Thick skin as in scleroderma and ichthyosis vulgaris
*All diseases that are not relieved by conventional treatment
*All diseases that are not relieved by conventional treatment
===Principles of treatment===
===Principles of treatment===
====Intoxication (mada)====
====Intoxication (mada)====
=====Pathogenesis=====
If an individual continuously indulges in stale foods and unhealthy/unhygienic habits, the [[dosha]] are vitiated at physical and mental level. His mind gets afflicted with [[raja]] and [[tama]]. The vitiated [[dosha]] obstructs channels carrying nutrient fluid ([[rasa]]), blood ([[rakta]]) and consciousness (sanjna). This causes altered state of consciousness resulting in intoxication (mada), syncope (murchcha) and coma (sanyasa). [Cha.Sa.[[Sutra Sthana]] 24/24-29] Weak minded persons are more susceptible if exposed to vitiation of tri[[dosha]] ([[vata]]/[[pitta]]/[[kapha]]) separately or in combination. [Cha.Sa.[[Sutra Sthana]] 24/28]
If an individual continuously indulges in stale foods and unhealthy/unhygienic habits, the [[dosha]] are vitiated at physical and mental level. His mind gets afflicted with [[raja]] and [[tama]]. The vitiated [[dosha]] obstructs channels carrying nutrient fluid ([[rasa]]), blood ([[rakta]]) and consciousness (sanjna). This causes altered state of consciousness resulting in intoxication (mada), syncope (murchcha) and coma (sanyasa). [Cha.Sa.[[Sutra Sthana]] 24/24-29] Weak minded persons are more susceptible if exposed to vitiation of tri[[dosha]] ([[vata]]/[[pitta]]/[[kapha]]) separately or in combination. [Cha.Sa.[[Sutra Sthana]] 24/28]
=====Stages of intoxication (mada)=====
Three stages of intoxication (mada) are mentioned. In initial stage the person will be over enthusiastic. [Su.Sa.Uttara Sthana. 47/11]<ref name=Susruta/> In the second stage person may talk irrelevantly and will be in delusion stage. In the final stage the person lies unconscious. He may loose his ability to perform any physical action. [Su.Sa.Uttara Sthana. 47/12]<ref name=Susruta/>
Three stages of intoxication (mada) are mentioned. In initial stage the person will be over enthusiastic. [Su.Sa.Uttara Sthana. 47/11]<ref name=Susruta/> In the second stage person may talk irrelevantly and will be in delusion stage. In the final stage the person lies unconscious. He may loose his ability to perform any physical action. [Su.Sa.Uttara Sthana. 47/12]<ref name=Susruta/>
=====Types and [[dosha]] specific features of intoxication (mada)=====
{| class="wikitable"
{| class="wikitable"
|+ Table 1: Types and [[dosha]] specific features of intoxication (mada)
|+ Table 2: Types and [[dosha]] specific features of intoxication (mada)
|-
|-
! [[Dosha]] !! Features of intoxication
! [[Dosha]] !! Features of intoxication
[Cha.Sa.[[Sutra Sthana]] 24/30-33]
[Cha.Sa.[[Sutra Sthana]] 24/30-33]
=====Prognosis=====
Intoxication (mada) caused by poison is most difficult to treat among all types. [A.Hr. Nidhana Sthana 6/29]<ref name=Hridaya/> The transient episodes of other types of intoxication (mada) and syncope (murchha) subside without any medical treatment. However, treatment is required to prevent recurrent episodes and progression in all these disorders.
Intoxication (mada) caused by poison is most difficult to treat among all types. [A.Hr. Nidhana Sthana 6/29]<ref name=Hridaya/> The transient episodes of other types of intoxication (mada) and syncope (murchha) subside without any medical treatment. However, treatment is required to prevent recurrent episodes and progression in all these disorders.
====Syncope (murchha)====
====Syncope (murchha)====
The obstruction of channel of consciousness by aggravated [[dosha]] lead to sudden aggravation of [[tamas]]. This results in cessation of feeling of happiness. The person falls down just like a log of wood. [Su.Sa.Uttara Sthana. 46/6]<ref name=Susruta/> This is a transient state of unconsciousness. The person awakes after the episode of aggravation of [[dosha]] is over.
The obstruction of channel of consciousness by aggravated [[dosha]] lead to sudden aggravation of [[tamas]]. This results in cessation of feeling of happiness. The person falls down just like a log of wood. [Su.Sa.Uttara Sthana. 46/6]<ref name=Susruta/> This is a transient state of unconsciousness. The person awakes after the episode of aggravation of [[dosha]] is over.
=====Pathogenesis=====
Weak or emaciated person with excessive vitiation of [[dosha]] are susceptible. If these persons indulge in incompatible food, suppression of natural urges, or if afflicted by injuries; then the excessively aggravated [[dosha]] affect sensory organs and mind. This results in sudden loss of consciousness. [Su.Sa.Uttara Sthana.46/4]<ref name=Susruta/> The predominant [[dosha]] in the pathogenesis of murchha is [[pitta]]. [Su.Sa.Uttara Sthana.46/8]<ref name=Susruta/>
Weak or emaciated person with excessive vitiation of [[dosha]] are susceptible. If these persons indulge in incompatible food, suppression of natural urges, or if afflicted by injuries; then the excessively aggravated [[dosha]] affect sensory organs and mind. This results in sudden loss of consciousness. [Su.Sa.Uttara Sthana.46/4]<ref name=Susruta/> The predominant [[dosha]] in the pathogenesis of murchha is [[pitta]]. [Su.Sa.Uttara Sthana.46/8]<ref name=Susruta/>
=====Premonitory symptoms=====
Pain in chest, excessive yawning, exhaustion, loss of strength and consciousness. [Su.Sa.Uttara Sthana.46/5]<ref name=Susruta/>
Pain in chest, excessive yawning, exhaustion, loss of strength and consciousness. [Su.Sa.Uttara Sthana.46/5]<ref name=Susruta/>
=====Types and Features of Syncope (murchha)=====
{| class="wikitable"
{| class="wikitable"
The excessively aggravated [[dosha]] affect speech, body and mind. They are lodged in heart (hridaya) and result in cessation of all body activities with absolute loss of consciousness. This condition is coma (sanyasa). [Cha.Sa.[[Sutra Sthana]] 24/42] This is a prolonged episode of unconsciousness.
The excessively aggravated [[dosha]] affect speech, body and mind. They are lodged in heart (hridaya) and result in cessation of all body activities with absolute loss of consciousness. This condition is coma (sanyasa). [Cha.Sa.[[Sutra Sthana]] 24/42] This is a prolonged episode of unconsciousness.
=====Diagnostic tests=====
A variety of blood tests like complete blood count, blood smear, blood type, Coombs test, blood culture, mixing study, bone marrow biopsy are available to diagnose the quality of blood tissue. Angiography, computed tomography scan, magnetic resonance imaging techniques are useful to diagnose abnormalities in blood vessels and blood circulation. Utilization of these diagnostic tools is helpful in knowing precise nature of pathological events in syncope and coma.
A variety of blood tests like complete blood count, blood smear, blood type, Coomb's test, blood culture, mixing study, bone marrow biopsy are available to diagnose the quality of blood tissue. Angiography, computed tomography scan, magnetic resonance imaging techniques are useful to diagnose abnormalities in blood vessels and blood circulation. Utilization of these diagnostic tools is helpful in knowing precise nature of pathological events in syncope and coma.
=====Prognosis=====
Immediate medical intervention is needed for coma (sanyasa). [A.Hr. Nidhana Sthana 6/36] Medical treatment is required to prevent recurrent episodes of disease and correct vitiation of blood tissues.
Immediate medical intervention is needed for coma (sanyasa). [A.Hr. Nidhana Sthana 6/36] Medical treatment is required to prevent recurrent episodes of disease and correct vitiation of blood tissues.
Metabolic acidosis and alkalosis should be considered to gain an understanding of blood disorders (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 blood disorders (raktaja vikara). Electrolyte imbalances should be evaluated for the keen diagnosis of mada, murchcha, and sanyasa. [59-60]
=====Management=====
The first aim of treatments mentioned are under emergency medical care is regaining consciousness. It includes stimulating and irritant therapies. Sensory stimuli by pricking with needle, applying potent collyrium etc. are used to check the level of consciousness. The drugs used are strong and penetrating in nature.
The first aim of treatments mentioned are under emergency medical care is regaining consciousness. It includes stimulating and irritant therapies. Sensory stimuli by pricking with needle, applying potent collyrium etc. are used to check the level of consciousness. The drugs used are strong and penetrating in nature.
After regaining the consciousness, the treatment should be continued to prevent the remission. This includes purificatory procedures like emesis ([[vamana]]), purgation ([[virechana]]), bloodletting ([[raktamoksha]]) etc. After that rejuvenating therapy ([[rasayana]]) is also advised. Medicated ghee processed with herbs is used for this purpose. The lipoidal nature of ghee (cow’s ghee) makes it an effective vehicle for carrying the active principles of processed drugs and it can easily cross the blood brain barrier.<ref>Karandikar YS, Bansude AS, Angadi EA. Comparison between the Effect of Cow Ghee and Butter on Memory and Lipid Profile of Wistar Rats. J Clin Diagn Res. 2016;10(9):FF11-FF15. doi:10.7860/JCDR/2016/19457.8512</ref>
After regaining the consciousness, the treatment should be continued to prevent the remission. This includes purification procedures like emesis ([[vamana]]), purgation ([[virechana]]), bloodletting ([[raktamoksha]]) etc. After that rejuvenating therapy ([[rasayana]]) is also advised. Medicated ghee processed with herbs is used for this purpose. The lipoidal nature of ghee (cow’s ghee) makes it an effective vehicle for carrying the active principles of processed drugs and it can easily cross the blood brain barrier.<ref>Karandikar YS, Bansude AS, Angadi EA. Comparison between the Effect of Cow Ghee and Butter on Memory and Lipid Profile of Wistar Rats. J Clin Diagn Res. 2016;10(9):FF11-FF15. doi:10.7860/JCDR/2016/19457.8512</ref>
==Case reports==
===Case reports===
'''Case 1:'''
'''Case 1:'''
A 43 year old male patient suffered from skull and facial bones fractures due to road traffic accident 10 years ago. He suffered from epilepsy and was taking treatment. The patient reported history of excess mental stress, excess fasting, anorexia and anger. He suffered from convulsions and became unconscious due to intracerebral hemorrhage of 7.9 x 5.6 cm size in right temporo-parietal region. The patient was treated with Ayurvedic medicines like Sindura bhushana mixed with Haridra ghana every four hourly applied on gums. Medicated water processed with gold (Suvarna siddha jala) and green gram soup was given to patient through Ryle’s tube. Jaymangal rasa and Guduchi ghana was added to treat fever. The fever subsided in one day and subsequently the patient started maintaining oxygen levels. The life support system was taken off. The orientation and consciousness improved significantly in a week of treatment. Arpisa rasayana, Jaymangal rasa, vara, and raktapachaka medicines were continued for next two weeks, till complete recovery of the patient. Significant clinical improvement in neurological functions were observed in this patient.<ref name=UpendraD/>
A 43 year old male patient suffered from skull and facial bones fractures due to road traffic accident 10 years ago. He suffered from epilepsy and was taking treatment. The patient reported history of excess mental stress, excess fasting, anorexia and anger. He suffered from convulsions and became unconscious due to intracerebral hemorrhage of 7.9 x 5.6 cm size in right temporo-parietal region. The patient was treated with Ayurvedic medicines like Sindura bhushana mixed with Haridra ghana every four hourly applied on gums. Medicated water processed with gold (Suvarna siddha jala) and green gram soup was given to patient through Ryle’s tube. Jaymangal rasa and Guduchi ghana was added to treat fever. The fever subsided in one day and subsequently the patient started maintaining oxygen levels. The life support system was taken off. The orientation and consciousness improved significantly in a week of treatment. Arpisa rasayana, Jaymangal rasa, vara, and raktapachaka medicines were continued for next two weeks, till complete recovery of the patient. Significant clinical improvement in neurological functions were observed in this patient.<ref name=UpendraD/>
==Effect of seasonal variations in blood physiology==
===Effect of seasonal variations in blood physiology===
A research work was conducted to study effect of seasonal variations on clinical features of blood vitiation described in this chapter. The research also included observations on hematological parameters. The study concluded that significant increase in clinical features of blood vitiation was observed in autumn season (sharad ritu) as compared to rainy season (varsha ritu) and early winters (hemant ritu). Mild seasonal variations were observed in hematological parameters like total red blood cells, white blood cell count, erythrocyte sedimentation rate, absolute eosinophil count, serum cholesterol. A large sample study is required to derive a concrete conclusion.
A research work was conducted to study effect of seasonal variations on clinical features of blood vitiation described in this chapter. The research also included observations on hematological parameters. The study concluded that significant increase in clinical features of blood vitiation was observed in autumn season (sharad ritu) as compared to rainy season (varsha ritu) and early winters (hemant ritu). Mild seasonal variations were observed in hematological parameters like total red blood cells, white blood cell count, erythrocyte sedimentation rate, absolute eosinophil count, serum cholesterol. A large sample study is required to derive a concrete conclusion.
==Contemporary views==
===Contemporary views===
Advanced medical technology has enhanced the understanding of microscopic nature of blood tissue, its components and all physical characteristics. The features described in [[Ayurveda]] text describe macroscopic changes related to affecting [[dosha]]. However, there is much scope of research in bridging the gaps between concepts of these two biomedical sciences.
Advanced medical technology has enhanced the understanding of microscopic nature of blood tissue, its components and all physical characteristics. The features described in [[Ayurveda]] text describe macroscopic changes related to affecting [[dosha]]. However, there is much scope of research in bridging the gaps between concepts of these two biomedical sciences.
Some researchers state that the clinical features are similar to the state of disorders due to change in blood pressure leading to hypertension. Some researchers opine that the pathogenesis and features of mada, murchcha and sanyasa show many similarities with shock due to severe hypotension.<ref>Soumya P. Viswan, Rashmi R. A critical review on hypotension and its management from Ayurvedic perspective. Int. J. Res. Ayurveda Pharm. 2020;11(5):114-120 http://dx.doi.org/10.7897/2277-4343.1105152</ref>
Some researchers state that the clinical features are similar to the state of disorders due to change in blood pressure leading to hypertension. Some researchers opine that the pathogenesis and features of mada, murchcha and sanyasa show many similarities with shock due to severe hypotension.<ref>Soumya P. Viswan, Rashmi R. A critical review on hypotension and its management from Ayurvedic perspective. Int. J. Res. Ayurveda Pharm. 2020;11(5):114-120 http://dx.doi.org/10.7897/2277-4343.1105152</ref>
==Future research areas==
===Future research areas===
*Role of causative factors described in this chapter in hematological disorders and disorders of cardio vascular system
*Role of causative factors described in this chapter in hematological disorders and disorders of cardio vascular system
*Understanding exact pathological and microscopic nature of vitiation of blood and relation with [[dosha]] specific changes
*Understanding exact pathological and microscopic nature of vitiation of blood and relation with [[dosha]] specific changes
*Influence of seasonal changes on blood physiology
*Influence of seasonal changes on blood physiology
*Epigenetic changes in blood tissue and its patho-physiological understanding
*Epigenetic changes in blood tissue and its patho-physiological understanding
==Related chapters==
==Related chapters==