AIAPGET POINTS
– Pana and Abhyanga of Purana Sarpi and Yogas described within the therapy of Graha Roga are additionally prescribed within the therapy of Apasmara.
– Godha-Nakuladhya Taila is used within the therapy of Apasmara.
– Rudra and Rudra Ganas needs to be worshipped day-after-day by sufferers affected by Apasmara.
– Panchagavya Ghrta described in Apasmara Pratisedha can be used within the therapy of Chaturthaka Jwara.
– Siddharthaka Ghrta described in Apasmara Pratisedha can be used within the therapy of Vishama Jwara
– In Apasmara, the individual loses Smriti and Bhutartha Vijnana.
– Sanjnavaha Srotas are affected by doshas, rajas and tamas in Apasmara.
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The 61st chapter of Uttaratantra of Sushruta Samhita is known as as Apasmāra Pratiședha. This chapter offers with Remedy of Epilepsy.
अथातोऽपस्मारप्रतिषेधमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We are going to now expound Apasmāra pratişedha – therapy of Epilepsy; as revealed by the venerable Dhanvantari.
Nirukti – definition
स्मृतिर्भूतार्थविज्ञानमपश्च परिवर्जने |
अपस्मार इति प्रोक्तस्ततोऽयं व्याधिरन्तकृत् ||३||
Apasmara is the title of a illness wherein the reminiscence and information of nature (of the issues) are misplaced. It will definitely causes the dying of the individual.
Nidāna – causes
मिथ्यातियोगेन्द्रियार्थकर्मणामभिसेवनात् |
विरुद्धमलिनाहारविहारकुपितैर्मलैः ||४||
वेगनिग्रहशीलानामहिताशुचिभोजिनाम् |
रजस्तमोभिभूतानां गच्छतां च रजस्वलाम् ||५||
तथा कामभयोद्वेगक्रोधशोकादिभिर्भृशम् |
चेतस्यभिहते पुंसामपस्मारोऽभिजायते ||६||
Beneath talked about are the causes of Apasmara –
– improper and extra affiliation of sense organs with their objects and
– improper and extra actions of the physique, thoughts and speech,
– extreme indulgence in incompatible and contaminated meals and improper actions resulting in aggravation of the doshas,
– suppression of the urges of the physique and
– routine consumption of soiled or polluted meals,
– being enormously engrossed with rajas and tamas qualities,
– copulation with girl throughout her menstrual durations,
– being enormously with lust, concern, agitation, anger, sorrow and such different feelings
Because of these causes, the thoughts of the individual will get disordered. Because of this, Apasmara develops.
Pūrvarūpa – premonitory signs
हृत्कम्पः शून्यता स्वेदो ध्यानं मूर्च्छा प्रमूढता |
निद्रानाशश्च तस्मिंस्तु भविष्यति भवन्त्यथ ||७||
Beneath talked about are the premonitory signs of Apasmara –
– tremor,
– feeling of vacancy of the guts (thoughts),
– sweating,
– fear,
– fainting,
– unconsciousness and
– lack of sleep
These signs seem earlier than the manifestation of the illness (apasmara).
Samprāpti – pathogenesis
सञ्ज्ञावहेषु स्रोतःसु दोषव्याप्तेषु मानवः |
रजस्तमःपरीतेषु मूढो भ्रान्तेन चेतसा ||८||
विक्षिपन् हस्तपादं च विजिह्मभ्रूर्विलोचनः |
दन्तान् खादन् वमन् फेनं विवृताक्षः पतेत् क्षितौ ||९||
अल्पकालान्तरं चापि पुनः सञ्ज्ञां लभेत सः |
सोऽपस्मार इति प्रोक्तः… |१०|
Beneath talked about occasions (indicators and signs) happen when the samjnavaha srotas i.e. channels carrying sensation change into crammed with vitiated by doshas, rajas and tamas additionally –
– the individual turns into mindless attributable to disordered thoughts,
– makes violent actions of the arms, legs, eyebrows and eyes,
– grinds the enamel,
– emits froth from the mouth,
– falls on the bottom with eyes open and regains consciousness after brief time
The illness presenting with the above mentioned options known as Apasmara.
Varieties of Apasmara
… स च दृष्टश्चतुर्विधः ||१०||
वातपित्तकफैर्नॄणां चतुर्थः सन्निपाततः |११|
Apasmara is of 4 varieties –
– one every by vata, pitta and kapha and
– the fourth one by sannipata – mixture of all of the three doshas
Lakṣaṇa – scientific options
Vataja Apasmara
वेपमानो दशन् दन्तान् श्वसन् फेनं वमन्नपि ||११||
यो ब्रूयाद्विकृतं सत्त्वं कृष्णं मामनुधावति |
ततो मे चित्तनाशः स्यात् सोऽपस्मारोऽनिलात्मकः ||१२||
An individual affected by epilepsy of vata origin has the beneath talked about indicators and signs –
– the individual has trembling, bites his enamel, has dyspnoea and vomiting of froth,
– he says that irregular black colored animals or objects are working after him and that
– he has misplaced his thoughts
Pittaja Apasmara
तृट्तापस्वेदमूर्च्छार्तो धुन्वन्नङ्गानि विह्वलः |
यो ब्रूयाद्विकृतं सत्त्वं पीतं मामनुधावति ||१३||
ततो मे चित्तनाशः स्यात् स पित्तभव उच्यते |१४|
Individuals affected by epilepsy of pitta origin has the beneath talked about indicators and signs –
– the individual suffers from thirst, heat, sweating and fainting, and shaking of the physique elements,
– he’s agitated,
– he says that irregular yellow animals or objects are working after him and that
– his thoughts has change into misplaced
Kaphaja Apasmara
शीतहृल्लासनिद्रार्तः पतन् भूमौ वमन् कफम् ||१४||
यो ब्रूयाद्विकृतं सत्त्वं शुक्लं मामनुधावति |
ततो मे चित्तनाशः स्यात् सोऽपस्मारः कफात्मकः ||१५||
Indicators and signs of epilepsy brought on by kapha –
– chilly (rigors),
– nausea,
– sleep,
– falling on the bottom vomiting kapha,
– seeing an irregular animal or object working after him (the affected person says so) and
– the thoughts being misplaced (as skilled and mentioned by the affected person)
हृदि तोदस्तृडुत्क्लेदस्त्रिष्वप्येतेषु सङ्ख्यया |
प्रलापः कूजनं क्लेशः प्रत्येकं तु भवेदिह ||१६||
In these three varieties, ache within the coronary heart, thirst and nausea are the particular signs respectively. Irrelevant speech, moaning and debility are additionally present in these varieties respectively.
Sannipataja Apasmara
सर्वलिङ्गसमवायः सर्वदोषप्रकोपजे |१७|
All of the signs of all doshas will probably be current collectively in apasmara produced by mixture of all of the doshas.
Añyamata – completely different opinion
अनिमित्तागमाद्व्याधेर्गमनादकृतेऽपि च ||१७||
आगमाच्चाप्यपस्मारं वदन्त्यन्ये न दोषजम् |१८|
Some students are of the opinion that Apasmara just isn’t produced by the doshas. Beneath talked about are the explanations –
– apasmara arises with none obvious trigger,
– apasmara disappears with none therapy and
– due to scriptures describing the illness in another way
Svamata – private opinion (of Suśruta)
क्रमोपयोगाद्दोषाणां क्षणिकत्वात्तथैव च ||१८||
आगमाद्वैश्वरूप्याच्च स तु निर्वर्ण्यते बुधैः |
देवे वर्षत्यपि यथा भूमौ बीजानि कानिचित् ||१९||
शरदि प्रतिरोहन्ति तथा व्याधिसमुद्भवः |
स्थायिनः केचिदल्पेन कालेनाभिप्रवर्धिताः ||२०||
दर्शयन्ति विकारांस्तु विश्वरूपान्निसर्गतः |
अपस्मारो महाव्याधिस्तस्माद्दोषज एव तु ||२१||
Clever individuals are of the definitive opinion that the illness is born from doshas solely as a result of –
– doshas change into steadily aggravated,
– the doshas are unstable i.e. altering from one stage to the opposite,
– in all of the scriptures it has been described that it’s brought on by the doshas and
– of getting many varieties
Regardless of the rains occurring at different occasions additionally, the seed within the floor sprouts solely throughout Sarad Rtu (autumn). Equally, the illness additionally develops from the doshas that are staying within the physique, getting aggravated in a really brief time and manifesting its completely different signs by their nature solely.
Therefore, this dreadful illness – apasmara is produced by doshas solely.
Cikitsä – therapy
तस्य कार्यो विधिः सर्वो य उन्मादेषु वक्ष्यते |
पुराणसर्पिषः पानमभ्यङ्गश्चैव पूजितः ||२२||
उपयोगो ग्रहोक्तानां योगानां तु विशेषतः |
ततः सिध्यन्ति ते सर्वे योगैरन्यैश्च साधयेत् |
शिग्रुकट्वङ्गकिण्वाहिनिम्बत्वग्रससाधितम् ||२३||
चतुर्गुणे गवां मूत्रे तैलमभ्यञ्जने हितम् |२४|
Every kind of therapies indicated for Unmada (madness, psychoses) within the subsequent chapter needs to be adopted within the therapy of this illness additionally.
Within the earlier chapter, consuming of previous ghee, anointing the physique with previous ghee and use of medicinal formulae are talked about for the therapy of grahas (demons). These therapies ought to specifically be executed on this illness additionally. Another methodology or therapies that are helpful in curing the affliction of grahas also needs to be adopted within the therapy of this illness.
Oil ready with decoction of the beneath talked about components is helpful for anointing –
– bark of sigru,
– katvanga,
– kinihi and
– nimba added with
– 4 elements of gomutra
गोधानकुलनागानां पृषतर्क्षगवामपि ||२४||
पित्तेषु सिद्धं तैलं च पानाभ्यङ्गेषु पूजितम् |२५|
तीक्ष्णैरुभयतोभागैः शिरश्चापि विशोधयेत् ||२५||
Oil ready with the beneath talked about components is particularly helpful for consuming and anointing –
– bile of iguana,
– mongoose,
– elephant and
– noticed deer and
– black deer
Purification of the physique in each higher and decrease instructions i.e. vamana and virechana needs to be executed. Other than this, purgation of the top also needs to be executed enormously with robust herbs.
पूजांरुद्रस्यकुर्वीततद्गणानांचनित्यशः।।
One ought to worship Rudra and his Gana (attendants, retinue) day-after-day.
वातिकं बस्तिभिश्चापि पैत्तिकं तु विरेचनैः ||२६||
कफजं वमनैर्धीमानपस्मारमुपाचरेत् |२७|
Apasmara of Vata origin needs to be
handled by the smart doctor by administering enema remedy.
Apasmara of Pitta origin needs to be handled by administration of purgation remedy.
Apasmara of Kapha origin needs to be handled by administration of emesis remedy.
कुलत्थयवकोलानि शणबीजं पलङ्कषाम् ||२७||
जटिलां पञ्चमूल्यौ द्वे पथ्यां चोत्क्वाथ्य यत्नतः |
बस्तमूत्रयुतं सर्पिः पचेत्तद्वातिके हितम् ||२८||
Decoction of the beneath talked about is ready –
– Kulattha,
– Yava,
– Kola,
– Sanabija,
– Palankasa,
– Jatila,
– Herbs comprising of each Pancamula (Dasamula) and
– Pathya
This decoction is added with goat’s urine and ghee is cooked with it. This ghee is helpful in treating apasmara produced by vata.
काकोल्यादिप्रतीवापं सिद्धं च प्रथमे गणे |
पयोमधुसितायुक्तं घृतं तत् पैत्तिके हितम् ||२९||
Beneath talked about are cooked collectively and medicated ghee is ready –
– ghee,
– decoction of herbs belonging to the primary gana i.e. vidarigandhadi gana group,
– paste of herbs belonging to kakolyadi gana group
This ghee is consumed, blended with milk, honey and sugar. It’s helpful in treating apasmara produced by pitta.
कृष्णावचामुस्तकाद्यैर्युक्तमारग्वधादिके |
पक्वं च मूत्रवर्गे तु श्लेष्मापस्मारिणे हितम् ||३०||
Ghee is cooked with –
– decoction of Aragvadhadi Gana group of herbs together with
– paste of Krsna, Vaca and Musta and
– mutra vargas – teams of urine
This medicated ghee is helpful in treating Apasmara produced by Kapha.
Siddharthaka ghṛta
सुरद्रुमवचाकुष्ठसिद्धार्थव्योषहिङ्गुभिः |
मञ्जिष्ठारजनीयुग्मसमङ्गात्रिफलाम्बुदैः ||३१||
करञ्जबीजशैरीषगिरिकर्णीहुताशनैः |
सिद्धं सिद्धार्थकं नाम सर्पिर्मूत्रचतुर्गुणम् ||३२||
कृमिकुष्ठगरश्वासबलासविषमज्वरान् |
सर्वभूतग्रहोन्मादानपस्मारांश्च नाशयेत् ||३३||
Decoction of the beneath talked about herbs is ready –
– Suradruma (Devadaru),
– Vaca,
– Kustha,
– Siddhartha,
– Vyosa,
– Hingu,
– Manjistha,
– Two sorts of Rajani,
– Samanga,
– Triphala,
– Ambuda,
– Karanja Bija,
– Sirisa,
– Girikarnika and
– Hutasana (Citraka)
This decoction is boiled and processed with one a part of ghee and 4 elements of gomutra and medicated ghee is ready.
Advantages – This ghee is named Siddharthaka Ghrta. When consumed, it cures ailments brought on by worms, pores and skin ailments, synthetic poisons, dyspnoea, kapha ailments, intermittent fevers, ailments brought on by all grahas (demons), madness and epilepsy.
Pañcagavya ghṛta
दशमूलेन्द्रवृक्षत्वङ्मूर्वाभार्गीफलत्रिकैः |
शम्पाकश्रेयसीसप्तपर्णापामार्गफल्गुभिः ||३४||
शृतैः कल्कैश्च भूनिम्बपूतीकव्योषचित्रकैः |
त्रिवृत्पाठानिशायुग्मसारिवाद्वयपौष्करैः ||३५||
कटुकायासदन्त्युग्रानीलिनीक्रिमिशत्रुभिः [१] |
सर्पिरेभिश्च गोक्षीरदधिमूत्रशकृद्रसैः ||३६||
साधितं पञ्चगव्याख्यं सर्वापस्मारभूतनुत् |
चातुर्थकक्षयश्वासानुन्मादांश्च नियच्छति ||३७||
Elements –
– Decoction of Dasamula, bark of Indravrksa, Murva, Bharngi, Phalatrika, Sampaka, Sreyasi, Saptaparna, Apamarga and Phalgu added with
– Paste of Bhunimba, Putika, Vyosa, Citraka, Trivrt, Patha, two sorts of Nisa, two sorts of Sariva, Puskaramula, Katuka, Yasa, Danti, Ugra, Nilini and Krimisatru (vidanga), together with
– Milk, curds, urine and juice of cow dung and ghee, all of cow
All of the above mentioned components are boiled and processed collectively in order to arrange their medicated ghee.
This recipe is named Pancagavya Ghrta. It cures all types of epilepsy, demons, quartan fever, consumption, dyspnoea and madness.
भार्गीशृते पचेत् क्षीरे शालितण्डुलपायसम् |
त्र्यहं शुद्धाय तं भोक्तुं वराहायोपकल्पयेत् ||३८||
ज्ञात्वा च मधुरीभूतं तं विशस्यान्नमुद्धरेत् |
त्रीन् भागांस्तस्य चूर्णस्य किण्वभागेन संसृजेत् ||३९||
मण्डोदकार्थे देयश्च भार्गीक्वाथः सुशीतलः |
शुद्धे कुम्भे निदध्याच्च सम्भारं तं सुरां ततः ||४०||
जातगन्धां जातरसां पाययेदातुरं भिषक् |४१|
Milk needs to be boiled and processed with decoction of Bharngi, rice and milk. This recipe needs to be fed to a boar which has been made to quick for 3 days. It needs to be fed for 3 days. The boar needs to be killed after confirming that the boar has change into candy after consuming the above talked about recipe.
Three elements of this meat needs to be taken and blended with one a part of kinva (yeast). That is now put into the decoction of Bharngi. This liquid is now poured right into a clear pot together with adjuvants similar to powder of Chaturjata, Pippali, Honey and so on. This pot is stored undisturbed for some days. The recipe needs to be given to the affected person for consuming as soon as it has attained good odor and style.
सिरां विध्येदथ प्राप्तां मङ्गल्यानि च धारयेत् ||४१||
After this, venepuncture could also be executed on the stipulated web site as defined in sarira sthana, chapter 8. Mangalya i.e. amulets created from auspicious herbs and so on also needs to be worn on the physique.
इति श्रीसुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते भूतविद्यातन्त्रेऽपस्मारप्रतिषेधो नाम (द्वितीयोऽध्यायः, आदितः) एकषष्टितमोऽध्यायः।।६१।।
Thus ends the sixty-first chapter by title Apasmāra pratisedha in Uttara sthana of Suśruta Samhita.