The seventh chapter of Uttara Sthanam of Ashtanga Hridayam is known as as Apasmara Pratisedha adhyāyaṃ. This chapter offers with the reason of ‘therapy of epilepsy’.
The matters coated on this chapter embrace –
- Nirvacana – Samprapti – Definition and Pathogenesis
- Bhedas – varieties
- Purva Rupa – prodromal signs
- Vataja Apasmara – Epilepsy of Vata origin
- Pittaja Apasmara – Epilepsy of Pitta origin
- Kaphaja Apasmara – Epilepsy of Kapha origin
- Cikitsa – therapy
- Pancagavya Ghrta
- Maha Pancagavya Ghrta
- Brahmyadi Ghrta
- Jivaniya Gana Siddha Ghrta
- Kashmaryadi Ghrta
- Anya Yoga
- Nasya Yoga – Nasal Drops
- Dhupa – Fumigation
Pledge by the creator (s)
अथातोऽपस्मारप्रतिषेधं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having supplied prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘therapy of the epilepsy’. Thus say (pledge) Atreya and different sages.
Nirvachana-Samprapti: Definition and Pathogenesis
स्मृत्यपायो ह्यपस्मारः स धीसत्त्वाभिसंप्लवात् ।
जायतेऽभिहते चित्ते चिन्ताशोकभयादिभिः ॥१॥
उन्मादवत्प्रकुपितैश्चित्तदेहगतैर्मलैः ।
हते सत्त्वे हृदि व्याप्ते सञ्ज्ञावाहिषु खेषु च॥२॥
तमो विशन् मूढमतिर्बीभत्साः कुरुते क्रियाः ।
दन्तान् खादन् वमन् फेनं हस्तौ पादौ च विक्षिपन्॥ ३ ॥
पश्यन्नसन्ति रूपाणि प्रस्खलन् पतति क्षितौ ।
विजिह्माक्षिभ्रुवो दोषवेगेऽतीते विबुध्यते ॥४॥
कालान्तरेण स पुनश्चैवमेव विचेष्टते ।
Apasmara is harmful and will trigger destruction of reminiscence, data of the environment, of previous occasions and outcomes from lack of/fluctuation of Dhi (understanding, knowledge) and satva (consciousness, thoughts) when the citta (thoughts, pondering) will get deranged by (the impact of) fear, grief, worry and many others. By the Doshas getting elevated in the identical means as in unmada (madness) localized within the coronary heart (thoughts) and Deha (physique), deranges (destroys) the thoughts, spreads within the coronary heart and Samjnavaha channels (pathways of nerve alerts / consciousness). The individual enters into darkness (lack of consciousness) together with his thoughts turning into
inactive, performs terrifying actions resembling grinding the enamel, emitting froth from the mouth, shaking the fingers and toes violently (convulsions), seeing non-existing issues, loses stability and falls on the bottom, with irregular eyes (actions) and eyebrows, will get up regaining acutely aware after the expiry of bouts of the Doshas. After a while (days or months) he performs such irregular actions in the identical means.
Bhedas: Varieties
अपस्मारश्चतुर्भेदो वाताद्यैर्निचयेन च ॥ ५ ॥
Epilepsy is of 4 varieties; by Vata and many others. (Vata, Pitta and Kapha) individually and by the mix of all of the three Doshas (Sannipata).
Purva Rupa: Prodromal signs
रूपमुत्पत्स्यमानेऽस्मिन् हृत्कम्पः शून्यता भ्रमः।
तमसो दर्शनं ध्यानं भ्रूव्युदासोऽक्षिवैकृतम् ॥६॥
अशब्दश्रवणं स्वेदो लालासिङ्घाणकस्रुतिः ।
अविपाकोऽरुचिर्मूर्छा कुक्ष्याटोपो बलक्षयः ॥७॥
निद्रानाशोऽङ्गमर्दस्तृट् स्वप्ने गानं सनर्तनम् ।
पानं तैलस्य मद्यस्य तयोरेव च मेहनम् ॥८॥
The options of the Apasmara are – tremors of the guts, feeling of the vacancy (of the guts), dizziness, seeing tamas – darkness earlier than the eyes (lack of consciousness) fear, dropping of the brows, irregular actions of the attention, hears sounds which aren’t current, sweating, saliva, and nasal secretion, indigestion, lack of urge for food, fainting, gurgling noise within the stomach, lack of energy, lack of sleep, bodyache, thirst, goals of singing, dancing, consuming of oil and wine and urinating the identical (all these in goals).
Vataja Apasmara: Epilepsy of Vata origin
तत्र वातात्स्फुरत्सक्थिः प्रपतंश्च मुहुर्मुहुः ।
अपस्मरति सञ्ज्ञां च लभते विस्वरं रुदन् ॥९॥
उत्पिण्डिताक्षः श्वसिति फेनं वमति कम्पते ।
आविध्यति शिरो दन्तान् दशत्याध्मातकन्धरः॥ १०॥
परितो विक्षिपत्यङ्गं विषमं विनताङ्गुलिः ।
रूक्षश्यावारुणाक्षित्वङ्नखास्यः कृष्णमीक्षते ॥११॥
चपलं परुषं रूपं विरूपं विकृताननम् ।
In that sort brought on by Vata, the affected person has tremors within the thighs, falls on the bottom time and again, dropping reminiscence (consciousness) and will get it again quickly; cries in a foul voice, eyes bulged out, has dyspnoea, vomits froth; shivers, strikes his head (to issues close by) grinds the enamel, shoulders are bulged, locations the physique elements (arms, legs) right here and there irregularly (convulsions), fingers are bent inward, dryness and bluish-red color within the eyes, pores and skin, nails and face; sees issues that are black, unsteady and tough in form or issues which don’t have any form and irregular faces.
Pittaja Apasmara: Epilepsy of Pitta origin
अपस्मरति पित्तेन मुहुः सञ्ज्ञां च विन्दति ॥१२
पीतफेनाक्षिवक्त्रत्वगास्फालयति मेदिनीम् ।
भैरवादीप्तरुषितरूपदर्शी तृषान्वितः ॥१३॥
In that brought on by Pitta, the individual loses consciousness and regains it rapidly, emits yellow froth from the mouth; eyes, face, pores and skin are yellowish, scratches the bottom (throughout convulsions) sees terrifying, burning, vivid pink coloured objects and suffers from thirst.
Kaphaja Apasmara: Epilepsy of Kapha origin
कफाच्चिरेण ग्रहणं चिरेणैव विबोधनम् ।
चेष्टाल्पा भूयसी लाला शुक्लनेत्रनखास्यता ॥१४॥
शुक्लाभरूपदर्शित्वं सर्वलिङ्गं तु वर्जयेत् ।
In that as a result of kapha, seizures are gradual with lengthy intervals, so additionally very long time for the awakening (regaining consciousness) actions (convulsions) are few and delicate, there’s extreme circulate of saliva, eyes, nails and face are white, sees objects that are white in colour. That as a result of all of the Doshas has all of the options showing collectively; it ought to be rejected.
Chikitsa: Remedy
अथावृतानां धीचित्तहृत्खानां प्राक्प्रबोधनम् ॥१५॥
तीक्ष्णैः कुर्यादपस्मारे कर्मभिर्वमनादिभिः ।
In epilepsy the channels of mind, reminiscence and hrt (thoughts) which have grow to be coated / obstructed (by the Doshas) ought to be cleared first by therapies resembling sturdy emesis and many others.
Chikitsa: Remedy
वातिकं वस्तिभूयिष्ठैः पैत्तं प्रायो विरेचनैः ॥१६॥
श्लैष्मिकं वमनप्रायैरपस्मारमुपाचरेत् ।
सर्वतः सुविशुद्धस्य सम्यगाश्वासितस्य च॥१७॥
अपस्मारविमोक्षार्थं योगान् संशमनाञ्छृणु ।
The apasmara brought on by Vata, ought to be handled with enema remedy, that brought on by Pitta by purgation remedy and that brought on by Kapha, particularly with emesis remedy. Hear now, medicinal recipes by pacifying motion for the treatment of epilepsy by all means, after doing correct – purificatory therapies and assurance.
Panchagavya Ghrita
गोमयस्वरसक्षीरदधिमूत्रैः शृतं हविः ॥१८॥
अपस्मारज्वरोन्मादकामलान्तकरं पिबेत् ।
Medicated ghee ready by boiling ghee added with juice of contemporary cow dung, cow milk, curd and cow urine ought to be consumed to treatment epilepsy, fever, madness jaundice.
Maha Panchagavya Ghrita
द्विपञ्चमूलत्रिफलाद्विनिशाकुटजत्वचः ॥१९॥ सप्तपर्णमपामार्गं नीलिनीं कटुरोहिणीम् ।
शम्याकपुष्करजटाफल्गुमूलदुरालभाः ॥२०॥
द्विपलाः सलिलद्रोणे पक्त्वा पादावशेषिते ।
भार्गीपाठाढकीकुम्भनिकुम्भव्योषरोहिषैः ॥२१॥
मूर्वाभूतिकभूनिम्बश्रेयसीशारिवाद्वयैः ।
मदयन्त्यग्निनिचुलैरक्षांशैः सर्पिषः पचेत् ॥२२॥
प्रस्थं तद्वद्द्रवैः पूर्वैः पञ्चगव्यमिदं महत् ।
ज्वरापस्मारजठरभगन्दरहरं परम् ॥२३॥
शोफार्शःकामलापाण्डुगुल्मकासग्रहापहम् ।
Two pala (96 grams) every of the 2 Panchamulas –
Bilva – Aegle marmelos
Agnimantha – Premnamucronata
Shyonaka – Oroxylum indicum
Patala – Stereospermumsuaveolens
Gambhari – Gmelina arborea
Shalaparni – Desmodiumgangeticum
Prishniparni – Urariapicta
Brihati – Solanum indicum
Kantakari – Solanum xanthocarpum
Gokshura – Tribulus terrestris,
triphalā – Triphala (Haritaki – Terminalia chebula, Vibhitaki – Terminalia bellerica & Amalaki – Emblica officinalis),
dviniśā – the 2 Nisa (Haridra – Curcuma longa & Daruharidra -Berberis aristata),
kuṭaja tvacaḥ – bark of Holarrhena antidysenterica,
saptaparṇaṃ – Alstonia scholaris,
apāmārgaṃ – Achyranthes aspera,
nīlinīṃ – Indigofera tinctoria,
kaṭurohiṇīm – Picrorrhiza kurroa,
śamyāka – Oroxylum indicum,
puṣkara jaṭā – Inula racemosa,
phalgumūla – Root of Ficus hispida
durālabhāḥ – Fagonia cretica,
are boiled in a single drone (12.228 litres) of water and decoction decreased to 1 fourth. To this are added the paste of 1 Aksa (12 grams) every of
bhārgī – Clerodendrum serratum,
pāṭhā – Cissampelos pareira,
aḍhakī – Cajanas cajana,
kumbha – Croton tiglium / Jatropha curcas,
nikumbha – Baliospermum montanum,
vyoṣa – Vyosa (Black pepper – Piper nigrum, Lengthy pepper fruit – Piper longum and Ginger – Zingiber officinale),
rohiṣaiḥ – Cymbopogon martinii,
mūrvā – Marsdenia tenacissima,
bhūtika – Trachyspermum ammi,
bhūnimba – Andrographis paniculata,
śreyasī – Scindapsus officinalis
śārivādvayaiḥ – the 2 Sariva (Shveta Sariva – white selection – Hemidesmus indicus and Krishna Sariva – Cryptolepis buchanani / Ichnocarpus frutescens),
madayanti – Lawsonia inermis,
agni – Plumbago zeylanica
niculai: – Barringtonia acutangula;
one Prastha (768 gram) of ghee, equally liquids talked about earlier (juice of contemporary dung, milk, curds, and urine of the cow) and medicated ghee ready. It is called Mahapancagavya Ghrta, is finest to treatment fever, epilepsy, enlargement of the stomach, fistula-in-ano, edema, hemorrhoids, jaundice, anemia, belly tumor, cough and ailments brought on by evil spirits.
Brahmi Ghritam
ब्राह्मीरसवचाकुष्ठशङ्खपुष्पीशृतं घृतम् ॥२४॥
पुराणं मेध्यमुन्मादालक्ष्म्यपस्मारपाप्मजित् ।
Previous ghee boiled with the contemporary juice of Bacopa monnieri,
vacā – Acorus calamus,
kuṣṭha – Saussurea lappa
śaṅkhapuṣpī – Convolvulus pluricaulis
medhyaṃ – improves intelligence
unmāda – and cures madness,
alakṣmī – sorcery,
apasmāra – epilepsy
pāpmajit – illness brought on by sins.
Jivaniya Gana Siddha Yamakam
तैलप्रस्थं घृतप्रस्थं जीवनीयैः पलोन्मितैः ॥२५॥
क्षीरद्रोणे पचेत्सिद्धमपस्मारविमोक्षणम् ।
One prastha (768 ml) of oil and one Prastha (768 ml) of ghee, one pala (48 grams) every of herbs of Jivaniya Gana (vide chapter 15 of Sutrasthana) are cooked in a single drona (12.228 litres) of milk. Thus ready medication relieves epilepsy.
Kashmaryadi Ghrita
कंसे क्षीरेक्षुरसयोः काश्मर्येऽष्टगुणे रसे ॥२६॥
कार्षिकैर्जीवनीयैश्च सर्पिःप्रस्थं विपाचयेत् ।
वातपित्तोद्भवं क्षिप्रमपस्मारं निहन्ति तत् ॥२७॥
Medicated ghee is ready with one Kamsa (one adhaka – 3.072 litres) every of milk, and juice of sugarcane, eight elements of juice of kāśmarye – Gmelina arborea, one Karsa (12 grams) every of the herbs of Jivaniya gana and one Prastha (768 grams) of ghee. This rapidly cures epilepsy brought on by Vata pitta collectively.
Anya Yoga | Kushmanda Yashtimadhu Ghrita
तद्वत्काशविदारीक्षुकुशक्वाथशृतं पयः ।
कूष्माण्डस्वरसे सर्पिरष्टादशगुणे शृतम् ॥२८॥
यष्टीकल्कमपस्मारहरं धीवाक्स्वरप्रदम् ।
Milk boiled with the decoction of kāśa – Saccharum spontaneum, vidāri – Pueraria tuberosa, ikṣu – Saccharum officinarum, kuśa – Desmostachya bipinnata, acts related. Ghee boiled with eighteen instances its amount of juice of Benincasa cerifera added with paste of Glycyrrhiza glabra cures epilepsy and bestows good intelligence, speech and voice.
Nasya Yoga: Nasal Drops
कपिलानां गवां पित्तं नावने परमं हितम् ॥२९॥
श्वशृगालबिडालानां सिंहादीनां च पूजितम् ।
Pitta (Bile) of the cow which is brown in color is helpful as nasal drops and is the most effective; that (bile) of the canine, śṛgāla – jackal, biḍālānāṃ – cat, siṃhādīnāṃ – lion and many others is finest.
Nasya Yoga: Nasal Drops
गोधानकुलनागानां पृषतर्क्षगवामपि ॥ ३० ॥
पित्तेषु साधितं तैलं नस्येऽभ्यङ्गे च शस्यते ।
Oil boiled with the bile of the iguana lizard, nakula – mongoose, nāgānāṃ – elephant, noticed deer (or leopard), bear, cow, is very helpful when used as nasal treatment and therapeutic massage over the physique.
Nasya Yoga: Nasal Drops
त्रिफलाव्योषपीतद्रुयवक्षारफणिज्जकैः ॥३१॥
श्र्याह्वापामार्गकारञ्जबीजैस्तैलं विपाचितम् ।
बस्तमूत्रे हितं नस्यं चूर्णं वा ध्मापयेद्भिषक्॥३२॥
Oil ought to be cooked with triphalā – triphala (Haritaki – Terminalia chebula, Vibhitaki – Terminalia bellerica & Amalaki – Emblica officinalis), vyoṣa – Vyosa (Black pepper – Piper nigrum, Lengthy pepper fruit – Piper longum and Ginger – Zingiber officinale), pītadru – Berberis aristata,
alkali ready of Hordeum vulgare, phaṇijjakaiḥ – Origanum majorana, śryāhva – Aegle marmelos, apāmārga – Achyranthes aspera, seed of Pongamia pinnata, with the addition of Goat’s urine this oil used as nasal drops or the powder of the above herbs blown into the nostril by the doctor is helpful.
Dhupa: Fumigation
नकुलोलूकमार्जारगृध्रकीटाहिकाकजैः ।
तुण्डैः पक्षैः पुरीषैश्च धूपमस्य प्रयोजयेत् ॥३३॥
Fumigation ought to be accomplished with the beak, feathers and excreta of the mongoose, owl, cat, vulture, bugs, snake or crow.
Lashunadi tailam
शीलयेत्तैललशुनं पयसा वा शतावरीम् ।
ब्राह्मीरसं कुष्ठरसं वचां वा मधुसंयुताम् ॥३४॥
Sesame oil blended with laśunaṃ – Allium sativum, śatāvarīm – Asparagus racemosus, blended with milk, contemporary juice of Bacopa monnieri, or juice of Saussurea lappa or of Acorus calamus could also be consumed day by day blended with honey.
Significance of Rasayana remedy
समं क्रुद्धैरपस्मारो दोषैः शारीरमानसैः ।
यज्जायते यतश्चैष महामर्मसमाश्रयः ॥३५॥
तस्माद्रसायनैरेनं दुश्चिकित्स्यमुपाचरेत् ।
तदार्तं चाग्नितोयादेर्विषमात्पालयेत्सदा ॥३६॥
Since epilepsy arises from the aggravation (enhance) of the Doshas of the physique and thoughts collectively after which localized in a Mahamarma (essential important organ, the pinnacle) so it’s tough to treatment; therefore it ought to be handled with Rasayana remedy (rejuvenator remedy). The individual affected by it ought to be shielded from hearth, water and such different hazardous issues at all times.
Strengthening the thoughts
मुक्तं मनोविकारेण त्वमित्थं कृतवान् इति ।
न ब्रूयाद्विषयैरिष्टैः क्लिष्टं चेतोऽस्य बृंहयेत्॥३७॥
After the thoughts turns into cleared of all issues, the affected person shouldn’t be instructed, you had been doing such and such acts and many others. His thoughts (which if feeble) troubles ought to be addressed and ought to be strengthened by supplying the issues desired.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थानेऽपस्मारप्रतिषेधो नाम सप्तमोऽध्याय:॥ ७॥
Thus, ends the chapter Apasmara Pratisedha the seventh in Uttarasthana o Astanga Hrudaya Samhita-composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
Thus, ends Bhuta Tantra/ Graha Cikitsa (demonology), the third department of Ayurveda.