Charak Samhita - Nidana Sthana - Chapter 8 (Apasmara Nidana)
Charaka Samhita is an ancient ayurvedic medicine text which is believed to have originated in the First century CE and was written by Acharya Charaka. In Charaka samhita there is explanation of various diseases, their causes, Symptoms, pathogenesis and their treatment. In Charak Samhita, there are a total of eight sthanas and 120 chapters which are named as Sutra sthana, Nidana sthana, Chikitsa sthana, vimana sthana, indriya sthana, kalp sthana, Siddhi Sthana, Sharira Sthana and has its own significance. In this article we will discuss the eighth chapter of Nidana Sthana named Apasmara Nidana.
Apasmara can be termed as epilepsy in modern times. It is a brain condition in which the person has Recurrent Seizures which disturbs the Brain functions and causes changes in the behaviour or attitude. This is considered a neurological condition. In ayurveda, loss of consciousness can be described as the feature of epilepsy which is caused due to vitiation of the Rajas and Tamas. It is of four types according to the doshas involved which shows different signs and symptoms which has been explained below thoroughly.
It arises in the humans as
- Mind disturbed by rajas and tamas
- Those who have Scattered
- Abnormal and plenty of the Doshas
- Usage of dirty, Unclean, Damaged eatables
- Improper observing the dietetic rules
- Apply Tantrika practices improperly that is breathing, yoga, meditation
- Practise The other uneven postures
Those who have minds disturbed by rajas and tamas, spread over the Hrudaya, and the seats of the sense organs and stay there dominantly. Being there, they get excited by passion, anger, fear, confusion, Greed, exhilaration, Anxiety, passion etc. and fill up the heart and seats of the sense organs and the person gets an attack of epilepsy.
Prodromal Symptoms Of Epilepsy
- Throwing the eyebrows aside
- Frequently abnormal movements of the eyes
- Hearing sounds in absence
- Excessive oozing of Saliva
- Oozing of the nasal mucus
- Aversion to food
- Stiffness in the cardiac region
- Abdominal Distension
- Tearing pain in the bones
- Body ache
- Mental confusion
- Darkness before the eyes
- Dreams of narcosis, Dancing, Piercing, trembling, aching, falling etc.
Sign & Symptoms
- Frequent fits
- Patient regains the consciousness instantly
- Protruded eyes
- Crying recklessly
- Emit froth from the mouth
- Excessive Swollen neck
- Puncturing pain in the head
- Irregularly contracted fingers
- Unstable hands and feets
- Reddish, Rough and blackish nails, eyes, skin, Face
- Vision of unstable fickle
- Coarse and rough objects
- Unsuitability of vata aggravating factors
- Fits which are frequent
- Regains the Consciousness frequently
- Groaning sound
- Striking against the earth
- Greenish, Yellowish and coppery nails, face, eyes, Skin
- Vision of bloody, agitated, luminous and irritated objects
- Unsuitability of the pitta aggravating things and suitability otherwise
- Delayed fits
- Delayed recovery
- Falling down
- Expression not very loathsome
- Emitting Saliva
- White nails, eyes, Face and skin
- Vision of white, Heavy and Unctuous objects
- Unsuitability of the kapha aggravating things.
The combination of all of these symptoms are present in sannipatika apasmara. Sometimes the exogenous factors can also be associated which will be described further. That can be known from the symptoms in addition to those which are described above and also some according to the symptoms of the dosha.
Beneficial In Apasmara
- Strong evacuation measures
- Pacificatory measures
In ancient times, During the Destruction of the Daksha's sacrifice, when the human beings fled in various directions, Running fast, Swimming, Jumping, Running And Leaping etc. which agitated the body and gave rise to Gulma, kushta, prameha due to the intake of the fatty material, Insanity due to torture, fear or grief. Due to impure contact of the various creatures, Fever arises from the forehead of the rudra (God), Internal haemorrhage from the increased heat, cachexia due to excessive sexual intercourse by moon, the king of stars.
Epilepsy is caused by vata, pitta, kapha and sannipataja (combination of three doshas) which is not treatable. The wise ones treat the curable ons cautiously with the strong evacuative measures and the pacificatory ones. When there is an association of the exogenous factors which are caused by the Dosa, the wise physicians prescribed general management for that.
The physician who knows the signs and symptoms of all the diseases and is also well versed with all the therapeutic measures, Destroys all the disorders and the one who doesn't get confused.
Diseases As A Causative Factor
Diseases are also observed as a causative factor for another disease. For example, This hyperpyrexia gives rise to the internal haemorrhage which in turn causes fever and both together give rise to Sosha (Cachexia). Enlargement of the Spleen gives rise to the udara roga (Ascitis) and it gives rise to the shotha (General oedema). From piles arises severe ascites and gulma. Coryza gave rise to cough which produces wasting and results as a cause of cachexia.
Initially it is only the disease but at later stages it serves as the Etiology. Sometimes it serves as both that is disease and aetiology and sometimes for either the disease or the aetiology. Because some diseases after causing another disorder subsides, while the other one does not and at the same time serve as aetiology.
Correctness Of Therapy
Thus, obstinate intermingling of diseases is observed due to faulty treatment and due to one origin to the other. Therapies which pacify one disorder and give rise to another one are not correct, The good one is that which pacifies the one disorder and does not excite the other.
Productivity Of Causative Factors
One causative factor can produce several disorders or sometimes only one. Similarly, one disorder is caused by many factors and sometimes many disorders are caused by them. For example, From the rough substances, it arises fever, Giddiness, Delirium etc. and sometimes the fever only. Similarly, various factors like roughness etc. causes only pyrexia (fever) while sometimes it causes many disorders in addition to the fever.
One pacifactory measure is useful in many disorders as well as in single disorder, similarly many measures are required to manage a Single disorder as well as arise from Amasaya and sometimes a single disease responds to the single reducing one. Likewise, the several measures such as intake of light diet etc. are prescribed in fever alone while all these are applied in various disorders like dyspnoea, fever, Hiccup etc.
Easily curable Disease is manageable with easy means and in a short time. Diseases which are curable with difficulty require a good effort and take time to cure. Palliable Diseases which are incurable are not eradicated. The other type of incurable diseases, the one which is rejectable, fails to respond to other measures.
Observing The State Of Disease
The physicians should observe the states of aggravation, Normalcy and diminution of diseases even if they are okay along with the condition of the body fire, Strength and mind. The physician who is wise constantly observes the condition of the Disorder and Administering the proper treatment accordingly obtains the beneficial four which are wealth, Virtue, enjoyment and emancipation.
The Aggravated Doshas, Spreads obliquely affects the patients for a very long term, in these conditions, the one knowing the body fire and strength, should not administer therapy in hurry. Instead of this, He should reduce them gradually with the help of therapeutic measures or bring them to the orifices, and from the orifices, they should be eliminated according to convenience.
For the sake of the knowledge, the signs and symptoms mentioned in this section are themselves diseases but in the Present Context they are the symptoms not the Diseases. In short, both the health and the disease are dependent on the respective causes and Cannot reside in each other's absence.
In this chapter we have discussed about the causes, prodromal, Symptoms, Pathogenesis, suitability, early origin, treatment principle in respect of the eight diseases fever etc. the Etiology, symptoms and therapy separately and individually, synonyms of cause, disease and symptoms has been described in brief in this and Administering the proper treatment accordingly to the condition will maintain the wealth, Virtue and enjoyment.