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Ashtanga samgrahaMADATYAYA NIDANAM - Diagnosis of Alcoholism - Ashtanga Sangraha Nidanasthana Chapter 6

MADATYAYA NIDANAM – Diagnosis of Alcoholism – Ashtanga Sangraha Nidanasthana Chapter 6

अथातो मदात्ययनिदानं नामाध्यायं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ॥१॥

We will now expound diagnosis of Madatyaya (alcoholism); thus said Atreya and other great sages. (1)

Madya guna – properties of alcohol

तीक्ष्णोक्ष्णरूक्षसूक्ष्माम्लं व्यवाय्याशुकरं लघु | विकाशि विशदं मद्यमोजसो ऽस्माद्विपर्ययः ॥२॥

तीक्ष्णादयो विषेऽप्युक्ताश्चित्तोपप्लाविनो गुणाः । जीवितान्ताय जायन्ते विषे तूत्कर्षवृत्तितः ॥३॥

Tiksna (penetrating into the tissue), usna (heat producing), ruksa (causing dryness), suksma (capacity to enter into minute pores), amla (sour), vyavayi(spreading all over the body quickly), asukara ( quick acting), laghu ( easily digestable), vikasi (producing loosening of the joints) and visada (non-unctous, non-greasy ) – these are the qualities of Madya (wine). The qualities of ojas (essence of the dhatus, the protective material of the tissues) are exactly opposite of those of wine), tiksna and others (qualities) which bring about abnormalities of the mind and acting as causes for termination of life are present in poison also, of course, in more powerful capacity (degree). (2-3)

Madya vega – stages of alcoholic intoxication

तीक्ष्णादिभिगुणैर्मद्यं मन्दादीनोजसो गुणान् । दशभिर्दश सङ्क्षोभ्या चेतो नयति विक्रियाम् ॥४॥

आद्ये मदे-द्वितीये तु प्रमादायतने स्थितः । दुर्विकल्पहतो मूढः सुखमित्यवबुध्यते ॥५॥

Madya (wine) with ten qualities such as tiksna (penetrating) etc. destroys the ten qualities of ojas such as manda (slowlness), and others, and brings about disorders of functions of the mind during the first stage of alcoholic intoxication. (4)

During the second stage (of alcoholic intoxication), the person goes into the sphere of risks seized by misunderstanding, acting like a fool, thinking that (condition) to be happiness. (5)

मध्यमोत्तमथोः सन्धिं प्राप्य राजसतामसः । निरङ्कुश इव व्यालो न किञ्चिन्नाचरेज्जडः ॥ ६ ॥

इयं भूमिरवद्यानां दौश्शील्यस्येदमास्पदम् । एकोऽयं बहुमार्गाया दुर्गतेर्देशिकः परम् ॥७॥

In the interval between the middle (second) and next higher stage (third) of intoxication, persons who are prone to the affiction of rajas, tamas should not indulge in any bad activity, just like a deaf, wild elephant devoid of any control. This stage is a cause for immoral behaviour, it is the chief leader of self-destruction, the aveneues of which are very many. (6-7)

निश्चेष्टः शववच्छेते तृतीये तु मदे स्थितः । मरणादपि पापात्मा गतः पापतरां दशाम् ॥८॥

In the third stage of intoxication, the person lies ( falls) on ground, throughly inactive, like a corpse, entering into the state of sin, more profound than death itself. ( 8 )

धर्माधर्मं सुखं दुःखमर्थानर्थ हिताहितम् । यदासक्तो न जानाति कथं तच्छीलयेद्बुधः ॥ ९ ॥

The person addicted (to alcoholic drinks) does not differentiate between the right and the wrong, happiness and unhappiness, good and bad, suitable and unsuitable, he does not even know how (the manner) it (liquor) should be used. (9)

मद्येमोहो भयंशोकः क्रोधो मृत्युश्च संश्रिताः । सोन्मादमदमूर्च्छायाः सापस्मारापतानकाः ॥१०॥

Delusion, fear, sorrow, anger and death- are all residing in wine so also diseases like unmada (insanity), mada (intoxication), murcha(fainting), apasmara (epilepsy), apatanaka (tetanus) etc. (10)

यत्रैकः स्मृतिविभ्रंशस्तत्र सर्वमसाधु यत् । अयुक्तियुक्तमन्नं हि व्याधये मरणाय च ॥ मद्यं त्रिवर्गधीधैर्यलज्जादेरपि नाशनम् ॥ ११ ॥

Where, even one disease like loss of memory, is present, there everything, will be bad (improper, hapazard).

Even food improperly used will lead either to disease or death; likewise alcoholic drinks bring about the destruction of the three pursuits of life (dharma, artha and kama), intellegence, courage (steadfastness), shyness and others (good qualities) also in addition (to diseases and death). (10-11%).

नातिमाद्यन्ति बलिनः कृताहारा महाशनाः । स्निग्धाः सत्ववयोयुक्ता मद्यनित्यास्तदन्त्रयाः ॥

मेदःकफाधिका मन्दवातपित्ता दृढाग्नयः ॥१२॥

विपर्ययेऽतिमाद्यन्ति विस्रब्धाः कुपिताश्च ये | मद्येन चाम्लरूक्षेण साजीर्णे बहुनाति च ॥१३॥

Persons who are strong, who drink (wine) after taking food, who eat large quantities of food, who are unctous (fatty), who have good mind (strong will) and age (adulthood), who take liquor everyday, who are descendants of such persons (who are habituated to liquor), who have predominance of fat and kapha (in their body), who have vata and pitta at low degree (inadequate, inefficient, slow functioning) and who have very stable (stong) digestive activity do not get into profound intoxication. (11-12)

On the contrary, those who are over-confident, who are in the mood of anger, who drink wine which is very sour and non-unctuous, who drink during indigestion, in the company of many and in large quantities- get into profound intoxication.

Lakshana – features of alcoholic intoxication

वातात् पित्तात् कफात् सर्वैश्चत्वारः स्युर्मदात्ययाः सर्वेऽपि सर्वैर्जायन्ते व्यपदेशस्तु भूयसा ॥१४॥

Madatyaya is of four kinds; one each from vata, pitta and kapha and one from all of these combined; each kind is having all the three doshas, but named differently on the predominant dosha. (14)

सामान्य लक्षणं तेषां प्रमोहो हृदयव्यवथा । विभेदः सततं तृष्णा सौम्याग्नेयोज्वरोऽरुचिः ॥ १५ ॥

शिरः पार्श्वास्थिरुक्कम्पो मर्मभेदस्त्रिकग्रहः । उरोविबन्धस्तिमिरं कासश्वासप्रजागराः ॥१६॥

स्वेदोऽतिमात्रं विष्टम्भः श्वयथुश्चित्तविभ्रमः । प्रलापश्छर्दिरुत्क्लेशो भ्रमो दुःस्वप्रदर्शनम् ॥१७॥

Their general symptoms are- severe delusion, pain in heart (or disturbance of the mind), diarrhoea, constant thirst, fever having both heat and cold (rigors), loss of appetite, pain in the head, flanks and bones; tremors (shaking), cutting pain in the vital parts, catching pain in the triangle of the back (meeting place of the shoulder, backbone and scapula), obstruction in the chest, blindness or unconsciousness, cough, dyspnoea, loss of sleep, excessive perspiration, indigestion and stasis of food inside the abdomen, for long time; swelling, disorders of the mind, irrelevent talk, vomiting excess salivation, giddiness and bad dreams. (15-17)

विशेषाज्जागरश्वासकम्पमूर्धरुजोऽनिलात् । स्वप्ने भ्रमत्युत्पतति प्रेतैश्च सह भाषते ॥१८॥

पित्ताद्दाहज्वरस्वेदमोहातीसारतृड्भ्रमाः । देहो हरिताहारिद्रो रक्तनेत्रकपोलता ॥ १९॥

श्रेष्मणा छर्दिहल्लासनिद्रोदर्दाङ्गगौरवम् । सर्वजे सर्वलिङ्गत्वम्

Especially, in that (kind) produced by vata, there is loss of sleep, dyspnoea, tremors, headache and dreams such as roaming about, falling from height and speaking with ghosts; in that produced by pitta, there is bruning sensation, fever, perspiration, delusion, diarrhoea, thirst, giddiness, green or yellow colouration of the body and red colour in the eyes and cheeks; in that produced by kapha, vomiting, nausia, sleep, rashes on the skin and feeling of heaviness of the body; in that produced by combination of all (doshas) the symptoms of all the doshas are present. (18-202)

मुक्त्वा मद्यं पिबेत्तु यः । सहसानुचितं चान्यत्तस्य ध्वंसकविक्षयौ ॥२०॥

भवेतां मारुतात् कष्टौ दुर्बलस्य विशेषतः । ध्वंसके लेष्मनिष्ठीवः कण्ठशोषोऽतिनिद्रता ॥ २१ ॥

शब्दासहत्वं तन्द्रा चविक्षयेऽङ्गशिरोऽतिरुक् | हृत्कण्ठरोधः सम्मोहः कासस्तृष्णा वमिज्वरः ॥ २२ ॥

He, who has discontinued drinking but starts drinking again suddenly, in wrong manner, or drinking a different variety, becomes afflicted with Dhvamsaka and Viksaya due to (increased) vata, both are difficult (to treat ) specially in the weak.

In Dhvamsaka, there is expectoration of kapha (sputum) dryness of the throat, excessive sleep, intolerance of noise and stupor; Viksaya manifests with severe pain in the body and head, obstruction in the heart (chest) and throat, severe delusion, cough thirst, vomiting and fever. (20-22 )

निवृत्तो यस्तु मद्येभ्यो जितात्मा बुद्धिपूर्वकृत् । विकारैः स्यूश्यते जातु न स शारीरमानसैः ॥ २३ ॥

He, who has discontinued drinking wine, who has control over his senses, and who acts after careful forethought, will not be affected by diseases of either of the body or the mind. (23)

रजोमोहाहिताहारपरस्य स्युस्त्रयो गदाः । रसासृक्वेतनावाहित्रोतोरोधसमुद्भवा ॥ मदमूर्च्छायसन्यासा यथोत्तरबलोत्तराः ॥२४॥

In those who are prone to (predominance of) Rajoguna, moha (confusion, delusion) and indulgence in unhealthy foods get afflicted with three diseases which are caused by the obstruction of the channels of rasa (plasma), asrk (blood), and chetana (consciousness, mind) they are Mada, Murchaya and Sannyasa, which are strong ( dreadful) in their successive order. (24)

Mada nidanam – other kinds of intoxication

मदोऽत्र दोषैः सर्वैश्च रक्तमद्यविषैरपि । सक्तानल्पद्रुताभाषश्चलस्खलितचेष्टितः ॥२५॥

रूक्षश्यावारुणतनुर्मदे वातोद्भवे भवेत् । पित्तेन क्रोधनो रक्तपीताभः कलहप्रियः ॥२६॥

ध्यानपरोऽलसः । सर्वात्मा सन्निपातेन

स्वल्पसम्बद्धवाक् पाण्डुः कफाद्

Mada, arises from each of the doshas, by the combination of all of them, by blood, drinking liquor and poison. Slurred, excessive and very fast speech, unsteady and incoordinated actions, the body (skin) becoming dry, and bluished are seen in that (mada) caused by vata; in that caused by pitta, the persion is in anger, yellowish: red in colour, fond of quarrel; in that caused kapha, the person will have very little of speech, talks with words mixed up or jumbled, appears whitish in colour, always worried and lazy; in that caused by combination of doshas the person will have the symptoms of all the three doshas. ( 25-26)

रक्तात् स्तब्धाङ्गदृष्टिता ॥२७॥

पित्तलिंगं च मद्येन विकृतेहास्वराङ्गता । विषात्कम्पोऽतिनिद्रा च सर्वेभ्योऽभ्यधिकश्च सः ।

लक्षयेल्लक्षणोत्कर्षाद्वातादीन् शोणितादिषु ||२८|

In that mada caused by blood, the person will have inactive body parts and fixed gaze; in that due to wine drinking, he will have the symptoms of (increase of) pitta, abnormal (unsual) movements (actions) speech and body parts; in that caused by poison there will be tremors and excess of sleep and it is very difficult to treat among all its kinds. Even in intoxication caused by blood, wine and poison, vata and other doshas should be recognised by predominance of the symptoms. (27-28 )

Murcha nidanam diagnosis

अरुणं नीलकृष्णं वा खं पश्यन् प्रविशेत्तमः । शीघ्रं च प्रतिबुध्येत हृत्पीडा वेपथुर्भमः ॥२९॥

कार्यं श्यावारुणा छाया मूर्च्छाये मारुतात्मके । पित्तेन रक्त पीतं वा नभः पश्यन् विशेत्तमः ॥३०॥

विबुध्येत च सस्वेदो दाहतृट्तापपीडितः । भिन्नविण्नीलपीताभो रक्तपीताकुलेक्षणः ॥ ३१ ॥

कफेन मेघसङ्काशं पश्यन्नाकाशमाविशेत् । तमश्चिराच्च बुध्येत सहलासप्रसेकवान् ॥३२॥

गुरुभिः स्तिमितैरङ्गैरार्द्रचर्मावनद्धवत् । सर्वाकृतिस्त्रिभिर्दोषैरपस्मारइवापरः ॥ पातयत्याशु निश्चेष्टं विना बीभत्सचेष्टितैः ॥३३॥

In Murcha (ya), produced by vata, the person goes into darkness (becomes unconscious) observing the sky (surroundings) as crimson, blue or black in colours, regains consciousness quickly; has pain int he heart; shivering, giddiness, emaciation and bluish complexion.

In that caused by pitta, the person enters into darkness ( loses consicousness), observing the sky (surrounding) asred or yellow, regains consciousness after perspiration, suffers from burning sensation, thirst and heat (increase of body temperature) diarrhoea, faeces is blue or yellow and eyes are red or yellow.

In that caused by kapha, the person sees the sky as full of clouds and goes into unconsciousness, regains consciousness after a long time; has nausea, excess of salivation, feeling of heaviness and stiffness (inactivity) of the body parts and feels as though covered with wet cloth.

In that caused by all the three doshas together, the person has the symptoms of all the three doshas, resembles a patient of apasmara ( epilepsy), falls on the ground quickly, without bhibhatsa cesta-freightening symptoms (such as peculiar cry, froth at the angles of the mouth and convulsions). (29-33)

दोषेषु मदमूर्च्छायाः कृतवेगेषु देहिनाम् । स्वयमेवोपशाम्यन्ति सन्न्यासो नौषधैर्विना ॥३४॥

The bouts (of consciousness) subside by their own accord in Mada and Murcha (ya) caused by the doshas, where as in Sannyasa, they do not subside wihout medication. (34)

Sanyasa Coma

वाग्देहमनसां चेष्टामाक्षिप्यातिबला मलाः । सन्यासं सन्निपतिताः प्राणायतनसंश्रयाः ॥३५॥

कुर्वन्ति तेन पुरुषः काष्ठभूतो मृतोपमः । म्रियते शीघ्रं शीघ्रं चेच्चिकित्सा न प्रयुज्यते ॥३६॥

When the doshas which are combined together and very strong (increased greatly) disrupt the activities of speech, body and mind, invade the seats of life in the body and produce the disease sannyasa the patient falls to the ground like a log of wood and resembles a corpse; if not treated quickly, he dies soon. (35-36)

अगाधे ग्राहबहुले सलिलौघ इवातटे । सन्यासे विनिमज्जन्तं नरमाशु निवर्तयेत् ॥३७॥

Relatives desert the person who has sunk into the ocean of sannyasa which resembles a boundless ocean of water, which is very deep, full of crocodiles. (37) मदमानरोषतोषप्रभृतिभिररिभिर्निजैः परिष्वङ्गः। युक्तायुक्तं च समं युक्तिवियुक्तेन मद्येन ॥३८॥

Just like the person who is engrossed (surrounded) with his natural enemies like infatuation, pride, anger, pleasure and such others (lust, anger etc. ) loses the capacity of descrimination between suitable and unsuitable (good and bad) and of intelligent activity, so also the person by the effect of wine (alcohol) (38)

बलकालदेशसात्म्यप्रकृतिसहायामयवयांसि । प्रविभज्य तदनुरूपं यदि पिबति ततः पिबत्यमृतम् ॥३९॥

He, who drinks wine carefully considering his strength, the time (season) time of the day, habitat, accustoms ( habits), his own constitution, company, diseases and age, and which is suitable, drinks only the nector. (39)

॥ इति षष्ठोऽध्यायः ॥

Thus ends the Sixth chapter.


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