षट्चत्वारिंशोऽध्यायः अथातो मूर्च्छाप्रतिषेधं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the chapter which deals with (the symptoms and) the medical treatment of fainting fits (Murccha Pratisedha ). 1
क्षीणस्य बहुदोषस्य विरुद्धाहारसेविनः | वेगाघातादभीघाताद्धीनसत्त्वस्य वा पुनः ॥ २ ॥ करणायतनेषूग्रा बाह्येष्वाभ्यन्तरेषु च। निविशन्ते यदा दोषास्तदा मूर्च्छन्ति मानवाः ॥ ३ ॥ संज्ञावहासु नाडीषु पिहितास्वनिलादिभिः । तमोऽभ्युपैति सहसा सुखदुःखव्यपोहकृत् ॥ ४॥ सुखदुः : खव्यपोहाच्च नरः पतति काष्ठवत् । मोहो मूर्च्छति तां प्राहुः षड्विधा सा प्रकीर्तिता ॥ ५ ॥ वातादिभिः शोणितेन मद्येन च विषेण च । षट्स्वप्येतासु पित्तं हि प्रभुत्वेनावतिष्ठते ॥ ६॥
Definition- The deranged and aggravated Dosas of the body of a person who is emaciated or accustomed to the use of incompatible articles of food or who has become very weak on account of a sudden suppression of his natural urgings or any external blows or injury give rise to fainting fits. The deranged bodily Vayu, etc. choking up the sense-carrying nerves of the body, produces that giddy state in a patient in which the world seems to vanish from the eyes of the afflicted person and the perception of the pleasure or pain is suspended for the time being. The patient, in consequence of this suspension of the senseperception drops down insensible as a log of wood and this disease is called Murccha or Moha (fainting). It admits of being divided into six kinds or types according to an attack and is due to the action of the deranged Dosas separately or to that of blood, wine or poison,but a predominance of the deranged Pitta may be detected in all forms of the disease due to any cause whatever. 2-6.
Premonitory Symptoms of Murccha
हत्पीडा जृम्भणं ग्लानि: संज्ञानाशो बलक्षयः । सर्वासां पूर्वरूपाणि यथास्वमुपलक्षयेत ॥ ७ ॥ अपस्मारोक्तलिङ्गानि तासामुक्तानि तत्त्वतः ॥ ८॥
Premonitory Symoptoms – Pain or oppression of the heart, yawning, lassitude, loss of consciousness and of strength are the symptoms which usher in an attack of the disease (Murccha) according to the nature of the deranged bodily Dosa lying at its root. The characteristics of these Murccha are mainly same as Apasmar. 7-8.
पृथिव्यम्भस्तमोरूपं रक्तगन्धश्च तन्मयः । तस्माद्रक्तस्य गन्धेन मूर्च्छन्ति भुवि मानवाः । द्रव्यस्वभाव इत्येके दृष्ट्वा यदभिमुह्यति ॥ ९ ॥ गुणास्तीव्रतरत्वेन स्थितास्तु विषमद्ययोः । त एव तस्माज्जायेत ताभ्यां मोहो यथेरितः ॥ १० ॥
The natural elements, water (Ap) and earth ( Ksiti ) abound with the attribute of Tamas (insensibility). A smell of blood also contains the same attribute, Tamas. It is therefore that persons generally lose their consciousness at the smell of blood. Several authorities hold that the loss of consciousness in these instances happens in virtue of the natural properties of the thing itself, viz., blood, wine and poison which also posses these properties in a greater degree and it is therefore that an use of either of these substances suspends animation and produces Moha (fainting). 9-10.
Symptoms of Murccha
मोन स्तब्धाङ्गदृष्टिस्त्वसृजा गूढोच्छ्वासश्च मूर्च्छितः । विलपञ्छेते नष्टविभ्रान्तमानसः । गात्राणि विक्षिपन् भूमौ जरां यावन्न याति तत् ॥ ११ ॥ वेपथुस्वप्नतृष्णा स्युः स्तम्भश्च विषमूर्च्छिते । वेदितव्यं तीव्रतरं यथास्वं विषलक्षणैः ॥ १२ ॥
Symptoms — A case of Murccha (fit of unconsciousness) due to the effects of (deranged) blood is characterised by stiffened condition of the limbs and by the fixedness of the eyes (Drsti) and by deep breathing. Delirious talks, mental aberration and the state of the patient convulsively lying flat on the earth until the wine is perfectly assimilated into the system are the symptoms of a case of Murccha due to the effects of wine; while shivering, drowsiness, thirst and numbness of the body) attended with the specific symptoms of poisoning form the general characterstics of the type due to the effect of poison. 11-12.
General Treatment of Fainting & Fits
सेकावगाहौ मणयः सहाराः शीताः प्रदेहा व्यजनानिलाश्च । शीतानि पानानि च गन्धवन्ति सर्वासु मूर्च्छास्वनिवारितानि ॥ १३ ॥ सिताप्रियालेक्षुरसाप्लुतानि द्राक्षामधूकस्वरसान्वितानि । खर्जूरकाश्मर्यरसैः शृतानि पानानि सर्पषि च जीवनानि ॥ १४ ॥ सिद्धानि वर्गे मधुरे पयांसि सदाडिमा जाङ्गलजा रसाश्च । तथा यवा लोहितशालयश्च मूर्च्छासु पथ्याश्च सदा सतीनाः ॥ १५ ॥
General Treatment constant sprinkling of water over the body (water-spray) plunge-bath in cold water, contact of cold gems and garlands of flowers, cold plasters and compresses, (cold) breeze and fanning, cold and perfumed drinks and cooling measures in general are efficacious in all cases of the desease under discussion. Cordials prepared with the expressed juice of Iksu, Priyala and Draksa and with sugar or with the expressed juice of Draksa and Madhuka (Maula) or those prepared by boiling Kasmarya and Kharjura or clarified butter duly cooked with the drugs of the Jivaniya group with the drugs of the Madhura group, or the essence of Jangala meat in combination with the expressed juice of pomegranate should be taken in a case of Murccha. The diet should consist of cooked red Sali-rice or barley grains or Satina-pulse.’ 13-15.
Specific Treatment of Murccha
भुजङ्गपुष्पं मरिचान्युशीरं कोलस्य मध्यञ्च पिबेत् समानि । शीतेन तोयेन विसं मृणालं क्षौद्रेण कृष्णां सितया च पथ्याम् । कुर्याच्च नासावदनावरोधं क्षीरं पिबेद् वाऽप्यथ मानुषीणाम् ॥ ९ ॥
Specific Treatment – A compound consisting of Naga-kesara. Marica, Usiira the kernal of Kola as well as Visa (lotus stock) and Mrnala (lotus-stem) taken in equal parts should be taken with the decoction of Satina (D. R. — with cold water ). Pippali with honey or Pathya with sugar should also be taken. The mouth and the nostrils should be pressed close during a fit and the breast-milk should be given to the patient to be drunk. 16
मूर्च्छा प्रसक्तान्तु शिरोविरेकैर्जयेदभीक्ष्णं वमनैश्च तीक्ष्णैः । हरीतकीक्वाथघृतं पिबेद् वा धात्रीफलानां स्वरसैः कृतं वा ॥ १७ ॥ द्राक्षासितादाडिमलाजवन्ति शीतानि नीलोत्पलपद्मवन्ति पिबेत् कषायाणि च गन्धवन्ति पित्तज्वरं यानि शमं नयन्ति ॥ १८ ॥
Strong medicinal errhine should be administered and strong emetics should be as well empoyed in cases of repeated attacks of the fit. Clarified butter duly cooked and prepared with the decoction of Haritaki or with expressed juice of Amalaki should be prescribed. The decoction remedial to Pittaja-fever should be given in a cold state, mixed with Draksa, sugar, Pomegranate, parched paddy, Nilotpala and Padma and well perfumed with any good-smelling scent. 17-18.
Sannyasa
प्रभूतदोषस्तमसोऽतिरेकात् संमूर्च्छितो नैव विबुध्यते यः । संन्यस्तसंज्ञो भृशदुश्चिकित्स्यो ज्ञेयस्तदा बुद्धिमता मनुष्यः ॥ १९ ॥ यथाऽऽमलोष्टं सलिले निषिक्तं समुद्धरेदाश्वविलीनमेव । तद्वच्चिकित्सेत् त्वरया भिषक् तमस्वेदनं मृत्युवशप्रयातम् ॥ २० ॥
Sannyasa – The case of a patient lying in a comatous state and incapable of being roused up or brought to under the circumstances owing to the aggravated nature of the delusion (unconsciousness) due to an extensive preponderance of the deranged bodily Dosa (involved therein) should be looked upon by an intelligent physicion as extremely hard to cure. This is said to be a case of Sannyasa (Epilepsy ? ). Just as a lump of clay, when thrown into water, should be instantaneously taken up before it is being finally desolved therein, so a patient lying unconscious under an attack of suspended animation (Sannyasa) should be speedily restored to consciousness with the help of medecinal remedies before the process of final dissolution (lit-death) sets in his body. 19-20.
1. Cakrapani and Vrnda both-read Mudga also in the list of the diet.
तीक्ष्णाञ्जनाभ्यञ्जनधूमयोगैस्तथा नखाभ्यन्तरतोन्नपातैः । वादित्रगीतानुनयैरपूर्वैर्विघट्टनैर्गुप्तफलावघर्षैः । आभिः क्रियाभिश्च न लब्धसंज्ञः सानाहलालाश्वसनश्च वर्ज्यः ॥ २१ ॥ प्रबुद्धसंज्ञं वमनानुलोम्यैस्तीक्ष्णैर्विशुद्धं लघुपथ्यभुक्तम् । फलत्रिकैश्चित्रकनागराढ्यैस्तथाऽश्मजाताज्जतुनः प्रयोगैः । सशर्करैर्मासमुपक्रमेत विशेषतो जीर्णघृतं स पाय्यः ॥ २२ ॥ यथास्वञ्च ज्वरघ्नानि कषायाण्युपयोजयेत् । सर्वमूर्च्छापरीतानां विषजायां विषापहम् ॥ २३ ॥
Treatment The patient should be tried to be roused up with the application of strong eye-salves ( Anjana ), unguents and inhalation of smoke (Dhuma) or by pricking needles into his finger-nails or by discoursing sweet words and music in his hearing or by shaking his limbs roughly or by rubbing his skin with the fruits of Atma-gupta creepers. An attack of the present disease not amenable to the above remedies but attended with, salivation, laboured breathing, retention of stool and urine and distension of the abdomen should be given up as irremediable. Strong emetics and purgatives should be exhibited after the return of consciousness and diet should consist of light articles of fare. Silajatu’ mixed with Tri-phala, Chitraka, Sunthi etc. should be employed in combination with sugar and continued for a month. Matured clarified butter should be used in particular. Medicinal compounds remedial to any case of fever originated by the Dosa in the case may be as well prescribed in any case of Murccha; and a case due to the action of poison should be remedied with the antitoxine remedies (mentioned in the Kalpa Sthana). 21-23.
1. According to Dalhana Silajatu should be prepared with the said drugs in the manner of Bhavana saturation and then be applied with sugar.
इति सुश्रुत संहितायामुत्तरतन्त्रे मूर्च्छाप्रतिषेधव्याख्यानाम षट्चत्वारिंशोऽध्यायः ॥ ४६॥
Thus ends forty-sixth chapter of the Uttara-Tantra in the Susruta Samhita which deals with the (symptoms and) treatment of Murccha.
