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ashtanga hridayaUNMADA PRATISEDHA - Treatment of Insanity - Ashtanga Hridaya Chapter 6

UNMADA PRATISEDHA – Treatment of Insanity – Ashtanga Hridaya Chapter 6

अथात उन्मादप्रतिषेधं व्याख्यास्यामः ।

इति ह स्माहुरात्रेयादयो महर्षयः ।

We shall now expound the chapter Unmada pratisedha-treatment of insanity; thus said Atreya and other great sages.

Unmada – bheda and nirvacana – kinds and definition

उन्मादाः षट् पृथग्दोषनिचयाधिविषोद्भवाः ।

उन्मादो नाम मनसो दोषैरुन्मार्गगैर्मदः ॥ १ ॥

Unmada (insanity ) is of six kinds, by each dosa seperately, by the combination of all of them, by sins and by poison.

Unmada is made (toxicity, disorder) of the manas (mind) produced by the dosas (vata etc.) moving in the wrong paths (because of their increase). 1.

Nidana and samprapti – causes and pathogenesis

शारीरमानसैर्दुष्टैरहितादन्नपानतः विकृतासात्म्यसमलाद्विषमादुपयोगतः ॥२॥

विषण्णस्याल्पसत्त्वस्य व्याधिवेगसमुद्गमात्। क्षीणस्य चेष्टावैषम्यात् पूज्यपूजाव्यतिक्रमात् ॥ ३ ॥

आधिभिश्चित्तविभ्रंशाद विषेणोपविषेण च । एभिर्हि हीनसत्त्वस्य हृदि दोषाः प्रदूषिताः ॥ ४ ॥

धियो विधाय कालुष्यं हत्वा मार्गान् मनोवहान् । उन्मादं कुर्वते, तेन धीविज्ञानस्मृतिभ्रमात् ॥ ५ ॥

भ्रष्टसारथिवद्रथः । देहो दुःखसुखभ्रष्टो भ्रमत्यचिन्तितारम्भः

Indulgence in unsuitable (unhealthy) foods and drinks, foods which are spoilt, unaccustomed, containing dirt (contaminated) and using (foods and drinks) in improper manner; those who are dejected (due to worry, grief etc.), who are of weak mind, by the effect of sudden increase of diseases, emaciated persons indulging in activities in improper ways, comitting mistakes in the procedure of worship of the worshipful, by comitting sinful acts, loss of balance of mind, by the effect of strong poisons or weak poisons-by these causes the dosas getting increased in the heart (mind) in persons of feeble mind, produce vitiation of the mind, and destroying (invading) the manovaha srotas (channels of the mind) cause unmada (insanity); dhi (discriminating/deciding capacity) vijnana (capacity of special knowledge to understand the science, arts etc.) and smrti (power of remembrance of earlier happenings) having become abnormal (lost or impiared) make the body lose the feeling of happiness and unhappiness and like a chariot devoid of a charioteer, the person begins to resort to activities without any thinking. 2-6b.


अस्थाने तत्र वातात्कृशाङ्गता ॥ ६ ॥

रोदनाक्रोशहसितस्मितनर्तनम् । गीतवादित्रवागङ्गविक्षेपास्फोटनानि असाम्ना वेणुवीणादिशब्दानुकरणं मुहुः ।

आस्यात्फेनागमोऽजस्त्रमटनं अलङ्कारोऽनलङ्कारैरयानैर्गमनोद्यमः च॥७॥ बहुभाषिता ॥ ८ ॥

गृद्धिरभ्यवहार्येषु तल्लाभे उत्पिण्डितारुणाक्षित्वं जीर्णे चान्ने गदोद्भवः । चावमानता ॥ ९॥

In unmada (insanity) produced by (increased) vata, the body is emaciated the person weeps becomes angry, laughs, smiles, dances, sings, plays musical notes, speaks, does movements of the different parts of the body, and makes loud sound-all these at improper time and place; imitates the sound of the flute, vina (lute) etc. voilently and often; froth exudes from the mouth, roams about constantly, speaks too much, decorates himself with non-decorating things, attempts to travel on things which are not vehicles; desires foods but abuses them after obtaining, the eyes protruding and red in colour and the disease (symptoms) appearing after the food is digested. 6b-10a.


पित्तात्सन्तर्जनं क्रोधो मुष्टिलोष्टाद्यभिद्रवः ॥ १०॥

शीतच्छायोदकाकाङ्क्षा नग्नत्वं पीतवर्णता | असत्यज्वलनज्वालातारकादीपदर्शनम् ॥ ११ ॥

In unmada (insanity) caused by pitta, the patient threatens others, becomes angry, attacks others with the fist, stones etc. desires cool shade and cold water, remains naked, has yellow colour (of the skin etc.) sees fire, flames, stars, and lamp which are not actually present. 10b-11.


कफादरोचकश्छर्दिरल्पेहाहारवाक्यता स्त्रीकामता रह: प्रीतिर्लालासिङ्घाणकस्स्रुतिः ॥ १२॥

वैभत्स्यं शौचविद्वेषो निद्रा श्वयथुरानने । उन्मादो बलवान् रात्रौ भुक्तमात्रे च जायते ॥ १३ ॥

In unmada (insanity ) caused by kapha, the person has loss of appetite, vomitting, very little of desires, foods and talk; desire for the woman ( sex ) and solitude, copius saliva and nasal secretions flowing, terrifying activities, hatredness to cleanliness, sleep, swelling of the face, symptoms strong during nights and soon after taking food. 12-13.


सर्वायतनसंस्थानसन्निपाते तदात्मकम् । उन्मादं दारुणं विद्यात् तं भिषक् परिवर्जयेत् ॥ १४ ॥

In that caused by all the dosas (increasing together) the symptoms of all the dosas appear simultaneously. This insanity is difficult to cure, hence the physician should reject it. 14.

Chitta ghataja unmada – insanity due to mental shock

धनकान्तादिनाशेन पाण्डुर्दीनो मुहुर्मुह्यन् दुःसहेनाभिषङ्गवान् । हाहेति परिदेवते ॥ १५ ॥

रोदित्यकस्मान्प्रियते तद्गुणान् बहु मन्यते । शोकक्लिष्टमना ध्यायन् जागरूको विचेष्टते ॥ १६ ॥

Loss of money, wife etc. which is unbearable, which persists for long time leads to insanity. The person becomes pale, timid, faints often, weeps making sounds such ha, ha etc. (alas, that is lost, alas that is gone etc.) weeps without any (other) reason; dies ( loses consciousness), praises the qualities of the things lost, with the mind suffering from grief,he worries much, keeps awake without sleep and does unusual acts. 15-16.

Vishaja unmada

विषेण श्याववदनो नष्टछायाबलेन्द्रियः । वेगान्तरेऽपि सम्भ्रान्तो रक्ताक्षस्तं विवर्जयेत् ॥ १७ ॥

In insanity caused by poisons (administered by other or consumed by himself) the face is blue, there is loss of complexion, strength and sensory activities, has unstable mind even during the intervals (of different stages of poisoning) and the eyes are red; such a patient should be rejected. 17.

Unmada Chikitsa – treatment of insanity

अथानिलज उन्मादे स्नेहपानं प्रयोजयेत् । पूर्वमावृतमार्गे तु सस्नेहं मृदु शोधनम् ॥ १८ ॥

कफपित्तभवेऽप्यादौ वमनं सविरेचनम्। स्निग्धस्विन्नस्य बस्ति च शिरसः सविरेचनम् ॥ १९ ॥

तथाऽस्य शुद्धदेहस्य प्रसादं लभते मनः ।

In insanity caused by vata, drinking of oil (internal oleation therapy) should be administered first; if there is obstruction of the channels, mild purgatives mixed with fats should be given. In that caused by kapha and pitta, emesis, purgation, and enema therapies, should be administered after doing oleation and sudation, so also purgative therapy for the head. After the body becomes purified by these therapies, the mind becomes tranquil (calm). 18-20a.

इत्थमप्यनुवृत्तौ तु तीक्ष्णं नावनमञ्जनम् ॥ २० ॥

हर्षणाश्वासनोत्त्रासभयताडनतर्जनम्अ भ्यङ्गोद्वर्तनालेपधूपान् पानं च सर्पिषः ॥ २१ ॥

युञ्ज्यात्तानि हि शुद्धस्य नयन्ति प्रकृतिं मनः ।

Even after these treatments, if the disease persists srong nasal drops, eye salves should be made use of; making him happy, assuring him, threatening, causing fear, beating and terrorising him should be resorted to, oil massage, dry massage, anointing with paste, fumigation, drinking of medicated ghee should be administered; purified by these the mind becomes normal.

हिङ्गुसौवर्चलव्योषैर्द्विपलांशैर्घृताढकम् ॥२२॥ सिद्धं समूत्रमुन्मादभूतापस्मारनुत्परम् ।

Medicated ghee prepared with two pala each of hingu, sauvarcala, and vyosa two adhaka of ghee, with addition of cow’s urine is best to cure insanity, seizure by evil spirits and epilepsy.

Brahmi ghirta

द्वौ प्रस्थौ स्वरसाद् ब्राह्म्या घृतप्रस्थं साधितम् ॥ २३ ॥

व्योषश्यामात्रिवृद्दन्तीशङ्खपुष्पीनृपद्रुमैः । ससप्तलाकृमिहरैः पलवृद्धया प्रयुञ्जीत परं मात्रा चतुष्पलम् । कल्कितैरक्षसम्मितैः ॥ २४ ॥

उन्मादकुष्ठापस्मारहरं वाक्स्वरस्मृतिमेधाकृद् धन्यं ब्राह्मीघृतं स्मृतम् । वन्ध्यासुतप्रदम् ॥ २५ ॥

Medicated ghee prepared with two prastha of fresh juice of brahmi, one prastha of ghee and paste of one aksa each of vyosa, syama, trivrt, danti, sankhapuspi, nrpadruma, saptala and krmihara-administered in does of one pala increased at each succeeding day till the maximum of four pala is reached. It cures insanity, leprosy and epilepsy, bestows sons to the barren woman, produces good speech, voice, memory and intellegence and is auspicious (beneficial ). This is Brahmi ghrta. 23-26a.

Kalyanaka ghrita

वराविशालाभद्रैलादेवदार्वेलवालुकैः द्विसारिवाद्विरजनीद्विस्थिराफलिनीनतैः ॥ २६ ॥

बृहतीकुष्ठमञ्जिष्ठानागकेसरदाडिमैः वेल्लतालीसपत्रैलामालतीमुकुलोत्पलैः ॥२७॥

सदन्तीपद्मकहिमैः कर्षांशै सर्पिष: पचेत् ॥ २८ ॥

प्रस्थं भूतग्रहोन्मादकासापस्मारपाप्मसु । पाण्डुकण्डूविषे मोहे मेहे गरे ज्वरे ॥ २९ ॥

अरेतस्यप्रजसि दैबोपहतचेतसि । वा अमेधसि स्खलद्वाचि स्मृतिकामेऽल्पपावके ॥ ३० ॥

बल्यं मङ्गल्यमायुष्यं कान्तिसौभाग्यपुष्टिदम् । कल्याणकमिदं सर्पिः श्रेष्ठं पुंसवनेषु च ॥ ३१ ॥

Medicated ghee is prepared with the dicoction and paste of one karsa each of vara, visala, bhadraila, devadaru, elavaluka, the two sariva, the two rajani, the two sthira, phalini, nata, brhati, kustha, manjistha nagakesara dadima, vella, talisapatra, ela, malatimukula, utpala, danti, padmaka and hima and two prastha of ghee. It is beneficial in warding off evil spirits, curing insanity, cough, epilepsy, diseases caused by sin, anaemia, itching poison, consumption, delusion, diabetes, artificial poison, fever; for persons who have no semen, no offspring; in whom the mind is affected by gods (providential, causes unknown ) for those who have no intellegence, whose voice is slipping, who desire good memory, who have poor digestive power; it bestows strength, auspiciousness, long-life complexion, fortune and nourishment. This Kalyanaka ghrta is best for pumsavana. (recipe to be get male progeny). 26b-31.

Mahakalyanaka ghrita

एभ्यो द्विसारिवादीनि जले पक्त्वैकविंशतिम् । रसे तस्मिन् पचेत्सर्पिर्दृष्टिक्षीरचतुर्गुणम् ॥ ३२ ॥

वींराद्विमेदाकाकोलीकपिकच्छूविषाणिभिः शूर्पपर्णीयुतैरेतन्महाकल्याणकं बृंहण सन्निपातघ्नं पूर्वस्मादधिकं गुणैः । । परम् ॥ ३३ ॥

Out of the above drugs, the twentyone ( drugs) commencing with the two sariva are boiled in water, and decoction prepared. Ghee is cooked with that decoction with the addition of four parts (of the quantity of ghee) of gristiksira (cow’s milk with in seven days of calving), and paste of vira; the two meda, kakoli, kapikacchu, visani (ka) and the two surpaparni; this Mahakalyanaka ghrta is best to make the body stout, mitigates sannipata and better in qualities than the earlier one. 32-34a..

Maha paisacika ghrta

जटिला पूतना केशीं चारटी मर्कटी वचा ॥ ३४ ॥

त्रायमाणा जया वीरा चोरकः कटुरोहिणी | वयःस्था शूकरी छत्रा सातिच्छत्रा पलङ्कषा ॥ ३५ ॥

महापुरुषदन्ता च कायस्था नाकुलीद्वयम् । कटम्भरा वृश्चिकाल शालिपर्णी च तैर्घृतम् ॥ ३६॥

सिद्धं चातुर्थिकोन्मादग्रहापस्मारनाशनम् । महापैशाचकं नाम नाम घृतमेतद्यथाऽमृतम् ॥ ३७ ॥

बुद्धिमेधास्मृतिकरं बालानां चाङ्गवर्धनम् ।

Medicated ghee prepared with (decoction and paste) of jatila, putana, kesi, carati, markati, vaca, trayamana, jaya, vira, coraka, katurohini, vayastha, sukari, chatra, aticchatra, palankasa, mahapurusadanta, kayastha, the two nakuli, katambhara, vrscikali, and salaparni and ghee. This, known as Mahapaisacaka ghrta cures quartan fever, insanity, evil spirits, and epilepsy; it is just like nector, bestows intellegence and growth of the body in children. 34b-38a.

ब्राह्मीमैन्द्री विडङ्गानि व्योषं हिङ्ग जटां मुराम् ॥ ३८ ॥

रास्नां विषघ्नां लशुनं विशल्यां सुरसां वचाम्। ज्योतिष्मतीं नागविन्नामनन्तां सहरीतकीम् ॥ ३९ ॥

काङ्क्षीं च हस्तिमूत्रेण पिष्टा छायाविशोषिता । वर्तिर्नस्याञ्जनालेषधपैरुन्मादसूदनी ॥ ४० ॥

Brahmi, aindri, vidanga, vyosa, hingu, jata, mura, rasna, visaghna, lasuna, visalya, surasa, vaca, jyotismati, nagavinna, ananta, haritaki and kanksi are macerated in elephant’s urine (made into pills) and dried in shade. Used as application into the eye, nasal drops, topical application and fumi•gation, it cures insanity. 38b-40.

अवपीडाश्च विविधाः सर्षपाः स्नेहसंयुताः ।

कटुतैलेन चाभ्यङ्गो ध्मापयेच्चास्य तद्रजः ॥ ४१॥ सहिङ्गुस्तीक्ष्णधूमश्च सूत्रस्थानोदितो हितः ।

Avapida (nasal drops from paste of drugs) of different kinds, mixed with oil of sarsapa; anointing the body with katu taila (mustured oil) and insufflation of its powder (of sarsapa) into the nose, strong fumigation with drugs mentioned in sutrasthana (chapter 21) mixed with hingu — are all beneficial. 41-42a.

शृगालशल्यकोलूकजलौकावृषबस्तजैः मूत्रपित्तशकृल्लोमनखचर्मभिराचरेत् धूपधूमाञ्जनाभ्यङ्गप्रदेहपरिषेचनम् ॥ ४२ ॥

Urine, bile, excreta, hairs, hoofs and skin of the jackal, porcupine, owl, jalauka (a kind of sparrow), bull and goat should made use of for fumigation, inhalation, collyrium, anointing, topical application and bath. 42b-43.

धूपयेत्सततं चैनं श्वगोमत्स्यैः सुपूतिभिः । वातश्लेष्मात्मके प्रायः पैत्तिके तु प्रशस्यते ॥ ४४ ॥

तिक्तकं जीवनीयं च सर्पिः स्नेहश्च मिश्रकः । शीतानि चान्नपानानि मधुराणि लघूनि च ॥ ४५ ॥

In insanity caused by vataslesma the patient should be contantly exposed to the fumes of foul smelling meat of dog, cow and fish; in that caused by pitta the use of tiktaka ghrta or jivaniya ghrta and misraka sneha, foods and drinks which are cold, sweet and easily digestible are beneficial.

विध्येच्छिरां यथोक्तां वा तृप्तं मेद्यामिषस्य वा । निवाते शाययेदेवं मुच्यते मतिविभ्रमात् ॥ ४६ ॥

Veins should be cut (to let out blood) after making the patient satisfied with fatty meat, and made to lie in a place deviod of breeze-by this he becomes cured of mental disorders.

Anya chikitsa – other treatment

प्रक्षिप्यासलिले कूपे शोषयेद्वा बुभुक्षया ।

वा आश्वासयेत्सुहृतं ब्रूयादिष्टविनाशं वा वा सर्षपतैलाक्तं बद्धं

कपिकच्छ्छाऽथवा तप्तेर्लोहतैलजलैः स्पृशेत् । कशाभिस्ताडयित्वा वा बद्धं श्वभ्रे विनिः क्षिपेत् ॥ ४९ ॥

अथवा वीतशस्त्राश्मजने सर्पेणोद्धृतदंष्ट्रेण दान्तैः सिंहैर्गजैश्च संतमसे

( त्रासयेच्छस्त्रहस्तैर्वा अथवा राजपुरुषा मापयेयुर्वधेनैनं वाक्यैर्धर्मार्थसंहितेः ॥ ४७ ॥

दर्शयेदद्भुतानि वा । न्यसेद्वोत्तानमातपे ॥ ४८ ॥

किरातारातितस्करैः बहिर्नीत्वा सुसंयतम् । तर्जयन्तो नृपाज्ञया ॥ ५१ ॥

देहदुःखभयेभ्यो हि परं प्राणभयं मतम् । तेन याति शमं तस्य सर्वतो विलुप्तं मनः ॥ ५२ |

सिद्धा क्रिया प्रयोज्येयं देशकालाद्यपेक्षया ।

The patient should be put into a well without water, made to suffer from hunger, his friends should assure him (of getting cured) with moral and religious talk, tell him the news of loss of the beloved ( persons, money etc.), show him wonderful things; body be smeared with mustard oil, should be bound (with ropes) and placed in the sun with his face up, the body should be touched with either kapikacchu (which causes sever itching ), heated metal, oil or water; beaten by lashes, thrown into a ravine after binding him, or impounded in a dark room free from weapons, stones and men; be bitten by a snake removed of its fangs, threatend by animals like the lion, or elephant, by persons carrying weapons or by tribal folk, bandits or thieves; or kings attendants should bring him out, bind him and threaten to kill him as though ordered by the king. The fear of death is more powerful than the fear of the troubles of the body, hency by the above methods (of loss of life) his mind becomes relieved of all its abnormalities. These methods of proven efficacy should be adopted as found apropriate to the place, time 47-53a. etc.

इष्टद्रव्यविनाशात्तु मनो यस्योपहन्यते ॥ ५३ ॥

तस्य तत्सदृशप्राप्तिसान्त्वाश्वासैः शमं नयेत् । कामशोकभयक्रोधहर्षेर्ष्यालोभसम्भवान् ॥५४॥

परस्परप्रतिद्वन्द्वैरेभिरेव शमं नयेत् । भूतानुबन्धमीक्षेत यद्युन्मादे प्रोक्तलिङ्गाधिकाकृतिम् ॥ ५५ ॥

ततः कुर्याद्भूतनिर्दिष्टमौषधम् । बलिं च दद्यात्पललं यावकं सक्तुपिण्डिकाम् ॥ ५६ ॥

स्निग्धं मधुरमाहारं तण्डुलान् रुधिरोक्षितान्। पक्कामकानि मांसानि सुरां मैरेयमासवम् ॥ ५७ ॥

अतिमुक्तस्य पुष्पाणि जात्याः सहचरस्य च। चतुष्पथे गवां तीर्थे नदीनां सङ्गमेषु च ॥ ५८ ॥

The mind which has become disordered due to loss (destruction) of the thing most liked should be made to become normal by supplying indentical things, assurances and consoling words.

That insanity caused by lust, grief, fear, anger, joy jealousy, and greed should be mitigated by exposing him to their respective opposite qualities.

spirits. When symptoms of seizures by evil spirits are found predominantly that kind of insanity should be treated with medicines/remedial measure indicated to ward-off the evil

Oblations consisting of meat, balls of flour of yava, food which are fatty and sweet, rice ( boiled) mixed with blood, cooked or uncooked meat, sura, maireya, asava, flowers of atimukta, jati and sahacara, offering being done at the meeting place of four roads, cattle shed or confluence of rivers. 53b-58.

निवृत्तामिषमद्यो यो हिताशी प्रयतः शुचिः | निजागन्तुभिरुन्मादैः सत्ववान्नं स युज्यते ॥ ५९ ॥

The person of a strong mind who does not indulge in meat and wine; who eats only healthy food, remains clean (both physically and mentally) does not become affected by either nija or agantu unmada (endogenous or exogenous insanity). 59.

प्रसाद इन्द्रियार्थानां बुद्ध्यात्ममनसां तथा । धातूनां प्रकृतिस्थत्वं विगतोन्मादलक्षणम् ॥ ६० ॥

Purity of the senes organs, their objects, intellect, soul and mind and normalcy of the tissues of the body are the features of (the person) cured of insanity. 60.

इति श्रीवैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने उन्मादप्रतिषेधो नाम षष्ठोऽध्यायः ॥ ६ ॥

Thus ends the chapter-Unmada pratisedha-the sixth in Uttarasthana of Astanga hrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.


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