Chapter LXII - Symptoms and Treatment of Insanity (Unmada)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of Insanity (Unmada-Pratishedha). 1.

Derivation:—

In as much as (in this disease) the deranged bodily Doshas traversing the upper part of the body affect the up-coursing nerves and produce thereby a distracting state of the mind, it is called Unmada (Insanity), and it is a disease of the Manas (mind). 2.

Classification:—

This disease is divided into five different types according to the nature of their origin —viz., the three types due to the several actions of the three deranged and aggravated Doshas, the one due to their concerted actions and the one due to grief, etc. (real or imaginary). There is a sixth kind also, viz., that due to the effects of poison, which should be treated according to the nature and intensity of the deranged Dosha or Doshas lying at the root and which in its early stage, if not abnormally aggravated, goes by the name of Mada. 3.

Premonitory Symptoms:—

Fits of unconsciousness, agitated state of the mind, ringing of the ears, emaciation of the body, excessive energy of action aversion to food, eating filthy things in dreams, perturbation i.e. palpitation (of the heart) due to Vayu and vertigo or giddiness are the symptoms in a patient which forebode a speedy and impending attack of insanity. 4.

Specific Symptoms of:—

Vataja, Pittaja and Kaphaja types:—Shaggy appearance, use of harsh language, appearance of a number of Dhamanis (nerves) over the body, laboured breathing (D. R. experience of excessive coldness), emaciation of the body and throbbing of the joints of the limbs are the specific features of a case of the Vataja type (of Unmada) and the patient in such a case reads clapping his hands, or sings while dancing, or shouts or wanders about. Excessive thirst, perspiration, burning sensation, voracious eating, insomnia, desire for shade, cold, wind and walks on the banks (of rivers or tanks), fits of anger, fancying fire in cold water and fancied sight of stars in the heavens in the day are the symptoms which characterise a case of the Pittaja type. Vomiting, dulness of appetite, lassitude or gone-feeling in the limbs, aversion to food, fondness for sexual propulsion and loveliness, stupidity, somnolence, reservedness in speech, eating little, fondness for warm things and aggravation of the disease in the night mark a case of the Kaphaja type of insanity. 5–7.

Tri-doshaja Type:—

A case of Sanpipatika insanity exhibits all the symptoms belonging to the three aforesaid types origined from the three Doshas, viz., Vata, Pitta and Kapha. A case in which the specific symptoms of the disease are manifested in full should be deemed as incurable. Several authorities, however, hold the Sannipatika type to be sometimes curable. 8.

Shokaja and Vishaja types:—

A person frightened by a thief, a king’s officers or his own enemy or any such person, or suffering from any distracted state of the mind owing to a loss of wealth, or from any grief (Soka) or bereavement or from any disappointed love would likely have an attack of mental distraction (insaility). In such cases he would unconsciously talk incoherently about subjects uppermost in his mind or would sing in a stupid fashion or laugh or weep. (These are the symptoms of Sokaja insanity). Redness of the eyes, dulness of complexion and of the perceptive faculties, diminution of bodily strength, extreme dejection, blush on face and loss of consciousness are the sym ptoms which mark a case of insanity due to the effects of poisoning. 9–10.

General Treatment:—

A patient suffering from insanity should be first treated with Sneha and Sveda and then subjected to a course of emetics, purgatives and head-purgatives (Shiro-Virecana). Powders of various sorts of (drugs used in) Avapida snuffing should be mixed with mustard oil and employed for the purpose (of snuffing). Fumigation with burnt putrid beef or dog’s flesh should be constantly employed. Snuffing and unguents of mustard oil are also efficacious in all cases. The patient should be surprised with wonderful sights and the news of the death of any of his dear ones should be related to him. He should be constantly frightened with sights of fierce-looking men, well-trained elephants or non-venomous snakes. The patient should be threatened with being fastened with ropes or being flogged, or frightened with bundles of blazing hay, after being fastened, while asleep. He should also be pierced in his body with pointed instruments, avoiding, however, the vulnerable parts^[1], or he should be made to reside constantly in a dry well with a cover over it. Barley gruel, powders of parched barley mixed with water alone should be given to him on every third day by an intelligent physician. The diet of the patient should consist also of palatable and appetising articles. 11.

Maha-Kalyana Ghrita:—

Clarified butter duly cooked with twice as much of milk and with Vidanga, Triphala, Musta, Manjishtha, Dadima, Utpala, Shyama, Ela-valuka, Ela, (red) Chandana, Deva-ddru, Barkishtha (Balaka), Haridra, Kushtha, Parnini (Sala-parni), Sariva, Harenuka, Trivrit, Danti, Vaca, Talisa-patra, Naga-keshara and Malati flowers as Kalka (is called Kalyana Ghrita ³⁰¹ and) proves curative in cases of Gulma, cough, fever, asthma, phthisis and insanity. Clarified butter duly cooked with four times as much of milk and with the aforesaid drugs as Kalka and with the drugs of the Kakolyadi group added to it by way of an after-throw is called Maha-kalyana Ghrita. The range of its therapeutic application includes (such ailments as) Apasmara, (attack by) Graha, consumption, impotency, emaciation and sterility as well as the diseases mentioned above. 12.

Phala Ghrita:—

Clarified butter duly cooked with Balaka, Kushtha, Manjishtha, Katuka, Ela, Haridra, Tri-phala, Hingu, Ashvagandha, Deva-daru, Vaca, Yamani, Kakoli, Meda, Yashti-madhu and Padmaki (as Kalka), and with four times as much of milk and with sugar as an after-throw would be beneficial. It should also be prescribed for infants struck by malignant stars as well as for male adults of evil propensities and short intellect. This is known as Phala-Ghrita^[2] and removes barrenness of women 13.

Brahmi (Manduka-parni), Aindri, Vidanga, Tri-katu, Hingu, Sura (Deva-daru), Jata (Jata-mamsi), Vishaghni (Haridra), Lashuna (garlic), Rasna, Vishalya (Guduci), Surasa, Vaca, Jyotishmati, Naga-vinna (a kind of Indra-varuni), Ananta, Abhaya and Saurashtri taken in equal parts should be pounded together and made into a paste with the addition of elephant’s urine. It should then be dried in the shade, and Vartis should be prepared thereof. These should be used by an intelligent person as an Anjana, unguent, snuff, fumigation and Avapida. 14.

Blood-letting from the Uras (chest), Apanga (outer corner of the eye) and Lalata (forehead) should be resorted to. Measures and drugs mentioned in connection with the treatment of Apasmara and Graha-roga may be likewise employed in the present instance. Oily purgatives (Sneha-vasti) should be administered after the subsidence of the deranged Dosha. 15.

In a case of the fifth kind (viz. Shokaja) of insanity the cause of grief should be first removed. In all forms of insanity the restoration of the serenity of mind should be first attempted. Mild and gentle forms of these remedies should be resorted to in a case of Mada (preliminary stage of insanity). Mild anti-venomous (anti-toxin) measures should be resorted to in a case (of insanity due to the effects of poison. 17–18.

 

Thus ends the sixty-second chapter in the Uttara-Tantra of the Sushruta Samhita which deals with the (symptoms and) treatment of Insanity.

Here ends the Bhuta-vidya-Tantra

Footnotes and references:

[1]:

Additional Text:—The patient should likewise be threatened with being forced into a burning hut. He should be also kept immersed in water or threatened with the fall of a thunder bolt.

[2]:

According to Dallana the mentions of these two recipes (Kalyāna Ghrita and Phala Grita) are interpolations.