Chapter XLVII - Symptoms and Treatment of Alcoholism (Panatyaya)

Now shall discourse on the (symptoms and) medical treatment of alcoholism and its kindred maladies (Panatyaya-Pratishedha). 1.

Properties and actions of Wine:—

Wine is heat-making in its potency, keen or sharp in its properties, subtile in its essence, acts as a soaker or cleanser of moisture and albuminous matter (Vishada), is dry, and instantaneous in its action (Ashukara), stimulating or exhilarating in its effect (Vyavayi) and is diffusive (Vikashi). It destroy cold and shivering by virtue of its heat-making potency. It suspends all cognitive process (lit.–intellectual motions) on account of its keenness or sharpness, enters into every limb and member of the body by reason of its subtlety (Sukshmatva), destroys Kapha (phlegm) and semen in virtue of its Vaishadya, enrages or aggravates the bodily Vayu on account of its dryness (Ruksh(a?m?)tva), and is instantaneous in its action by reason of its Ashukaritva. It is exhilarating on account of its Vyavayitva and diffusive (coursing swiftly all through the body) for its Vikashitva. Wine is acid in its taste, is light and appetising, and produces fresh relish for food. Others assume the presence of all the tastes except the saline one in it. 3—4.

Wine taken in combination with cooked meat and boiled rice, or any other articles of food profusely saturated with a Sneha (clarified butter, etc.) adds to the longevity, muscular strength and corpulency of a person (using it in moderate quantities) and to the exhilarated state of mind accompanied with beauty, fortitude, vigour and valour and these benefits one may derive from the proper use of wine. This fiery liquid in combination with the aggravated bodily fire (Kaya-Agni) produces the symptoms of intoxication and unconciousness, etc. (Mada) in a foolish person taking it without food or in an empty stomach and in an inordinate quantity. 5.

Evil effects Of Drinking:—

Excessive drinking.produces incidental nescience which gradually creeps into and clouds the sense-perceptions, destroying all power of self control (control over the sense-organs) and giving publicity to the innermost thoughts (in the mind) of the intoxicated person. 6.

Three stages of Alcoholic Intoxication:—

There are three stages of intoxication—viz., the first, the second or intermidiate and the third or last. The first or preliminary stage (of intoxication) is marked by an exhilarated state of mind with increased valour, and conviviality as well as satisfaction and talkativeness, etc. The second or intermediate stage is indicated by incoherent speech, exhilaration and the performance of proper and improper acts. In the third or last stage the man lies down unconscious, bereft of all powers of action, of memory and of judging the ethic effects of his acts. 7.

A man who is in the habit of taking fatty food or in whom Shleshma predominates, or in whose constitution, there is only a little of Pitta, is not so easily affected by the action of wine, which, however, proves distressing in a person of contrary nature. Wine, if taken daily without food by a man in an empty stomach, gives rise to many distressing and dangerous diseases in his organism and leads to the ultimate dissolution of his body. 8–9.

Cases where wine is prohibited:—

Wine should not be taken by a person under the influence of anger, grief, fright, thirst or hunger. The use of wine is prohibited immediately after a fatiguing journey, physical exercise or an act of load-carrying, or after the repressing of any physical urging, or after the use of excessively acid food, (D. R. excessive water and food) to the full, or before the proper digestion of food or by a weak person, or by one suffering from the effects of heat. In the above cases, wine undoubtedly proves a source of a host of bodily derangements such as Panatyaya, Paramada, Panajirna and the violent Pana-vibhrama the characterstic symptoms of which I shall presently describe. 10.

Specific symptoms of Panatyaya:—

The Vataja type of Panatyaya is marked by such symptoms as numbness and aching pain in the limbs, palpitation, a catching and pricking pain in the region of the heart and headache. Perspiration, delirium, dryness of the mouth, burning sensation and fainting fits (loss of consciousness) [and yellowness of the face and eyes are the features which distinguish the Pittaja type (of Panatyaya). Vomiting, shivering and water-brash are the indications which mark the Kaphaja type. The symptoms of all the three preceeding types being exhibited in the one due to the concerted action of the three deranged bodily Doshas—Tri-Doshaja type of Panatyaya. 11.

Symptoms of Para-mada:—

Heat and a sense of heaviness in the body, bad taste in the mouth, excessive accumulation of Sleshma in the body, an aversion to food, supression of stool and urine, thirst, headache and a crushing pain in the joints are the symptoms which the learned physicion sets down to Para-mada (reactionary effects of the abuse of wine). 12.

Panajirna and Pana-Vibhrama:—

Distension of the abdomen (tympanites), acid or sour taste (in the mouth), vomiting, deficient gastric digestion are the symptoms which are exhibited in a Pana-jirna type (alcoholic indigestion). Aggravation of the deranged Pitta should be regarded by a physicion as the exciting factor of the disease. The malady which exhibits such symptoms as piercing pain in the heart and limbs, vomiting, fever, a sensation of the rising of fumes into the throat, salivation, epileptic fits, headache, a burning sensation in the throat and an aversion to all sorts of food and wine (in connection with an abuse of wine) is called Pana-Vibhrama. 13–14.

Prognosis:—

A patient suffering from the effects of excessive drinking and exhibiting such symptoms as protuded upper lip, excessive shivering or burning sensation and clamminess of the face, black or blue colour of the tongue, lips or teeth and yellowness or blood-colour of the eyes should be giving up as incurable. Hiccough, fever, vomiting, shivering, tremor, cramp of the sides, cough and vertigo are the supervening symptoms (Upadrava) which are found in all forms of Panatyaya (alcoholism). 15.

Treatment of Vataja type:—

Now hear me describe the medicinal remedies for all the above said maladies. Wine saturated with the mixture of pulverised Chukra, Marica, Adraka, Dipya (Yamani), Kushtha and Sauvarchala should be given for the relief of the Vataja type of Panatyaya, or one mixed with Prithvika, Dipyaka, Mahaushadhi and Hingu, or with Souvarchala should be taken for comfort. Shadavas or cordials made of Amrataka, Amra-fruits, Dadinia and Matulunga should be given for relief. In the alternative, the cooked flesh of an animal of Anupa group i.i. tortoise, etc. should be seasoned with the expressed juice of above fruits and be taken. 16.

Treatment of Pittaja type:—

In the Pittaja-type of Panatyaya, wine mixed with the decoction of the drugs of the Madhura group and saturated and flavoured with the admixture of sugar and scented drugs should be taken, or wine profusely mixed with the expressed juice of sugar-cane should be taken and fully vomited out, a short while thereafter. Meat-juice (Rasa) of Lava, Ena and Tittira unmixed with any acid, or Mudga soup should be taken with sugar and clarified butter. 17.

Treatment of Kaphaja and Tri-Doshaja type, etc.:—

In the Kaphaja type of Panatyaya, the mucus should be eliminated by taking a potion of wine mixed with the expressed juice or decoction of Vimibi and Vidula (Vetasa). Meat-juice of any fatty Jangala animal mixed with bitter and and pungent articles as also the Mudga-soup made bitter and pungent should be taken as beneficial to the patient. The diet should consist of preparations of barley, flesh of Jangala animals and also the Kapha-subduing articles, as well as those calculated as remedial to the present type of Panatyaya. The above kinds of medicines and diet should be combinedly applied in the one due to the concerted action of the three Doshas of the body (Tri-Doshaja type), while in the Dvi-Doshaja types, the treatment should be according to the nature of the predominant Doshas. 18—19.

Now I shall describe the medicinal compounds which tend to relieve the delirious state of mind and may be employed for the relief of all forms of Panatyaya in general. The fine powder of Naga-pushpa, Magadhika, Ela, Madhuka, Dhanya, Ajaji and Marica taken in equal parts mixed copiously with the expressed juice of Kapittha, water and Parushaka should be duly taken in all forms of Panatyaya after the mixture is strained through a piece of cloth. The body of the patient should be anointed with a paste of Haridra, Padma, Paripelava, Karavira, Padmaka, drugs of the Sativadi group and acquatic flower pasted togathcr, and clear and cold water should be sprinkled over the body of the patient in a case of Madatyaya. 20–21.

Panaks:—

A Pauak prepared with Tvak, Patra, Chocha, Markka, Ela, Naga-pushpa and flowers of Shleshmataka ground together into a paste and mixed with treacle and Draksha, should be filtered and perfumed and given to a person suffering from an attack of Panatyaya. The patient would find relief by the frequent use of a Panaka (draughts) composed of Yashti-madhu, Katurohini, Draksha and Trapusha- roots, or of Karpasa- roots, Naga-vala and Suvarchala (Surjavarta) all taken in equal parts. 22—23.

Treatment of Para-mada:—

A Panaka (cordial) made of the fruits of Kashmarya, Daru, Dadima, Vit, Pippali, Draksha pasted together and disolved in water and taken in combination with the expressed juice of Vijapuraka, instantly gives relief in discomforts due to an abuse of wine (Para-mada). Panakas. made of sugar, Draksha, Madhuka, Jiraka, Dhanya, Krishna (Pippali) and Trivrit, or of Sauvarchala, the meat-soup (Rasa) of any fatty Jangala animal and Phalamla should be taken. Cold infusion of Bhargi would be found beneficial in sprinkling. 2 4—25.

Treatment of Panajirna:—

Vomiting should be induced with an Anjali measure of milk duly cooked with the admixture of Ikshvaku, Dhamargava, Brikshaka and two kinds of Udumvarika after which the patient should be advised to take wine in the evening in a case of indigestion due to an abuse of wine (Panajirna). Phalamla in combination with Tvak, Pippali, Naga-puskpa, Vid, Hingu, Marica and Ela, or a compouud consisting of Saindhava, vid, Tvak, Chabya, Ela, Hingu, Pippali, Pippali-roots and Shunthi pounded and desolved in warm water should be taken. The food of the patient should be made palatable with the admixture of Khada-jusha^[1] in the present instance. 27.

Treatment of Pana-vibhrama:—

A Panaka composed of Draksha, Kapittha, Phala (Matu-lunga, etc.) and Dadima sweetened with profuse quantity of sugar and honey, as well as the one made with the expressed juice of Kola and Amrataka sweetened in the same manner would prove curative in a case of Pana-vibhrama. A compound consisting of Kharjura, Vetra, Karira, Parushaka, Draksha and Trivrit pounded together and disolved in cold water should be taken, sweetened with sugar, or the same should be taken in combination with Shri-parni. In the alternative, the tender sprouts of Kshiri -trees, Visa (Mrinala), Jiraka, Nagapushpa, Patra, Elavalu, Sita-sariva, Padmaka, Amrataka, Bhavyaly, Karamarda, Kapittha, Kola, Vrikshamla, Vetra- fruits, Jiraka, Dadima, Yashti-madhu and Utpala, all pounded together and mixed with the cold infusion of such drugs as Marica, Jiraka, Naga-pushpa, Tvak, Patra, Vishva, Cavika and Ela filtered through a piece of thin linen duly perfumed with the addition of scented drugs would be found curative in the seven types of distempers which have their origin in drinking excesses. 28.

Objects which are pleasing to the five sense-organs of man and gratifying to the mind and heart, as well as light wine should be always prescribed in a ease of Panatayaya and the patient should be enlivened with the embrace of handsome and youthful damsels exceedingly attached to the gratification of the senses with splendid hips and thighs with their slender waists drooping under the weight of the exuberance of their breasts. 29.

Potions prepared with powders of Naga-pushpa, Ajaji, Krishna and Marica taken in equal parts mixed with sugar, Madhuka and Tri-sugandhi and then disolved in the expressed juice of Kushmanda fruits, should be taken. The drugs known as Varshabhu, Yashtyahva, Madhuka, Laksha, Tvak, tender sprouts of Karvudara, Jiraka, Draksha, Krishna and Keshara should be given mixed with tepid milk. 30—31.

A person afflicted with diseases due to the excess of Sura, Asava, etc. should be treated with the same wines (Sura, Asava, etc.) duly administered otherwise he will be ruined, in the same manner as a person who has incurred the king’s displeasure, should be saved by courting the royal favour. An inveterate drunkard giving up his habit of drinking is afflicted with the symptoms of Panatyaya if he suddenly revert to his former pernicious habit. 32—33.

The Agneya and Vayaviya virtues of wine tend to produce a dryness in the water carrying channels of the body, hence thirst is experienced by a drunkard person. A cold infusion of Patola, flowers and bulbs of Utpala, and Mudga-parni mixed with Magadhika should be taken under the circumstances (reactionary thirst), or oil, clarified butter, Vasa (lard) and marrow (D. R.—milk) should be duly cooked with curd (four times), expressed juice of Bhringa-raja (four times), and the decoction of Vilva and Yava (four times) with the Kalkas of the drugs known as the Sarva-gandha should be applied as an Abhyanga. The body should be sprinkled (Seka) with the cold decoction^[2]. Palatable foods and cold, pleasing and scented cordials should be prescribed according to the nature and intensity of the deranged bodily Doshas underlying the disease. 34–35,

The heat generated by drinking being aggravated by bodily Pitta and blood of an intoxicated person, escapes through the surface of the skin and causes a feeling of intense burning (Daha) which should be remedied with measures and therapeutic agents prescribed in connection with the aggravation of Pitta. 36.

Remedies for Daha:—

Now I shall describe the cooling measures which should be employed for alleviating the burning sensation (Daha) in the case of a rich patient. The body of such a patient under the circumstances should be smeared at the outest with Chandana (white sandal wood) pastes made cooler by the contact of cold beams of the moon, pearl-necklaces and the water produced from melted ice. He should be laid down in a bed of full-blown lotus flowers sparkling with dew drops or of lotus-leaves sprinkled with spray of translucent water, and youthful damsels decked with necklace and bangles of lotus-stems cooler even than cold water, should be asked to touch him. He should try to alleviate the burning feeling by strolling on the banks of a tank in a garden in the soft, cool and sweet breeze bearing on its wings the soft perfume of Kalhara (red) lotus and water-moss dancing in the adjoining tank. Water cooled and charged with Ushira, Valaka and (white) sandal paste should be sprinkled over his body, or he should be made to sport in a cleansed tank filled with freshly collected water embalmed with full-blown red and blue lotus-flowers and scents (e.g., sandal pastes) after being smeared with sandal paste and with the hairs of his body standing on their roots with the magnetic touch of beloved female hands. Here he should take his bath with young, gay and beautiful damsels skilful in aquatic sports refreshing him with the lotus-like touch of their cold hands, thighs and mouth and hard (i.e., full-grown) breasts and with their sweet words. 37–A.

He should lie down, when tired, in a cool chamber çooled with watery breeze, fitted with fountains and made dusky with the misty jets (vapours) of water. The floor of the chamber should be sprinkled over with scented water and flowers and the walls thickly coated with pastes of sandal wood, Teja-patra and Valaka. The chamber should be scented and decorated with Mansi, Tamala, Musta, Kumkuma, Padma- leaves, Jati- flower, Utpala (blue-lotus), Priyangu, Keshara (Bakula), and Pundarika (red-lotus), Punnaga, Naga-Keshara, and Karavira and there in the room with garlands of flowers gently swinging in the sweet and lazy wind, the patient should lie down and listen to the sweet discourses about the Hemanta, the Vindhya, the Malaya or the Himalaya mountains as well as about cold water, leaves of Kadali or of any other evergreen tree or plant and about the receptacles of full-blown blue or red lotus, as well as about topics of moon-rise, or any other subject which may be calculated to be agreeable to his mind under the circumstances. Young and beautiful damsels with their full and thick-set breasts and thighs anointed with sandal pastes, being clad in wet clothes (adhering to and advantageously showing the splendid contours of their limbs, etc.,) and with their necklaces and girdles loosely sliding down their bosoms and slender waists should lie there with him in their firm embrace. These damsels should refresh him with their secret charms in that lonely chamber and by means of their bodily coolness would be able to alleviate the burning sensation of aggravated Pitta due to overdrinking. 37.

These are the measures in general which should be employed also in the cases of burning sensation due to the aggravated condition of blood, Pitta and thirst. Now hear me discourse on the measures which are to be specifically employed in the case of a burning sensation in the body under different circumstances. 38A.

Symptoms of Raktaja Daha:—

The blood coursing through the whole body when aggravated by any cause whatsoever becomes heated and imparts a copper colour to the skin, complexion and the eyeballs of the patient. It produces a bloody smell in the mouth and the body, and the patient feels a burning and contracting sensation as if he is surrounded by fire. 38.

Treatment:—

Fasting should be prescribed at the outset in such a case and then the diet should be regulated conformably to the nature and intensity of the deranged bodily Dosha involved therein. If such burning sensation (in the body) be still unrelieved, the patient should be treated with a diet largely composed of the soup of Jangala flesh and venesection in the extremeties should then be resorted to duly in conformity with the rules (prescribed in Chapter VIII—Sarira Sthana). Cases of burning sensation due to the aggravation of Pitta would produce the symptoms of Pittaja fever and remedies for Pittaja fever should in such cases be resorted to. 39.

Symptoms and treatment of Daha due to thirst:—

The watery part is dried up in the event of an unslaked thirst, thus generating a heat in the organism. This produces an extreme dryness of the lip, throat and palate and a burning sensation (Daha) both in the skin and inside the organism of the patient followed by the coming out of the tongue and the trembling of the whole body. The medical treatment under such circumstances consists in alleviating the heat and adding to the watery component of the body. A large draught of cold water or cooled milk saturated with a copious quantity of sugar, or of the expressed juice of sugar-cane or of Mantha should be given to the patient to his satiety under the circumstances. 40–41.

An intense burning sensation in the body is caused by the presence of accumulated blood in the abdomen (Koshtha), the symptoms and therapeutics of which are those mentioned in the chapter on Sadyo-vrana (Chap. II—Chikitsita-Sthana) A burning sensation of the body incidental to the waste (Kshaya) of any of its fundamental organic principles (Dhatus) brings on thirst, fainting fits, feebleness of voice, suspension of physical and mental faculties or functions, weakness and lassitude in its train which should be remedied with measures laid down under Rakta-pitta. Emulsive and Vayu-subduing remedies are likewise applicable therein. 42–43.

A severe internal burning sensation in the body may also be produced by (the aggravation of) blood due to (the breach of the rules of) diet and to grief of any kind. The symptoms in such cases are thirst, fainting fits and delirium The remedy should consist in giving the patient the wished-for objects, and the diet under the circumstances should largely consist of milk and meat-essence to be partaken of in company with friends in the manner described before. A burning sensation in the body incidental to a hurt or to a blow on any of its vulnerable or tender parts (Marma) is the seventh of its kind and should be deemed as incurable. All kinds of burning sensation in the body with a coolness of its surface are incurable. Emetics and purgatives should be exhibited according to the Dosha involved even after the subsidence of the supervening symptoms of excess in wine. 44-46.

Wine mixed with half its quantity of water and scented with Jiraka, Sauvarchala, Ardraka and Shunthi becomes palatable and immediately allays thirst. Wine, taken with meal and with cooked meat by a person besmeared with sandal paste and wearing wet clothes and garlands of flowers, does not produce any of its bad after-effects nor brings on intoxication which in its turn would throw the mind and mental faculties off their balance. 47–48.

 

Thus ends the forty-seventh chapter of the Uttara-Tantra in the Sushruta Samhita which deals with the (symptoms and) medical treatment of alcoholism.

Footnotes and references:

[1]:

Dallana in his commentatory says that some read “madyauḥ” in place of “hṛdyauḥ” others read “phalauḥ” in place of “khaḍauḥ”.

[2]:

Decoction of the drugs of Madhura-gana and of the drugs of cold virtues.