A brief description of Madatya w.s.r to Alcohol poisoning -A Conceptual Study

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P a g e | 71 Review Article. ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION International Research Journal of Ayurveda & Yoga An International Peer Reviewed Journal for Ayurveda & Yoga VOLUME 4 ISSUE 6 1 Prof & HOD Agad Tantra department SBLD Ayurved Viswabharti, Sardarshar, Churu, Rajasthan 2 Assistant Professor Rog Nidan evam Vikriti Vigyana Department SBLD Ayurved Viswabharti, Sardarshar, Churu, Rajasthan Corresponding Author:- Durga Lal Sharma Prof & HOD Agad Tantra department SBLD Ayurved Viswabharti, Sardarshar, Churu, Rajasthan Mail idsharmadurgalal 67@gmail.com Phone no-8949355737 Article received on 26 May 2021 Article Accepted 19 June 2021 Article published 30 June 2021 ABSTRACT: - Alcoholism is a global health and societal concern that is on the rise. The stomach absorbs approximately 20% of the alcohol consumed. The remaining 80% is absorbed primarily through the small intestine. The circulatory also transports alcohol to the liver, which eliminates it from the bloodstream through a process known as "metabolising," in which it is transformed to a harmless chemical. The liver can only digest so much at a time, thus the remainder circulates throughout the body. As a result, the strength of the effect on the body is proportional to the amount consumed. When the amount of alcohol in the blood exceeds a particular threshold, the respiratory (breathing) system slows significantly, and oxygen no longer reaches the brain, resulting in a coma or death. Ayurveda classifies acute alcoholism, chronic alcoholism, and alcohol withdrawal as Madhya (Alcohol), Mada Intoxication, Madatya (Alcoholism), and Panapkaram, respectively. Though Ayurveda addresses alcoholism, chronic toxicity, withdrawal, and treatment, the opinions and principles for diagnosis and treatment are fragmented and differ from book. An attempt is made to organise the existing Ayurvedic literature on Madya and treatment of Madatya in a way that is both easy to understand and rewarding in the realm of treatment. Keywords - Madya, Madatya , Alcoholism. This work is licensed under a creative attribution -Non-commercial-No derivatives 4.0 International License commons How to cite this article: Sharma D.L, Saini R, “ A brief description of Madatya w.s.r to Alcohol poisoning -A Conceptual Study; IRJAY. [Online] 2021;4(6): 71-77. Available from: http://irjay.com ; DOI:https://doi.org/10.47223/IRJAY.2021.4611 A brief description of Madatya w.s.r to Alcohol poisoning -A Conceptual Study Durga Lal Sharma, 1 Shri Ram Saini 2

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P a g e | 72 Review Article. ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION INTRODUCTION Madya refers to the compounds that have an influence on the brain and mind following indigestion. The major alcohol ethanol (ethyl alcohol), which is the most common alcohol in alcoholic beverages, was previously referred to as alcohol [1] It is classified as a depressant of the central nervous system. Alcohol enters the bloodstream through small blood vessels in the stomach and small intestine walls. Within minutes of drinking alcohol, it moves from the stomach to the brain, where it swiftly takes effect and slows nerve cell activity [2] Alcoholism is described to in Ayurveda as Madatya (Alcoholism), and chronic toxicity of alcohol is divided into four parts: Vataj, Pittaj, Kaphaj, and Tridoshaja madatya . (Alcoholism)with its clinical manifestation in Ayurveda while in modern science it is described under the systemic toxicity of gastrointestinal tract, nervous system, cardiovascular system, hematological system and reproductive system. Although Ayurveda recognizes alcohol addiction, its chronic toxicity, withdrawal, and treatment, the opinions and principles of diagnosis and treatment are scattered and differ from book to text. There is also needed to highlight some new problems along with its management which are not mentioned in Ayurveda. AIMS AND OBJECTIVE • Various Ayurvedic concepts related to alcoholism will be evaluated, discussed, and elaborated. • To describe the therapeutic measures mentioned in Ayurvedic texts. MATERIAL AND METHOD A comprehensive literary analysis is carried out for this assessment. Charak, Sushruta, and Vagbhatta are used to analyze the content. Other Ayurvedic, modern texts, and research articles are also used as reference. Conceptual Study Madatyaya is made up of two terms : Mada - any exciting or intoxicating condition, and Atyaya any exhilarating or intoxicating situation. Atyaya is a Sanskrit word that means "suffering." [3] As a result, Madatyaya refers to someone who is inebriated. Excess Madya drinking is the source of this euphoria. The harmful consequences of the Dosha vary depending on its involvement [4],[5] Table no 1. Stages of Mada (Alcoholism) [6] Stages of mada LAKSHANAS B.A.C ‘[7] BEHAVIORAL CORELATES SROTAS INVOLVED PRATHAMA Happy, relaxed. Promotes good sleep. 25-100 mg% Excitement Buddhivaha DWITEEYA Impaired Speech, vision and thought process. Inappropriate activities. 100- 200 mg% Excitement Confusion Manovaha Buddhivaha Cheshtavaha TRITEEYA Lack of self-control. 200- 300 mg% Slurred speech Confusion incoordination Sanjnavaha (Smrithi) chestavaha CHATURTHA (Vangasena) Hypothermia Dysarthria Cold sweats Unconsciousness >300 mg% Respiratory distress. Coma. Death. Sanjnavaha Chetanavaha

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P a g e | 73 Review Article. ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION Table no 2. Types of Madatya [8] TYPES SIGNS AND SYMPTOMS PANAATYAYA Sthambha, angamarda, hrudaya graha, thodha, kampa, shiroruja- Vata Dosha Sweda, pralapa, mukhashosha, daha, murcha- Pitta dosha Vamathu, seeta, kapha praseka- Kapha dosha Presence of all symptoms -Sannipata dosha PARAMADA Ushma, Angagurutha, virasanuntvam, Aruchi, Malamutra sangam,Trushna and Shiroruja, sandhibheda PANAAJIRNA Adhmana, sour vomiting, dahaduring digestion – predominance of pitta. PANAVIBHRAMA Hrudgatrathoda, chardi, jwara, murcha, shiroruja, daha, Dveshatowards sura and food. Table no 3. Doshic Background of Madatya [9] DOSHA NIDANA SIGNS AND SYMPTOMS VATAJA Indulges in sthri, shoka,bhaya Heavy work, alcohol which is rukshaleads to impairment of sleep. Hikka, shwasa, kampa, parsva shula, prajagara, pralapa PITTAJA Food intake which is tikshna, ushna, having madya which is tikshna, amla Trushna, daha, jwara, sweda,murcha, atisara, bhrama. KAPHAJA Intake of madhura, sneha, guda, not doing regular exercises, day sleep, consumes alcohol not properly fermented. Chardhi, arochaka, hrillasa, tandra, heaviness and chills. SANNIPATA Mixed nidana of tridoshas, effect will be as of visha, but not as powerful as visha. Mixed signs and symptoms, may cause death or leads to disease

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P a g e | 74 Review Article. ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION Samprapti Ghataka ➢ Dosha- Tridoshaja ➢ Dhatu-Rasadidhatus, Especially Rasa, Rakta ➢ Manasika Dosha-Rajas And Tamas ➢ Srotas-Manovaha, Rasadi Sarva Srotas ➢ Satva-Avara ➢ Mula Sthana-Hridaya Samprapti Excessive alcohol(madya) Tikshna, ushna, vidahi, By vyavayi, vikasi, sukshma guna Makes annarasa utkleda Hrudaya is the sthana of Ojas, satva, buddhi, indriya,Mana Antardaha, trishna, jvara causes obstruction of vayu Pramoha,vibhrama, and mada pt. suffers from pain MADATYAYA Contemporary View Ethanol depresses the CNS by dissolving the lipid membrane of the cell and generating lipid matrix disorder (membrane fluidization) [10] Ethanol works by boosting the function of the Gamma aminobutyric acid (GABA) receptor and the related chloride ion channel. Formic acid oxidation via the catalase–peroxidase system or tetrahydrofolate metabolism are both dependent on the carbon pool, which is catalysed by 10 formyl-tetrahydrofolate synthetase [11] Ethyl alcohol depresses the CNS irregularly in descending order from cortex to medulla. Stage of excitement is due to removal of inhabitations. Alcohol from the blood flows through the lungs and into the alveolar air, giving off an alcoholic odour. It promotes widespread vasodilation, is hypnotic, gives a warm feeling but causes increased heat loss, stimulates appetite, is diuretic, diaphoretic, and causes gastritis [12] Because the rate of oxidation of methyl alcohol is one-fifth that of ethanol, methanol and its metabolites, formaldehyde and formic acid, accumulate in the brain and optic nerve [13] The approximate % of absolute alcohol in diverse beverages determines the mechanism of degree of extent of alcohol. Alcohol is a CNS depressant that works by blocking the receptor for - aminobutyric acid (GABA), the nervous system's main inhibitory neurotransmitter. At blood alcohol levels as low as 0.02-0.03 g/dl, behavioral, cognitive, and psychomotor alterations can occur [14] Management of Madatya (Alcoholism) through Ayurveda In the beginning, all varieties of Madatyaya are caused by the vitiation of all three Doshas , and the most predominant Dosha is treated. If all of the Doshas are equally inflamed, treatment begins with Kapha , then Pitta, and finally Vata . [15] Ailments induced by consuming alcohol in an inappropriate manner, in excess quantity, or in insufficient quantity can be treated by consuming the same alcohol in the appropriate manner and quantity.

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P a g e | 75 Review Article. ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION Following steps adopted for de-addiction treatment of drug addicted person Clinical care is delivered in both outpatient and inpatient settings, and includes a number of procedures such as registration, consultation, evaluation, treatment planning, and counselling. A team of addiction experts assesses progress and makes personalized recommendations. Practical approach of Management Samanya Chikitsa (general management) and Visisthta Chikitsa (specific treatment) a Samanya Chikitsa a. Doshanusara Chikitsa- Because all varieties of alcoholism are Tridoshaja, the physician should treat the Dosha that is prominent in the patient first. Otherwise, because it is mostly flanked by Pitta and Vata , treatment for alcoholism should begin with Kapha . [16] b. Administration of Madhya (Madhya Prayoga) - If provided properly, disorders caused by insufficient, incorrect, or excessive alcohol use can be healed. Vayu is clogged in channels due to Dosha elicited by wine, which causes great agony in the head, bones, and joints, according to Charaka. In such cases for liquefying the Dosha particularly wine should be given because of its properties like quick absorption, sharpness and hotness unlike of other remedial measures. Wine clears blocked channels, carminates vata , enhances savour, promotes digestive fire, and becomes appropriate with experience. Pain and diseases are relieved when obstructions in channels are removed and vata is carminate c. Administration of Milk ( Dugda Prayoga )- If the alcoholism does not improve with these tried-and-true remedies, it is recommended that milk be consumed instead of wine. When Kapha is reduced, debility and lightness arise as a result of lightening ( Langana, Pachana, Shodhana procedures and Shamana measures), and Vata and Pitta predominate in the wineaffected patient, so milk administration acts as a boon, similar to rains for a tree that is extremely dried in the summer [17] d. Beyond seven or eight days, administer drugs to cure alcoholic intoxication; by this time, the wine that is residing in unusual (wrong) channels has been digested, and any diseases that persist after this time should be treated appropriately with drugs suitable for alcoholic intoxication [18] Visistha Chikitsa a. Vataja Madatyaya - Chukra, Maricha, Ardraka, Dipya, and Kusta, together with a pinch of Sauvarchala , should be consumed with Madya, Prtvika, Dipyaka, Mahaushada, and Hingu, as well as Sauvarchala salt. Pana should be served with Amra Phala, Amrataka, Dadima, and Matulunga . Alternatively, the patient can consume meat soup ( Mamsa Rasa) mixed with Matulunga Swarasa and Mamsa of marshy animals, as well as Sugandi Dravyas (flavouring agents) [19] b. Pittaja Madatyaya - Madhya should be combined with Kashaya made with Madura Rasa Dravyas, Madhu , and Sita , and the wonderful flavours will benefit you. After drinking this Madhya, one should drink Ikshu Rasa and vomit it out fully. Then Lava Mamsa Rasa, Aina, and Tittira, or Mudga Rasa, Sita, and Ghruta , should be given to drink for good health. c. Kaphaja Madatyaya - Vamana can be induced with the use of Madhya, Bimbi , and Vidula Swarasa. Mamsa Rasa of wild fatty animals with bitters and pungent flavours should be offered, as well as soups made with pulses [20] d . Sannipataja Madatyaya - Due to all three Dosas , actions to counteract all of them should be performed; however, in the situation of dual Dosas participation, the principal one should be treated first once both have been assessed. In addition, all additional positive measures, including those that satisfy the mind, should be implemented [21]

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P a g e | 76 Review Article. ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION DISCUSSION Alcohol, when consumed in the right way, at the right time, with good food, in the right dose, and according to one's own strength, can be just as beneficial as Amrita. However, alcoholism in the present generation causes both mental and physical problems for the individual. As we have seen, alcohol is a highly addictive chemical that has a negative impact on critical body functions. Because 80 percent of alcohol is absorbed in the small intestine and much more is processed in the liver, it has a toxic effect on the liver and destroys it. In some circumstances, excessive alcohol use and longterm drinking might lead to malignant stages in several organs [22] It mostly affects a person's hepatic system, resulting in liver cirrhosis. Anorexia, loss of appetite, gastrointestinal pain, vomiting, constipation, and other GIT issues will result as a result. Counselling is one of the most important aspects of alcoholism treatment The individual must be rationally consoled or convinced, and high levels of motivation must be maintained. Education about alcohol and its harmful effects on the body must be known to everyone, and family or friends must be introduced to cease protecting the person from the issues created by alcohol . Madatyaya exhibits clinical symptoms that are similar to alcoholism, according to Ayurvedic scriptures. The imbalance of Dosha and Dushya is the main cause of any ailment. It is essential to balance these components in order to treat any sickness. Tridosha, Rasa, and Rakta are dushyas in Madatyaya , as are Rasavaha, Raktavaha , and Sangyavaha Shrotas . Hridaya is the main adhisthan that causes Ojakshaya, Dhatukshaya, Sharirkampa, Pralapa, Bhrama, Agni Vikar, and Anidra in people. So, a medicine with a Tridosha shamak effect and properties that promote oja, bala, and dhatu, as well as deepana, pachana, anulomana, yakrita uttejak, mutral, raktavardhak, raktashodhak, vishaghna, rasayan , and medhya properties, can provide relief from signs and symptoms. Ayurveda's Madatyaya can be linked to the withdrawal symptoms of prolonged drinking to some extent CONCLUSION As a result, it can be argued that Madatyaya (Alcohol Intoxication) is well-explained in Ayurvedic texts, which aids us in understanding the pathophysiology, diagnosis, and treatment of madatyaya based on the Doshas' involvement. Acknowledgment: Nil Financial Support: Nil. Conflict of Interest: Nil REFERENCES 1 Banerjee N. Neurotransmitters in alcoholism: A review of neurobiological and genetic studies. Indian journal of human genetics ; 2014 20 (1), 20–31. https://doi.org/10.4103/0971- 6866.132750. 2 https://www.sciencedirect.com/topics/medicin e- /hepatic-portal-system 3 Abhimanyu M.L., Amarkosha of Amara singh, Trutiya Khanda 3 choukhamba Publication; 1999.p.204 4 Tripathi B, Charak Samhita,(5 th ed) Chikitsa Sthana 24, verse no.55, Delhi choukhamba publication;1998.p.812. 5 Tripathi B, Charak Samhita,(5 th ed) Chikitsa Sthana 24, verse no.25, Delhi choukhamba publication;1998.p.434 6 Tripathi B, Charak Samhita,(5 th ed) Chikitsa Sthana 24, verse no.41-42, Delhi choukhamba publication;1998.p.394 7 https://www.sciencedirect.com/topics/biochem istry-genetics-and-molecular-biology/bloodalcohol-content

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P a g e | 77 Review Article. ISSN NO. 2581-785 X IRJAY IS OFFICIAL JOURNAL OF BALA G PUBLICATION 8 Shastri S.P, Sushruta Samhita, Uttarardha, 47/19 Varanashi Krishna Das Academy ;1985.p. 684. 9 Shastri S.P, Sushruta Samhita, Uttarardha, 47/17 Varanashi Krishna Das Academy ;1985.p. 684. 10 Pillay V.V, Modern Medical Toxicology, Jaypee brother publication New Delhi, 4 th edition 2013, p. 182,183,193 11 Parikh C.K., Parikh’s Text Book Of Medical Jurisprudence, Forensic Medicine And Toxicology (6 th ed.) CBS Publication And Distributer Pvt. Ltd;2005. p- 10.17,10.18 12 http://sciencenetlinks.com /alcohol-and-yourbrain/ 13 https://emedicine.medscape.com/article/11748 90-overview 14 Lobo I. A., & Harris, R. A. GABA(A) receptors and alcohol. Pharmacology, biochemistry, and behavior ;2008. 90 (1), 90–94. https://doi.org/10.1016/j.pbb.2008.03.006 15 Tripathi B, Charak Samhita,(5 th ed) Chikitsa Sthana 24, verse no.107, Delhi choukhamba publication;2004.p.410 16 Tripathi B, Charak Samhita,(5 th ed) Chikitsa Sthana 24, verse no.195, Delhi choukhamba publication;2004.p.428 17 Tripathi B, Charak Samhita,(5 th ed) Chikitsa Sthana 24, verse no.196, Delhi choukhamba publication;2004.p.428 18 Tripathi B, Charak Samhita,(5 th ed) Chikitsa Sthana 24, verse no.191-193, Delhi choukhamba publication;2004.p. 387 19 Shastri S.P, Sushruta Samhita, Uttarardha, 47/24-25, Varanashi Krishna Das Academy ;1985.p. 684. 20 Shastri S.P, Sushruta Samhita, Uttarardha, 47/26-27, Varanashi Krishna Das Academy ;1985.p. 684. 21 https://www.drugabuse.gov/publications/princ iples-adolescent-substance-use-disordertreatment-research-based-guide/introduction 22 Paton A. Alcohol in the body. BMJ (Clinical research ed.) ;2005 330 (7482), 85–87. https://doi.org/10.1136/bmj.330.7482.85

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