Madatyaya Chikitsa

Chikitsa Sthana Chapter 24. Management of Madatyaya (Intoxication)

Madatyaya Chikitsa

Section/Chapter	Chikitsa Sthana Chapter 24
Preceding Chapter	Visha Chikitsa
Succeeding Chapter	Dwivraniya Chikitsa
Other Sections	Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Kalpa Sthana, Siddhi Sthana

Abstract

This chapter describes in sequence, the origin of madya (liquor) practice, the preferred formulation of the liquor, correct methods of consumption, and advantages of its consumption. Then, another aspect of the liquor consumption is described, starting from different stages of intoxication, disadvantages of liquor consumption, and various other forms of intoxication which should be understood by the treating physician.

The chapter also highlights the preferred quality of liquor with preferred composition which shall be multi-ingredient based rather than the single ingredient. Comparison of the liquor with visha, the poison has also been described.

Ojas and its significance has been elaborated here with respect to the liquor effects on the human body; The ojas is the constant energy source of the body which may get affected by the liquor intoxication leading to perplexity which is commonly observed due to liquor and poison. The treatments prescribed in this chapter for intoxication are aimed to establish the consciousness and improve the energy which eventually will maintain the vigor.

Keywords: Madya, Madatyaya, Oja, Visha, liquor, intoxication, personified liquor.

Introduction

The state of Moha, that is, perplexity and delusion till the loss of consciousness is common due to the effects of poison and also due to liquor. Therefore, the chapter for the treatment of madatyaya or drunkenness has been placed after the chapter on poison. Similarly, the moha occurs due to increased tama, which is associated with the quality of kapha. Therefore, the line of treatment for increased tama is equally essential in the visha chikitsa and madatyaya.

Alcohol is classed under sedative hypnotic drugs, leading to depression of Central Nervous System (CNS). Madya, by its etymology, means the intoxicating drink, gladdening, vinous, spirited drink, liquor, ale, wine or alcoholic beverage. Each of these words has specific meaning in particular context. Sometimes, only alcohol is the word used to represent the madya, but it is the chemical name and therefore may not always reflect the drinks made up of various ingredients including alcohol. Alcoholic beverage is the term which is quite inclusive for almost all types of madya, which are further differentiated as soft and hard or according to the concentration and type of the beverage. Generally, alcoholic beverage contains 3% to 40% alcohol in it. The alcoholic beverages which are usually distilled are called as spirit or liquor. In today's context, beer, wine, cider are not the distilled alcoholic beverages while the rest whisky, rum, brandy, vodka,tequila are all distilled alcoholic beverages.

Liquor is the word derived from liquorice, which is sweet in nature and most of the traditional alcoholic beverages described in this chapter are predominantly sweet, therefore the word liquor has been used for madya in this chapter; which does not essentially mean distilled drinks only in the present context. Perhaps, distilled alcoholic beverages were hardly common in use in ancient days, though the people of that era knew the distillation methods quite well; which was practiced in manufacturing of drugs. Liquor, certainly has advantages but these advantages can be experienced with limited quantity consumption only. It is the source of food energy, mainly due to its carbohydrate content. Consumption of alcoholic beverage potentiates the insulin reaction to glucose in humans.Needs citation It prevents carbohydrate and fat oxidation by converting carbohydrates consumed by an individual to fats. Liquor has its role on digestion depending upon its use before or after meal consumption.

This chapter emphasizes on quantity of liquor and type of liquor which is suitable for the prakriti (body type) of the individual. The properties of liquor vary with respect to the type of manufacturing process. At lower doses it acts as stimulant, causing euphoria and talkativeness; while with high doses it leads to drowsiness and ultimately unconsciousness. Upon consumption it gets absorbed rapidly by stomach and small intestine 20% and 80% respectively; to feel the effect within 5 to 10 minutes and peak effect by 90 minutes. The feeling of effect usually depends upon the quantity and the food taken before, during, and / or after consumption of the liquor. Presently, the effect is correlated to the Blood Alcohol Levels (BAC) of an individual. The BAC depends upon various factors which are: capacity of liver to metabolize the liquor, food interaction, concentration of the alcoholic beverage, duration of consumption, body type of the consumer-lean or obese, age, gender, ethnicity, and frequency of consumption. All these factors have been discussed methodically and at length in this chapter.

The health effects of liquor consumption are observed in two ways as they appear; short term effects or immediate effects and long term effects or late effects. The ojas (the vigor), reflects the short term as well as long term effects, if liquor is consumed beyond the prescribed limit. The ojas is quite dynamic phenomenon of human body, which is said to have similar properties like milk; which indicates the productive benefits to the body. The alcoholic beverages possess exact opposite properties to the ojas, and excess drinking can also cause suppression of ojas leading to intoxication and death with complete obliteration of ojas. The purpose of describing and discussing ojas here indicates the importance to conserve the ojas in the treatment of madatyaya (alcoholism). Most of the formulations prescribed here directly or indirectly lead to enhancement of ojas to achieve conscious state.

Sanskrit Text, Transliteration and English Translation

अथातो मदात्ययचिकित्सितं व्याख्यास्यामः ||१||

इति ह स्माह भगवानात्रेयः ||२||

athātō madātyayacikitsitaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAto madAtyayacikitsitaM vyAkhyAsyAmaH ||1||

iti ha smAha bhagavAnAtreyaH ||2||

Now we shall expound the chapter on management of state of intoxication (due to excess consumption of liquor). Thus said Lord Atreya. [1-2]

Origin of sura

सुरैः सुरेशसहितैर्या पुरा [१] परिपूजिता |

सौत्रामण्यां हूयते या कर्मिभिर्या प्रतिष्ठिता ||३||

यज्ञौही या यया शक्रः सोमातिपतितो भृशम् |

निरोजस्तमसाऽऽविष्टस्तस्माद्दुर्गात् समुद्धृतः ||४||

विधिभिर्वेदविहितैर्वा यजद्भिर्महात्मभिः |

दृश्या स्पृश्या प्रकल्पया च यज्ञीया यज्ञसिद्धये ||५||

suraiḥ surēśasahitairyā purā [1] paripūjitā|

sautrāmaṇyāṁ hūyatē yā karmibhiryā pratiṣṭhitā||3||

yajñauhī yā yayā śakraḥ sōmātipatitō bhr̥śam|

nirōjastamasāviṣṭastasmāddurgāt samuddhr̥taḥ||4||

vidhibhirvēdavihitairvā yajadbhirmahātmabhiḥ|

dr̥śyā spr̥śyā prakalpyā ca yajñīyā yajñasiddhayē||5||

suraiH sureshasahitairyA purA [1] paripUjitA |

sautrAmaNyAM hUyate yA karmibhiryA pratiShThitA ||3||

yaj~jauhI yA yayA shakraH somAtipatito bhRusham |

nirojastamasA~a~aviShTastasmAddurgAt samuddhRutaH ||4||

vidhibhirvedavihitairvA yajadbhirmahAtmabhiH |

dRushyA spRushyA prakalpayA ca yaj~jIyA yaj~jasiddhaye ||5||

Sura, which is admired by the Gods and the kings since ancient era and offered as an oblation in Sautramani yagna (A special type of yagna where sura is indicated as havi means substance for sacrificing) by Yagnauhi (sages performing sacrifice). By the use of which the depressed Indra after drained energy due to excessive consumption of soma, recovered from the condition; which is a visible, touchable, and applicable instrument of sacrifice conducive to the successful completion as enjoyed by the great sages performing sacrifices as per the prescribed methods in the vedas. [3-5]

योनिसंस्कारनामाद्यैर्विशेषैर्बहुधा च या |

भूत्वा भवत्येकविधा सामान्यान्मदलक्षणात् ||६||

yōnisaṁskāranāmādyairviśēṣairbahudhā ca yā|

bhūtvā bhavatyēkavidhā sāmānyānmadalakṣaṇāt||6||

yonisaMskAranAmAdyairvisheShairbahudhA ca yA |

bhUtvA bhavatyekavidhA sAmAnyAnmadalakShaNAt ||6||

It has several varieties depending upon its specific source material, sanskara (method of preparation), nomenclature, etc; which is at the same time unitary in character on account of the common features of intoxication.[6]

Various forms of sura

या देवानमृतं भूत्वा स्वधा भूत्वा पित्तॄंश्च या |

सोमो भूत्वा द्विजातीन् या युङ्क्ते श्रेयोभिरुत्तमैः ||७||

yā dēvānamr̥taṁ bhūtvā svadhā bhūtvā pittr̥̄ṁśca yā|

sōmō bhūtvā dvijātīn yā yuṅktē śrēyōbhiruttamaiḥ||7||

yA devAnamRutaM bhUtvA svadhA bhUtvA pittRUMshca yA |

somo bhUtvA dvijAtIn yA yu~gkte shreyobhiruttamaiH ||7||

It bestows auspicious par excellence by providing nourishment to the Gods in the form of ambrosia, to the ancestors in the form of svadha (the term used for offering oblatory to the ancestors), to dvijas (considered as the twice born) in the form of soma. [7]

Importance of sura

आश्विनं या महत्तेजो बलं सारस्वतं च या |

वीर्यमैन्द्रं च या सिद्धा सोमः सौत्रामणौ च या ||८||

शोकारतिभयोद्वेगनाशिनी या महाबला |

या प्रीतिर्या रतिर्या वाग्या पुष्टिर्या च निर्वृतिः ||९||

या सुरा सुरगन्धर्वयक्षराक्षसमानुषैः |

रतिः सुरेत्यभिहिता तां सुरां विधिना पिबेत् ||१०||

āśvinaṁ yā mahattējō balaṁ sārasvataṁ ca yā|

vīryamaindraṁ ca yā siddhā sōmaḥ sautrāmaṇau ca yā||8||

śōkāratibhayōdvēganāśinī yā mahābalā|

yā prītiryā ratiryā vāgyā puṣṭiryā ca nirvr̥tiḥ||9||

yā surā suragandharvayakṣarākṣasamānuṣaiḥ|

ratiḥ surētyabhihitā tāṁ surāṁ vidhinā pibēt||10||

AshvinaM yA mahattejo balaM sArasvataM ca yA |

vIryamaindraM ca yA siddhA somaH sautrAmaNau ca yA ||8||

shokAratibhayodveganAshinI yA mahAbalA |

yA prItiryA ratiryA vAgyA puShTiryA ca nirvRutiH ||9||

yA surA suragandharvayakSharAkShasamAnuShaiH |

ratiH suretyabhihitA tAM surAM vidhinA pibet ||10||

Which represents the great luster of the Ashwins, the prowess of mantras, and the supremacy of Indra, who perfected soma in the sautramani sacrifice; which eradicates grief, depression, fear and bewilderment; which itself represents the invincible strength, love, voice, nourishment and peace; and which is called sura by the Gods, gandharvas (celestial musicians), yaksha, rakshasa (devils) and human beings should take appropriately (as per the prescription of the shashtras).[8-10]

Procedure of drinking madya

शरीरकृतसंस्कारः शुचिरुत्तमगन्धवान् |

प्रावृतो निर्मलैर्वस्त्रैर्यथर्तूद्दामगन्धिभिः ||११||

विचित्रविविधस्रग्वी रत्नाभरणभूषितः |

देवद्विजातीन् सम्पूज्य स्पृष्ट्वा मङ्गलमुत्तमम् ||१२||

देशे यथर्तुके शस्ते कुसुमप्रकरीकृते |

सरसासम्मते [१] मुख्ये धूपसम्मोदबोधिते ||१३||

सोपधाने सुसंस्तीर्णे विहिते शयनासने |

उपविष्टोऽथवा तिर्यक् स्वशरीरसुखे स्थितः ||१४||

सौवर्णै राजतैश्चापि तथा मणिमयैरपि |

भाजनैर्विमलैश्चान्यैः सुकृतैश्च पिबेत् सदा ||१५||

रूपयौवनमत्ताभिः शिक्षिताभिर्विशेषतः |

वस्त्राभरणमाल्यैश्च भूषिताभिर्यथर्तुकैः ||१६||

शौचानुरागयुक्ताभिः प्रमदाभिरितस्ततः |

संवाह्यमान इष्टाभिः [२] पिबेन्मद्यमनुत्तमम् ||१७||

मद्यानुकूलैर्विविधैः फलैर्हरितकैः शुभैः |

लवणैर्गन्धपिशुनैरवदंशैर्यथर्तुकैः ||१८||

भृष्टैर्मांसैर्बहुविधैर्भूजलाम्बरचारिणाम् |

पौरोगवर्गविहितैर्भक्ष्यैश्च विविधात्मकैः ||१९||

पूजयित्वा [३] सुरान् पूर्वमाशिषः प्राक् प्रयुज्य च |

प्रदाय सजलं मद्यमर्थिभ्यो वसुधातले ||२०||

śarīrakr̥tasaṁskāraḥ śuciruttamagandhavān|

prāvr̥tō nirmalairvastrairyathartūddāmagandhibhiḥ||11||

vicitravividhasragvī ratnābharaṇabhūṣitaḥ|

dēvadvijātīn sampūjya spr̥ṣṭvā maṅgalamuttamam||12||

dēśē yathartukē śastē kusumaprakarīkr̥tē|

sarasāsammatē [1] mukhyē dhūpasammōdabōdhitē||13||

sōpadhānē susaṁstīrṇē vihitē śayanāsanē|

upaviṣṭō'thavā tiryak svaśarīrasukhē sthitaḥ||14||

sauvarṇai rājataiścāpi tathā maṇimayairapi|

bhājanairvimalaiścānyaiḥ sukr̥taiśca pibēt sadā||15||

rūpayauvanamattābhiḥ śikṣitābhirviśēṣataḥ|

vastrābharaṇamālyaiśca bhūṣitābhiryathartukaiḥ||16||

śaucānurāgayuktābhiḥ pramadābhiritastataḥ|

saṁvāhyamāna iṣṭābhiḥ [2] pibēnmadyamanuttamam||17||

madyānukūlairvividhaiḥ phalairharitakaiḥ śubhaiḥ|

lavaṇairgandhapiśunairavadaṁśairyathartukaiḥ||18||

bhr̥ṣṭairmāṁsairbahuvidhairbhūjalāmbaracāriṇām|

paurōgavargavihitairbhakṣyaiśca vividhātmakaiḥ||19||

pūjayitvā [3] surān pūrvamāśiṣaḥ prāk prayujya ca|

pradāya sajalaṁ madyamarthibhyō vasudhātalē||20||

sharIrakRutasaMskAraH shuciruttamagandhavAn |

prAvRuto nirmalairvastrairyathartUddAmagandhibhiH ||11||

vicitravividhasragvI ratnAbharaNabhUShitaH |

devadvijAtIn sampUjya spRuShTvA ma~ggalamuttamam ||12||

deshe yathartuke shaste kusumaprakarIkRute |

sarasAsammate [1] mukhye dhUpasammodabodhite ||13||

sopadhAne susaMstIrNe vihite shayanAsane |

upaviShTo~athavA tiryak svasharIrasukhe sthitaH ||14||

sauvarNai rAjataishcApi tathA maNimayairapi |

bhAjanairvimalaishcAnyaiH sukRutaishca pibet sadA ||15||

rUpayauvanamattAbhiH shikShitAbhirvisheShataH |

vastrAbharaNamAlyaishca bhUShitAbhiryathartukaiH ||16||

shaucAnurAgayuktAbhiH pramadAbhiritastataH |

saMvAhyamAna iShTAbhiH [2] pibenmadyamanuttamam ||17||

madyAnukUlairvividhaiH phalairharitakaiH shubhaiH |

lavaNairgandhapishunairavadaMshairyathartukaiH ||18||

bhRuShTairmAMsairbahuvidhairbhUjalAmbaracAriNAm |

paurogavargavihitairbhakShyaishca vividhAtmakaiH ||19||

pUjayitvA [3] surAn pUrvamAshiShaH prAk prayujya ca |

pradAya sajalaM madyamarthibhyo vasudhAtale ||20||

(Describing the standard directives for drinking) One who after cleansing of the body, purification (of the mind), with fragrance, hygienic apparels and scented as per ritu (the season), put on garlands, trinkets and ornaments worshiping God and brahmanas; touching the propitious things shall be seated or reclined on well spread cushion as per the own comfort of body; with endowment of the seasonal flowers adored by the friends and filled with the fragrance of incense and shall drink in the vessels made of gold, silver, precious stones or other clean and well maintained vessels served by the beloved females who are proud of their beauty and youthfulness, particularly trained, adorned with the dress, ornaments and garlands according to the season and endowed with sincerity and affection.

One shall always prefer best liquor to drink along with a variety of apposite fruits, natural green vegetables, salted and veteran seasonal fruits, a variety of roasted meat of terrestrial, aquatic animals and flying birds and different edibles prepared by the group of chefs; after being worshiped by the Gods, with blessings and pouring the liquor mixed with water to be given to the willing persons on this earth.[11-20]

Pre-procedures based on dosha dominant prakriti

अभ्यङ्गोत्सादनस्नानवासोधूपानुलेपनैः |

स्निग्धोष्णैर्भावितश्चान्नैर्वातिको मद्यमाचरेत् ||२१||

शीतोपचारैर्विविधैर्मधुरस्निग्धशीतलैः |

पैत्तिको भावितश्चान्नैः पिबन्मद्यं न सीदति ||२२||

उपचारैरशिशिरैर्यवगोधूमभुक् पिबेत् |

श्लैष्मिको धन्वजैर्मांसैर्मद्यं मारिचकैः सह ||२३||

विधिर्वसुमतामेष भविष्यद्विभवाश्च ये |

यथोपपत्ति तैर्मद्यं पातव्यं मात्रया हितम् ||२४||

वातिकेभ्यो हितं मद्यं प्रायो गौडिकपैष्टिकम् |

कफपित्ताधिकेभ्यस्तु मार्द्वीकं माधवं च यत् ||२५||

abhyaṅgōtsādanasnānavāsōdhūpānulēpanaiḥ|

snigdhōṣṇairbhāvitaścānnairvātikō madyamācarēt||21||

śītōpacārairvividhairmadhurasnigdhaśītalaiḥ|

paittikō bhāvitaścānnaiḥ pibanmadyaṁ na sīdati||22||

upacārairaśiśirairyavagōdhūmabhuk pibēt|

ślaiṣmikō dhanvajairmāṁsairmadyaṁ māricakaiḥ saha||23||

vidhirvasumatāmēṣa bhaviṣyadvibhavāśca yē|

yathōpapatti tairmadyaṁ pātavyaṁ mātrayā hitam||24||

vātikēbhyō hitaṁ madyaṁ prāyō gauḍikapaiṣṭikam|

kaphapittādhikēbhyastu mārdvīkaṁ mādhavaṁ ca yat||25||

abhya~ggotsAdanasnAnavAsodhUpAnulepanaiH |

snigdhoShNairbhAvitashcAnnairvAtiko madyamAcaret ||21||

shItopacArairvividhairmadhurasnigdhashItalaiH |

paittiko bhAvitashcAnnaiH pibanmadyaM na sIdati ||22||

upacArairashishirairyavagodhUmabhuk pibet |

shlaiShmiko dhanvajairmAMsairmadyaM mAricakaiH saha ||23||

vidhirvasumatAmeSha bhaviShyadvibhavAshca ye |

yathopapatti tairmadyaM pAtavyaM mAtrayA hitam ||24||

vAtikebhyo hitaM madyaM prAyo gauDikapaiShTikam |

kaphapittAdhikebhyastu mArdvIkaM mAdhavaM ca yat ||25||

An individual of vata dominant prakriti shall imbibe madya after abhyanga (massage), utsadana (rubbing with herbs), bathing, dressed up, holy incense, anulepanam (unguent) and unctuous hot food.

An individual of pitta dominant prakriti shall undergo various cooling regimens; sweet, unctuous and cooling food to not get affected by madya, i.e., liquor.

An individual of kapha dominant prakriti shall imbibe madya (the liquor) with warm regimens; drink yava (barley), wheat, meat of wild animals along with black pepper.

These standard methods are advised for the affluent or to be affluent, drinking natural madya in prescribed quantity as appropriate for the person.

Appropriate madya for vatika person is that which is prepared predominantly by jaggery and flour. For kapha and pitta predominant person madya prepared by grapes and honey is appropriate (to drink) respectively. [21-25]

Pros and cons of drinking madya

बहुद्रव्यं बहुगुणं बहुकर्म मदात्मकम् |

गुणैर्दोषैश्च तन्मद्यमुभयं चोपलक्ष्यते ||२६||

विधिना मात्रया काले हितैरन्नैर्यथाबलम् |

प्रहृष्टो यः पिबेन्मद्यं तस्य स्यादमृतं यथा ||२७||

यथोपेतं पुनर्मद्यं प्रसङ्गाद्येन पीयते |

रूक्षव्यायामनित्येन विषवद्याति तस्य तत् ||२८||

bahudravyaṁ bahuguṇaṁ bahukarma madātmakam|

guṇairdōṣaiśca tanmadyamubhayaṁ cōpalakṣyatē||26||

vidhinā mātrayā kālē hitairannairyathābalam|

prahr̥ṣṭō yaḥ pibēnmadyaṁ tasya syādamr̥taṁ yathā||27||

yathōpētaṁ punarmadyaṁ prasaṅgādyēna pīyatē|

rūkṣavyāyāmanityēna viṣavadyāti tasya tat||28||

bahudravyaM bahuguNaM bahukarma madAtmakam |

guNairdoShaishca tanmadyamubhayaM copalakShyate ||26||

vidhinA mAtrayA kAle hitairannairyathAbalam |

prahRuShTo yaH pibenmadyaM tasya syAdamRutaM yathA ||27||

yathopetaM punarmadyaM prasa~ggAdyena pIyate |

rUkShavyAyAmanityena viShavadyAti tasya tat ||28||

Liquor prepared by multiple ingredients carry multiple qualities and multiple actions, characterized by advantages and disadvantages. It is like ambrosia; for the one who drinks as per the standard guidelines, in optimum quantity, at suitable time, with advisable diet, as per the capacity and with exhilaration. On the contrary, it will be like poison for the one who indulges in excessive drinking any kind of liquor, and who have excess dryness in body and follows excess exertion. [26-28]

Properties and effects of madya on oja

मद्यं हृदयमाविश्य स्वगुणैरोजसो गुणान् |

दशभिर्दश सङ्क्षोभ्य चेतो नयति विक्रियाम् ||२९||

लघूष्णतीक्ष्णसूक्ष्माम्लव्यवाय्याशुगमेव च |

रूक्षं विकाशि विशदं मद्यं दशगुणं स्मृतम् ||३०||

गुरु शीतं मृदु श्लक्ष्णं बहलं मधुरं स्थिरम् |

प्रसन्नं पिच्छिलं स्निग्धमोजो दशगुणं स्मृतम् ||३१||

गुरुत्वं लाघवाच्छैत्यमौष्णादम्लस्वभावतः |

माधुर्यं मार्दवं तैक्ष्ण्यात्प्रसादं चाशुभावनात् ||३२||

रौक्ष्यात् स्नेहं व्यवायित्वात् स्थिरत्वं श्लक्ष्णतामपि |

विकासिभावात्पैच्छिल्यं वैशद्यात्सान्द्रतां तथा ||३३||

सौक्ष्म्यान्मद्यं निहन्त्येवमोजसः स्वगुणैर्गुणान् |

सत्त्वं तदाश्रयं चाशु सङ्क्षोभ्य जनयेन्मदम् ||३४||

रसवातादिमार्गाणां [१] सत्त्वबुद्धीन्द्रियात्मनाम् |

प्रधानस्यौजसश्चैव हृदयं स्थानमुच्यते ||३५||

अतिपीतेन मद्येन विहतेनौजसा च तत् |

हृदयं याति विकृतिं तत्रस्था ये च धातवः ||३६||

madyaṁ hr̥dayamāviśya svaguṇairōjasō guṇān|

daśabhirdaśa saṅkṣōbhya cētō nayati vikriyām||29||

laghūṣṇatīkṣṇasūkṣmāmlavyavāyyāśugamēva ca|

rūkṣaṁ vikāśi viśadaṁ madyaṁ daśaguṇaṁ smr̥tam||30||

guru śītaṁ mr̥du ślakṣṇaṁ bahalaṁ madhuraṁ sthiram|

prasannaṁ picchilaṁ snigdhamōjō daśaguṇaṁ smr̥tam||31||

gurutvaṁ lāghavācchaityamauṣṇādamlasvabhāvataḥ|

mādhuryaṁ mārdavaṁ taikṣṇyātprasādaṁ cāśubhāvanāt||32||

raukṣyāt snēhaṁ vyavāyitvāt sthiratvaṁ ślakṣṇatāmapi|

vikāsibhāvātpaicchilyaṁ vaiśadyātsāndratāṁ tathā||33||

saukṣmyānmadyaṁ nihantyēvamōjasaḥ svaguṇairguṇān|

sattvaṁ tadāśrayaṁ cāśu saṅkṣōbhya janayēnmadam||34||

rasavātādimārgāṇāṁ [1] sattvabuddhīndriyātmanām|

pradhānasyaujasaścaiva hr̥dayaṁ sthānamucyatē||35||

atipītēna madyēna vihatēnaujasā ca tat|

hr̥dayaṁ yāti vikr̥tiṁ tatrasthā yē ca dhātavaḥ||36||

madyaM hRudayamAvishya svaguNairojaso guNAn |

dashabhirdasha sa~gkShobhya ceto nayati vikriyAm ||29||

laghUShNatIkShNasUkShmAmlavyavAyyAshugameva ca |

rUkShaM vikAshi vishadaM madyaM dashaguNaM smRutam ||30||

guru shItaM mRudu shlakShNaM bahalaM madhuraM sthiram |

prasannaM picchilaM snigdhamojo dashaguNaM smRutam ||31||

gurutvaM lAghavAcchaityamauShNAdamlasvabhAvataH |

mAdhuryaM mArdavaM taikShNyAtprasAdaM cAshubhAvanAt ||32||

raukShyAt snehaM vyavAyitvAt sthiratvaM shlakShNatAmapi |

vikAsibhAvAtpaicchilyaM vaishadyAtsAndratAM tathA ||33||

saukShmyAnmadyaM nihantyevamojasaH svaguNairguNAn |

sattvaM tadAshrayaM cAshu sa~gkShobhya janayenmadam ||34||

rasavAtAdimArgANAM [1] sattvabuddhIndriyAtmanAm |

pradhAnasyaujasashcaiva hRudayaM sthAnamucyate ||35||

atipItena madyena vihatenaujasA ca tat |

hRudayaM yAti vikRutiM tatrasthA ye ca dhAtavaH ||36||

The madya (liquor) affects heart by counteracting the ojas (the vital essence of body ) and its ten qualities with the ten qualities of (the liquor) itself.

Laghu (agile), ushna (hot), teekshna (sharply acting), sukshma (tiny), amla (sour), vyavayi (pervading), ashu (fast acting), ruksha (arid), vikashi (expanding), vishada (non-slimy) are the ten qualities of the liquor.

Guru (heavy), sheeta (cool), mridu (soft), shlakshna (smooth), bahala (viscous), madhura (sweet), sthira (stable), prasanna (lucid), pichhila (slimy), snigdha (unctous) are the ten qualities of ojas.

Liquor counteracts the qualities of ojas by its own qualities- it counteracts heaviness with agility, coolness with heat, sweetness with sourness, softness with sharpness, lucidity with fast action, unctuousness with roughness , stability with the ability to pervade, smoothness by expanding, slimy by non-slimy, viscous by tiny qualities.

This leads to agitation of mental strength that is dependent on oja and results in perplexity.

The heart is the site for the channels of the rasa, vata and others, sattva (mental strength), buddhi (intellect), indriya (senses), aatman (self) and primary ojas (vital essence). The excess drinking of liquor and gradual impediment of ojas affects the heart and the dhatus located at the heart.[29-36]

Stages of mada (intoxication)

ओजस्यविहते पूर्वो हृदि च प्रतिबोधिते |

मध्यमो विहतेऽल्पे च विहते तूत्तमो मदः ||३७||

नैवं विघातं जनयेन्मद्यं पैष्टिकमोजसः |

विकाशिरूक्षविशदा गुणास्तत्र हि नोल्बणाः ||३८||

ōjasyavihatē pūrvō hr̥di ca pratibōdhitē|

madhyamō vihatē'lpē ca vihatē tūttamō madaḥ||37||

naivaṁ vighātaṁ janayēnmadyaṁ paiṣṭikamōjasaḥ|

vikāśirūkṣaviśadā guṇāstatra hi nōlbaṇāḥ||38||

ojasyavihate pUrvo hRudi ca pratibodhite |

madhyamo vihate~alpe ca vihate tUttamo madaH ||37||

naivaM vighAtaM janayenmadyaM paiShTikamojasaH |

vikAshirUkShavishadA guNAstatra hi nolbaNAH ||38||

The early stage of intoxication starts when it spreads up to the heart but ojas is not disturbed; in the middle stage ojas gets disturbed and in the later stage there is severe disturbance to the ojas.

Consumption of liquor prepared by the flour does not affect ojas severely due to lack of (harmful) qualities like expanding property, dryness/roughness, and non-sliminess.[37-38]

Characteristic features of mada

हृदि मद्यगुणाविष्टे हर्षस्तर्षो रतिः सुखम् |

विकाराश्च यथासत्त्वं चित्रा राजसतामसाः ||३९||

जायन्ते मोहनिद्रान्ता मद्यस्यातिनिषेवणात् |

स मद्यविभ्रमो नाम्ना ‘मद’ इत्यभिधीयते ||४०||

hridi madyaguṇāviṣṭē harṣastarṣō ratiḥ sukham|

vikārāśca yathāsattvaṁ citrā rājasatāmasāḥ||39||

jāyantē mōhanidrāntā madyasyātiniṣēvaṇāt|

sa madyavibhramō nāmnā ‘mada’ ityabhidhīyatē||40||

hRudi madyaguNAviShTe harShastarSho ratiH sukham |

vikArAshca yathAsattvaM citrA rAjasatAmasAH ||39||

jAyante mohanidrAntA madyasyAtiniShevaNAt |

sa madyavibhramo nAmnA ‘mada’ ityabhidhIyate ||40||

The heart overwhelmed with the qualities of liquor exhilaration, delight, thirst, sexual pleasure and other rajas, tamas disorders leads to the state of infatuation and sleep due to over-drinking. This derailment due to liquor is called as mada (intoxication). [39-40]

Features of different stages of mada

पीयमानस्य मद्यस्य विज्ञातव्यास्त्रयो मदाः |

प्रथमो मध्यमोऽन्त्यश्च लक्षणैस्तान् प्रचक्ष्महे ||४१||

प्रहर्षणः प्रीतिकरः पानान्नगुणदर्शकः |

वाद्यगीतप्रहासानां कथानां च प्रवर्तकः ||४२||

न च बुद्धिस्मृतिहरो विषयेषु न चाक्षमः |

सुखनिद्राप्रबोधश्च प्रथमः सुखदो मदः ||४३||

मुहुः स्मृतिर्मुहुर्मोहो(ऽ)व्यक्ता [१] सज्जति वाङ्मुहुः |

युक्तायुक्तप्रलापश्च प्रचलायनमेव च ||४४||

स्थानपानान्नसाङ्कथ्ययोजना सविपर्यया |

लिङ्गान्येतानि जानीयादाविष्टे मध्यमे मदे ||४५||

मध्यमं मदमुत्क्रम्य मदमाप्राप्य [२] चोत्तमम् |

न किञ्चिन्नाशुभं कुर्युर्नरा राजसतामसाः ||४६||

को मदं तादृशं विद्वानुन्मादमिव दारुणम् |

गच्छेदध्वानमस्वन्तं बहुदोषमिवाध्वगः ||४७||

तृतीयं तु मदं प्राप्य भग्नदार्विव निष्क्रियः |

मदमोहावृतमना जीवन्नपि मृतैः समः ||४८||

रमणीयान् स विषयान्न वेत्ति न सुहृज्जनम् |

यदर्थं पीयते मद्यं रतिं तां च न विन्दति ||४९||

कार्याकार्यं सुखं दुःखं लोके यच्च हिताहितम् |

यदवस्थो न जानाति कोऽवस्थां तां व्रजेद्बुधः ||५०||

स दूष्यः सर्वभूतानां निन्द्यश्चाग्राह्य एव च |

व्यसनित्वादुदर्के च स दुःखं व्याधिमश्नुते ||५१||

pīyamānasya madyasya vijñātavyāstrayō madāḥ|

prathamō madhyamō'ntyaśca lakṣaṇaistān pracakṣmahē||41||

praharṣaṇaḥ prītikaraḥ pānānnaguṇadarśakaḥ|

vādyagītaprahāsānāṁ kathānāṁ ca pravartakaḥ||42||

na ca buddhismr̥tiharō viṣayēṣu na cākṣamaḥ|

sukhanidrāprabōdhaśca prathamaḥ sukhadō madaḥ||43||

muhuḥ smr̥tirmuhurmōhō(')vyaktā [1] sajjati vāṅmuhuḥ|

yuktāyuktapralāpaśca pracalāyanamēva ca||44||

sthānapānānnasāṅkathyayōjanā saviparyayā|

liṅgānyētāni jānīyādāviṣṭē madhyamē madē||45||

madhyamaṁ madamutkramya madamāprāpya [2] cōttamam|

na kiñcinnāśubhaṁ kuryurnarā rājasatāmasāḥ||46||

kō madaṁ tādr̥śaṁ vidvānunmādamiva dāruṇam|

gacchēdadhvānamasvantaṁ bahudōṣamivādhvagaḥ||47||

tr̥tīyaṁ tu madaṁ prāpya bhagnadārviva niṣkriyaḥ|

madamōhāvr̥tamanā jīvannapi mr̥taiḥ samaḥ||48||

ramaṇīyān sa viṣayānna vētti na suhr̥jjanam|

yadarthaṁ pīyatē madyaṁ ratiṁ tāṁ ca na vindati||49||

kāryākāryaṁ sukhaṁ duḥkhaṁ lōkē yacca hitāhitam|

yadavasthō na jānāti kō'vasthāṁ tāṁ vrajēdbudhaḥ||50||

sa dūṣyaḥ sarvabhūtānāṁ nindyaścāgrāhya ēva ca|

vyasanitvādudarkē ca sa duḥkhaṁ vyādhimaśnutē||51||

pIyamAnasya madyasya vij~jAtavyAstrayo madAH |

prathamo madhyamo~antyashca lakShaNaistAn pracakShmahe ||41||

praharShaNaH prItikaraH pAnAnnaguNadarshakaH |

vAdyagItaprahAsAnAM kathAnAM ca pravartakaH ||42||

na ca buddhismRutiharo viShayeShu na cAkShamaH |

sukhanidrAprabodhashca prathamaH sukhado madaH ||43||

muhuH smRutirmuhurmoho(~a)vyaktA [1] sajjati vA~gmuhuH |

yuktAyuktapralApashca pracalAyanameva ca ||44||

sthAnapAnAnnasA~gkathyayojanA saviparyayA |

li~ggAnyetAni jAnIyAdAviShTe madhyame made ||45||

madhyamaM madamutkramya madamAprApya [2] cottamam |

na ki~jcinnAshubhaM kuryurnarA rAjasatAmasAH ||46||

ko madaM tAdRushaM vidvAnunmAdamiva dAruNam |

gacchedadhvAnamasvantaM bahudoShamivAdhvagaH ||47||

tRutIyaM tu madaM prApya bhagnadArviva niShkriyaH |

madamohAvRutamanA jIvannapi mRutaiH samaH ||48||

ramaNIyAn sa viShayAnna vetti na suhRujjanam |

yadarthaM pIyate madyaM ratiM tAM ca na vindati ||49||

kAryAkAryaM sukhaM duHkhaM loke yacca hitAhitam |

yadavastho na jAnAti ko~avasthAM tAM vrajedbudhaH ||50||

sa dUShyaH sarvabhUtAnAM nindyashcAgrAhya eva ca |

vyasanitvAdudarke ca sa duHkhaM vyAdhimashnute ||51||

There are three stages of intoxication after consumption of liquor known as first, middle and late stages as described with following symptoms:

The early stage is exhilarating, delighting, reflecting the qualities of the food and the drink, invokes instrumental and vocal music, amusement and anecdotes. It neither affects the intellect and memory nor lead to the incapability of the senses. The pattern of sleep and awakening is restored and overall, a delighting phase.

In the mid stage memory gets affected (transiently), causes confusions, distinct speech turns to indistinct, relevant or irrelevant talkativeness, irrelevant movements, rambling postures, food, drink and speech.

The individual with rajas and tamas predominance, who has intoxicated to cross the mid stage, but yet not achieved the late stage behaves nastily and inappropriately without any consideration.

Who is being wise enough to enter the stage of intoxication causing psychosis, insanity leading to the increasingly imperfect path to the troublesome consciousness?

With attaining the third stage, the individual becomes static like a torn wood, with mind occupied by narcosis and confusion; similar to a dead but still alive.

The individual does neither identify the pleasant senses nor friends. He even does not recognize the reason of pleasure for which the liquor has been consumed.

He proceeds to a stage where the identification of right or wrong, happiness or sorrow, desirable or undesirable in the universe is not recognizable.

He will become hated and non acceptable among the people, and because of addiction will consequently attain a stage of painful diseases afterwards.[41-51]

Overall effects of madya

प्रेत्य चेह च यच्छ्रेयः श्रेयो मोक्षे च यत् परम् |

मनःसमाधौ तत् सर्वमायत्तं सर्वदेहिनाम् ||५२||

मद्येन मनसश्चास्य सङ्क्षोभः क्रियते महान् |

महामारुतवेगेन तटस्थस्येव शाखिनः ||५३||

मद्यप्रसङ्गं तं चाज्ञा महादोषं महागदम् |

सुखमित्यधिगच्छन्ति रजोमोहपराजिताः ||५४||

मद्योपहतविज्ञाना वियुक्ताः सात्त्विकैर्गुणैः |

श्रेयोभिर्विप्रयुज्यन्ते मदान्धा मदलालसाः ||५५||

मद्ये मोहो भयं शोकः क्रोधो मृत्युश्च संश्रितः |

सोन्मादमदमूर्च्छायाः सापस्मारापतानकाः ||५६||

यत्रैकः स्मृतिविभ्रंशस्तत्र सर्वमसाधुवत् |

इत्येवं मद्यदोषज्ञा मद्यं गर्हन्ति यत्नतः ||५७||

सत्यमेते महादोषा मद्यस्योक्ता न संशयः |

अहितस्यातिमात्रस्य पीतस्य विधिवर्जितम् ||५८||

किन्तु मद्यं स्वभावेन यथैवान्नं तथा स्मृतम् |

अयुक्तियुक्तं रोगाय युक्तियुक्तं यथाऽमृतम् ||५९||

प्राणाः प्राणभृतामन्नं तदयुक्त्या निहन्त्यसून् |

विषं प्राणहरं तच्च युक्तियुक्तं रसायनम् ||६०||

prētya cēha ca yacchrēyaḥ śrēyō mōkṣē ca yat param|

manaḥsamādhau tat sarvamāyattaṁ sarvadēhinām||52||

madyēna manasaścāsya saṅkṣōbhaḥ kriyatē mahān|

mahāmārutavēgēna taṭasthasyēva śākhinaḥ||53||

madyaprasaṅgaṁ taṁ cājñā mahādōṣaṁ mahāgadam|

sukhamityadhigacchanti rajōmōhaparājitāḥ||54||

madyōpahatavijñānā viyuktāḥ sāttvikairguṇaiḥ|

śrēyōbhirviprayujyantē madāndhā madalālasāḥ||55||

madyē mōhō bhayaṁ śōkaḥ krōdhō mr̥tyuśca saṁśritaḥ|

sōnmādamadamūrcchāyāḥ sāpasmārāpatānakāḥ||56||

yatraikaḥ smr̥tivibhraṁśastatra sarvamasādhuvat|

ityēvaṁ madyadōṣajñā madyaṁ garhanti yatnataḥ||57||

satyamētē mahādōṣā madyasyōktā na saṁśayaḥ|

ahitasyātimātrasya pītasya vidhivarjitam||58||

kintu madyaṁ svabhāvēna yathaivānnaṁ tathā smr̥tam|

ayuktiyuktaṁ rōgāya yuktiyuktaṁ yathā'mr̥tam||59||

prāṇāḥ prāṇabhr̥tāmannaṁ tadayuktyā nihantyasūn|

viṣaṁ prāṇaharaṁ tacca yuktiyuktaṁ rasāyanam||60||

pretya ceha ca yacchreyaH shreyo mokShe ca yat param |

manaHsamAdhau tat sarvamAyattaM sarvadehinAm ||52||

madyena manasashcAsya sa~gkShobhaH kriyate mahAn |

mahAmArutavegena taTasthasyeva shAkhinaH ||53||

madyaprasa~ggaM taM cAj~jA mahAdoShaM mahAgadam |

sukhamityadhigacchanti rajomohaparAjitAH ||54||

madyopahatavij~jAnA viyuktAH sAttvikairguNaiH |

shreyobhirviprayujyante madAndhA madalAlasAH ||55||

madye moho bhayaM shokaH krodho mRutyushca saMshritaH |

sonmAdamadamUrcchAyAH sApasmArApatAnakAH ||56||

yatraikaH smRutivibhraMshastatra sarvamasAdhuvat |

ityevaM madyadoShaj~jA madyaM garhanti yatnataH ||57||

satyamete mahAdoShA madyasyoktA na saMshayaH |

ahitasyAtimAtrasya pItasya vidhivarjitam ||58||

kintu madyaM svabhAvena yathaivAnnaM tathA smRutam |

ayuktiyuktaM rogAya yuktiyuktaM yathA~amRutam ||59||

prANAH prANabhRutAmannaM tadayuktyA nihantyasUn |

viShaM prANaharaM tacca yuktiyuktaM rasAyanam ||60||

The credit, in this life and in life after death and utmost credit in salvation depends upon the meditation state of mind of all human beings.

The liquor causes significant agitation of the mind like a storm causes to a tree. An ignorant person being influenced by rajas and tamas gets addicted to the liquor goes willingly towards the major defects and major diseases.

Intoxicated by the liquor, affecting the sattvik qualities, the person becomes blind through alcoholism and addicted to the liquor; consequently gets deprived of all credits.

Liquor causes perplexity, phobia, grief, rage, death along with the psychosis, intoxication, loss of consciousness, epilepsy and spasm of tendons.

In case of only loss of memory everything is reprehensible; therefore those who know disadvantages of liquor intentionally stay away from it.

The defects mentioned due to the liquor are definite and certain, when drunk in undesired manner, in excess quantity by ignoring the standard method of drinking.

But liquor by nature is similar to the food. It causes disorders when consumed improperly; while it is like amritam (elixir) when consumed properly. Food is like the vitality of life for the human beings; but the same may be fatal if ingested improperly. The poison is fatal, but it can be rasayana if used sensibly.[52-60]

Benefits of madya

हर्षमूर्जं मुदं पुष्टिमारोग्यं पौरुषं परम् [१] |

युक्त्या पीतं करोत्याशु मद्यं सुखमदप्रदम् ||६१||

रोचनं दीपनं हृद्यं स्वरवर्णप्रसादनम् |

प्रीणनं बृंहणं बल्यं भयशोकश्रमापहम् ||६२||

स्वापनं नष्टनिद्राणां मूकानां वाग्विबोधनम् |

बोधनं चातिनिद्राणां विबद्धानां विबन्धनुत् ||६३||

वधबन्धपरिक्लेशदुःखानां चाप्यबोधनम् |

मद्योत्थानां च रोगाणां मद्यमेव प्रबाधकम् ||६४||

रतिर्विषयसंयोगे प्रीतिसंयोगवर्धनम् |

अपि प्रवयसां मद्यमुत्सवामोदकारकम् ||६५||

पञ्चस्वर्थेषु कान्तेषु या रतिः प्रथमे मदे |

यूनां वा स्थविराणां वा तस्य नास्त्युपमा भुवि ||६६||

बहुदुःखहतस्यास्य शोकेनोपहतस्य च |

विश्रामो जीवलोकस्य मद्यं युक्त्या निषेवितम् ||६७||

harṣamūrjaṁ mudaṁ puṣṭimārōgyaṁ pauruṣaṁ param [1] |

yuktyā pītaṁ karōtyāśu madyaṁ sukhamadapradam||61||

rōcanaṁ dīpanaṁ hr̥dyaṁ svaravarṇaprasādanam|

prīṇanaṁ br̥ṁhaṇaṁ balyaṁ bhayaśōkaśramāpaham||62||

svāpanaṁ naṣṭanidrāṇāṁ mūkānāṁ vāgvibōdhanam|

bōdhanaṁ cātinidrāṇāṁ vibaddhānāṁ vibandhanut||63||

vadhabandhapariklēśaduḥkhānāṁ cāpyabōdhanam|

madyōtthānāṁ ca rōgāṇāṁ madyamēva prabādhakam||64||

ratirviṣayasaṁyōgē prītisaṁyōgavardhanam|

api pravayasāṁ madyamutsavāmōdakārakam||65||

pañcasvarthēṣu kāntēṣu yā ratiḥ prathamē madē|

yūnāṁ vā sthavirāṇāṁ vā tasya nāstyupamā bhuvi||66||

bahuduḥkhahatasyāsya śōkēnōpahatasya ca|

viśrāmō jīvalōkasya madyaṁ yuktyā niṣēvitam||67||

harShamUrjaM mudaM puShTimArogyaM pauruShaM param [1] |

yuktyA pItaM karotyAshu madyaM sukhamadapradam ||61||

rocanaM dIpanaM hRudyaM svaravarNaprasAdanam |

prINanaM bRuMhaNaM balyaM bhayashokashramApaham ||62||

svApanaM naShTanidrANAM mUkAnAM vAgvibodhanam |

bodhanaM cAtinidrANAM vibaddhAnAM vibandhanut ||63||

vadhabandhaparikleshaduHkhAnAM cApyabodhanam |

madyotthAnAM ca rogANAM madyameva prabAdhakam ||64||

ratirviShayasaMyoge prItisaMyogavardhanam |

api pravayasAM madyamutsavAmodakArakam ||65||

pa~jcasvartheShu kAnteShu yA ratiH prathame made |

yUnAM vA sthavirANAM vA tasya nAstyupamA bhuvi ||66||

bahuduHkhahatasyAsya shokenopahatasya ca |

vishrAmo jIvalokasya madyaM yuktyA niShevitam ||67||

The liquor when consumed sensibly, instantaneously leads to the best of cheerfulness, energy, joy, nourishment, strength. The liquor gives happiness and excitement.

The liquor is charming, appetizing, pleasing and improving voice and complexion; appeasing, nourishing, strengthening, and pacifier of phobia, grief and exhaustion.

It makes sleep to those who have the sleeplessness, stimulates voice of the speechless, awakens the excess sleepy, releases obstruction in the constipated. It also anesthetizes those with capital punishment or imprisonment, in pain and sorrow. The diseases caused by the (intoxication of) liquor can even be kept away with the liquor.

The liquor raises the wish and joy for pleasant desire for sexual relations, enhances the affectionate relation, even in elderly.

The excitement enjoyed in the first stage of intoxication with respect to the five senses by the youth or elderly is the unique in the world.

The liquor use astutely for the relaxation by the people will help those who are inflicted with intense pain and deep sorrow.[61-67]

अन्नपानवयोव्याधिबलकालत्रिकाणि षट् |

त्रीन्दोषांस्त्रिविधं सत्त्वं ज्ञात्वा मद्यं पिबेत्सदा ||६८||

तेषां त्रिकाणामष्टानां योजना युक्तिरुच्यते |

यया युक्त्या पिबन्मद्यं मद्यदोषैर्न युज्यते ||६९||

मद्यस्य च गुणान् सर्वान् यथोक्तान् स समश्नुते |

धर्मार्थयोरपीडायै नरः सत्त्वगुणोच्छ्रितः ||७०||

सत्त्वानि तु प्रबुध्यन्ते प्रायशः प्रथमे मदे |

द्वितीयेऽव्यक्ततां यान्ति मध्ये चोत्तममध्ययोः ||७१||

सस्यसम्बोधकं वर्षं, हेमप्रकृतिदर्शकः |

हुताशः, सर्वसत्त्वानां मद्यं तूभयकारकम् ||७२||

प्रधानावरमध्यानां रूपाणां [१] व्यक्तिदर्शकः |

यथाऽग्निरेवं सत्त्वानां मद्यं प्रकृतिदर्शकम् ||७३||

annapānavayōvyādhibalakālatrikāṇi ṣaṭ|

trīndōṣāṁstrividhaṁ sattvaṁ jñātvā madyaṁ pibētsadā||68||

tēṣāṁ trikāṇāmaṣṭānāṁ yōjanā yuktirucyatē|

yayā yuktyā pibanmadyaṁ madyadōṣairna yujyatē||69||

madyasya ca guṇān sarvān yathōktān sa samaśnutē|

dharmārthayōrapīḍāyai naraḥ sattvaguṇōcchritaḥ||70||

sattvāni tu prabudhyantē prāyaśaḥ prathamē madē|

dvitīyē'vyaktatāṁ yānti madhyē cōttamamadhyayōḥ||71||

sasyasambōdhakaṁ varṣaṁ, hēmaprakr̥tidarśakaḥ|

hutāśaḥ, sarvasattvānāṁ madyaṁ tūbhayakārakam||72||

pradhānāvaramadhyānāṁ rūpāṇāṁ [1] vyaktidarśakaḥ|

yathā'gnirēvaṁ sattvānāṁ madyaṁ prakr̥tidarśakam||73||

annapAnavayovyAdhibalakAlatrikANi ShaT |

trIndoShAMstrividhaM sattvaM j~jAtvA madyaM pibetsadA ||68||

teShAM trikANAmaShTAnAM yojanA yuktirucyate |

yayA yuktyA pibanmadyaM madyadoShairna yujyate ||69||

madyasya ca guNAn sarvAn yathoktAn sa samashnute |

dharmArthayorapIDAyai naraH sattvaguNocchritaH ||70||

sattvAni tu prabudhyante prAyashaH prathame made |

dvitIye~avyaktatAM yAnti madhye cottamamadhyayoH ||71||

sasyasambodhakaM varShaM, hemaprakRutidarshakaH |

hutAshaH, sarvasattvAnAM madyaM tUbhayakArakam ||72||

pradhAnAvaramadhyAnAM rUpANAM [1] vyaktidarshakaH |

yathA~agnirevaM sattvAnAM madyaM prakRutidarshakam ||73||

The liquor shall always be consumed with understanding of six triads of the food, drink, age, disease, strength, and time; as well as tridosha and three psyches (described in earlier chapters).

Sensible planning of the eight triads is called as yukti, for consumption of liquor without causing any disorders.

The person predominant in sattva quality enjoys all the advantages of the liquor without affecting the observance of the virtue and the wealth.

Generally, the psyches are stimulated in the first stage of intoxication, during the second stage the psyches descends towards the subconscious level and in the last stage gets in complete loss of consciousness.

The rain stimulates growth of the crops and fire exposes the nature of the gold. The liquor in humans performs both the functions. Superior, average and inferior is the types of human character, similar to the fire; the liquor expresses the nature of psyche of the human.[68-73]

Behavior of persons of different psyche after consumption of madya

सुगन्धिमाल्यगन्धर्वं सुप्रणीतममाकुलम् |

मिष्टान्नपानविशदं सदा मधुरसङ्कथम् ||७४||

सुखप्रपानं [१] सुमदं हर्षप्रीतिविवर्धनम् |

स्वन्तं सात्त्विकमापानं न चोत्तममदप्रदम् ||७५||

वैगुण्यं सहसा यान्ति मद्यदोषैर्न सात्त्विकाः |

मद्यं हि बलवत्सत्त्वं गृह्णाति सहसा न तु [२] ||७६||

सौम्यासौम्यकथाप्रायं विशदाविशदं क्षणात् |

चित्रं राजसमापन्नं प्रायेणास्वन्तकाकुलम् ||७७||

हर्षप्रीतिकथापेतमतुष्टं पानभोजने |

सम्मोहक्रोधनिद्रान्तमापानं तामसं स्मृतम् ||७८||

आपाने सात्त्विकान् बुद्ध्वा तथा राजसतामसान् |

जह्यात्सहायान् यैः पीत्वा मद्यदोषानुपाश्नुते ||७९||

sugandhimālyagandharvaṁ supraṇītamamākulam|

miṣṭānnapānaviśadaṁ sadā madhurasaṅkatham||74||

sukhaprapānaṁ [1] sumadaṁ harṣaprītivivardhanam|

svantaṁ sāttvikamāpānaṁ na cōttamamadapradam||75||

vaiguṇyaṁ sahasā yānti madyadōṣairna sāttvikāḥ|

madyaṁ hi balavatsattvaṁ gr̥hṇāti sahasā na tu [2] ||76||

saumyāsaumyakathāprāyaṁ viśadāviśadaṁ kṣaṇāt|

citraṁ rājasamāpannaṁ prāyēṇāsvantakākulam||77||

harṣaprītikathāpētamatuṣṭaṁ pānabhōjanē|

sammōhakrōdhanidrāntamāpānaṁ tāmasaṁ smr̥tam||78||

āpānē sāttvikān buddhvā tathā rājasatāmasān|

jahyātsahāyān yaiḥ pītvā madyadōṣānupāśnutē||79||

sugandhimAlyagandharvaM supraNItamamAkulam |

miShTAnnapAnavishadaM sadA madhurasa~gkatham ||74||

sukhaprapAnaM [1] sumadaM harShaprItivivardhanam |

svantaM sAttvikamApAnaM na cottamamadapradam ||75||

vaiguNyaM sahasA yAnti madyadoShairna sAttvikAH |

madyaM hi balavatsattvaM gRuhNAti sahasA na tu [2] ||76||

saumyAsaumyakathAprAyaM vishadAvishadaM kShaNAt |

citraM rAjasamApannaM prAyeNAsvantakAkulam ||77||

harShaprItikathApetamatuShTaM pAnabhojane |

sammohakrodhanidrAntamApAnaM tAmasaM smRutam ||78||

ApAne sAttvikAn buddhvA tathA rAjasatAmasAn |

jahyAtsahAyAn yaiH pItvA madyadoShAnupAshnute ||79||

Aromatic flowers, garlands, music, good company, with delicious food and drink, clean and engaged in favorite conversation, with relaxed drinking, joyful, delighted, and contribution to desired intoxication, promoting exhilaration, pleasure, and not indulging third stage of the intoxication is known as sattvika drinking.

Generally, defectiveness does not occur with the drinking of liquor in sattvika way. Usually, intoxicating effects do not take the person with strong sattva towards defectiveness.

The rajas way of drinking is perhaps with momentary kind or unkind talks, clean or unclean, with varied colors and teeming with the bad ailments.

The tamas way of drinking is devoid of exhilaration, pleasure and gossip; dissatisfied with food and end up with excessive daze, rage and sleepiness.

While drinking, one should know the people following sattvika, rajasika and tamasika way of drinking and try to be at distance from such companions due to whom one may suffer by bad effects of liquor consumption.[74-79]

सुखशीलाः सुसम्भाषाः सुमुखाः सम्मताः सताम् |

कलास्वबाह्या विशदा विषयप्रवणाश्च ये ||८०||

परस्परविधेया ये येषामैक्यं सुहृत्तया |

प्रहर्षप्रीतिमाधुर्यैरापानं वर्धयन्ति ये ||८१||

उत्सवादुत्सवतरं येषामन्योन्यदर्शनम् |

ते सहायाः सुखाः पाने तैः पिबन्सह मोदते ||८२||

रूपगन्धरसस्पर्शैः शब्दैश्चापि मनोरमैः |

पिबन्ति सुसहाया ये ते वै सुकृतिभिः समाः ||८३||

पञ्चभिर्विषयैरिष्टैरुपेतैर्मनसः [१] प्रियैः |

देशे काले पिबेन्मद्यं प्रहृष्टेनान्तरात्मना ||८४||

स्थिरसत्त्वशरीरा ये पूर्वान्ना मद्यपान्वयाः |

बहुमद्योचिता ये च माद्यन्ति सहसा न ते ||८५||

क्षुत्पिपासापरीताश्च [२] दुर्बला वातपैत्तिकाः |

रूक्षाल्पप्रमिताहारा विष्टब्धाः सत्त्वदुर्बलाः ||८६||

क्रोधिनोऽनुचिताः क्षीणाः परिश्रान्ता मदक्षताः |

स्वल्पेनापि मदं शीघ्रं यान्ति मद्येन मानवाः ||८७||

sukhaśīlāḥ susambhāṣāḥ sumukhāḥ sammatāḥ satām|

kalāsvabāhyā viśadā viṣayapravaṇāśca yē||80||

parasparavidhēyā yē yēṣāmaikyaṁ suhr̥ttayā|

praharṣaprītimādhuryairāpānaṁ vardhayanti yē||81||

utsavādutsavataraṁ yēṣāmanyōnyadarśanam|

tē sahāyāḥ sukhāḥ pānē taiḥ pibansaha mōdatē||82||

rūpagandharasasparśaiḥ śabdaiścāpi manōramaiḥ|

pibanti susahāyā yē tē vai sukr̥tibhiḥ samāḥ||83||

pañcabhirviṣayairiṣṭairupētairmanasaḥ [1] priyaiḥ|

dēśē kālē pibēnmadyaṁ prahr̥ṣṭēnāntarātmanā||84||

sthirasattvaśarīrā yē pūrvānnā madyapānvayāḥ|

bahumadyōcitā yē ca mādyanti sahasā na tē||85||

kṣutpipāsāparītāśca [2] durbalā vātapaittikāḥ|

rūkṣālpapramitāhārā viṣṭabdhāḥ sattvadurbalāḥ||86||

krōdhinō'nucitāḥ kṣīṇāḥ pariśrāntā madakṣatāḥ|

svalpēnāpi madaṁ śīghraṁ yānti madyēna mānavāḥ||87||

sukhashIlAH susambhAShAH sumukhAH sammatAH satAm |

kalAsvabAhyA vishadA viShayapravaNAshca ye ||80||

parasparavidheyA ye yeShAmaikyaM suhRuttayA |

praharShaprItimAdhuryairApAnaM vardhayanti ye ||81||

utsavAdutsavataraM yeShAmanyonyadarshanam |

te sahAyAH sukhAH pAne taiH pibansaha modate ||82||

rUpagandharasasparshaiH shabdaishcApi manoramaiH |

pibanti susahAyA ye te vai sukRutibhiH samAH ||83||

pa~jcabhirviShayairiShTairupetairmanasaH [1] priyaiH |

deshe kAle pibenmadyaM prahRuShTenAntarAtmanA ||84||

sthirasattvasharIrA ye pUrvAnnA madyapAnvayAH |

bahumadyocitA ye ca mAdyanti sahasA na te ||85||

kShutpipAsAparItAshca [2] durbalA vAtapaittikAH |

rUkShAlpapramitAhArA viShTabdhAH sattvadurbalAH ||86||

krodhino~anucitAH kShINAH parishrAntA madakShatAH |

svalpenApi madaM shIghraM yAnti madyena mAnavAH ||87||

Those companions are delightful in drinking who are of fair character, talk reasonably, good in appearance, well recognized, fhave some appreciation for arts, neat, adopting the subject matter, mutually submissive, friendly, enjoying merrily more than a festival upon meeting; with them one feel glad to drink.

Those are fortunate who drink with the delighted appearance, aroma, taste, touch and (musical) sound with good companions. One should drink with the properly positioned five senses, mind and in accordance to the place, time, thrilled with delight, satisfying the soul within.

Those with the stable psyche and body, consumed food in advance, lineage of drunkards and regular drunkard; do not get intoxicated suddenly.

The person who are suffering with hunger and thirst, weak, predominant with vata and pitta, consuming arid, less and deficient food, harden stool, weak in psyche, wrong in getting angry, emaciated, exhausted, sore due to the intoxication, gets instantly affected by even smaller quantity of the liquor.[80-87]

Etiology and clinical features of vata dominant madatyaya

ऊर्ध्वं मदात्ययस्यातः सम्भवं स्वस्वलक्षणम् |

अग्निवेश! चिकित्सां च प्रवक्ष्यामि यथाक्रमम् ||८८||

स्त्रीशोकभयभाराध्वकर्मभिर्योऽतिकर्शितः |

रूक्षाल्पप्रमिताशी च यः पिबत्यतिमात्रया ||८९||

रूक्षं परिणतं मद्यं निशि निद्रां विहत्य च |

करोति तस्य तच्छीघ्रं वातप्रायं मदात्ययम् ||९०||

हिक्काश्वासशिरःकम्पपार्श्वशूलप्रजागरैः |

विद्याद्बहुप्रलापस्य वातप्रायं मदात्ययम् ||९१||

ūrdhvaṁ madātyayasyātaḥ sambhavaṁ svasvalakṣaṇam|

agnivēśa! cikitsāṁ ca pravakṣyāmi yathākramam||88||

strīśōkabhayabhārādhvakarmabhiryō'tikarśitaḥ|

rūkṣālpapramitāśī ca yaḥ pibatyatimātrayā||89||

rūkṣaṁ pariṇataṁ madyaṁ niśi nidrāṁ vihatya ca|

karōti tasya tacchīghraṁ vātaprāyaṁ madātyayam||90||

hikkāśvāsaśiraḥkampapārśvaśūlaprajāgaraiḥ|

vidyādbahupralāpasya vātaprāyaṁ madātyayam||91||

UrdhvaM madAtyayasyAtaH sambhavaM svasvalakShaNam |

agnivesha! cikitsAM ca pravakShyAmi yathAkramam ||88||

strIshokabhayabhArAdhvakarmabhiryo~atikarshitaH |

rUkShAlpapramitAshI ca yaH pibatyatimAtrayA ||89||

rUkShaM pariNataM madyaM nishi nidrAM vihatya ca |

karoti tasya tacchIghraM vAtaprAyaM madAtyayam ||90||

hikkAshvAsashiraHkampapArshvashUlaprajAgaraiH |

vidyAdbahupralApasya vAtaprAyaM madAtyayam ||91||

Agnivesha, (I am) consequently describing the etiology, distinct features and the treatment of madatyaya (the alcoholism).

If a person is emaciated due to excess sexual intercourse, grief, fear, bearing heavy weight, traveling, consuming arid, less in quantity and deficient in quality food, drinks, arid and older liquor in excess quantity at night, disturbing sleep leads to vata dominant madatyaya.

Hiccups, breathlessness, tremors in head, pain in flanks, sleeplessness, and frequent delirium are the symptoms of vata dominant madatyaya.[88-90]

Etiology and clinical features of pitta dominant madatyaya

तीक्ष्णोष्णं मद्यमम्लं च योऽतिमात्रं निषेवते |

अम्लोष्णतीक्ष्णभोजी च क्रोधनोऽग्न्यातपप्रियः ||९२||

तस्योपजायते पित्ताद्विशेषेण मदात्ययः |

स [१] तु वातोल्बणस्याशु प्रशमं याति हन्ति वा ||९३||

तृष्णादाहज्वरस्वेदमूर्च्छातीसारविभ्रमैः |

विद्याद्धरितवर्णस्य पित्तप्रायं मदात्ययम् ||९४||

tīkṣṇōṣṇaṁ madyamamlaṁ ca yō'timātraṁ niṣēvatē|

amlōṣṇatīkṣṇabhōjī ca krōdhanō'gnyātapapriyaḥ||92||

tasyōpajāyatē pittādviśēṣēṇa madātyayaḥ|

sa [1] tu vātōlbaṇasyāśu praśamaṁ yāti hanti vā||93||

tr̥ṣṇādāhajvarasvēdamūrcchātīsāravibhramaiḥ|

vidyāddharitavarṇasya pittaprāyaṁ madātyayam||94||

tIkShNoShNaM madyamamlaM ca yo~atimAtraM niShevate |

amloShNatIkShNabhojI ca krodhano~agnyAtapapriyaH ||92||

tasyopajAyate pittAdvisheSheNa madAtyayaH |

sa [1] tu vAtolbaNasyAshu prashamaM yAti hanti vA ||93||

tRuShNAdAhajvarasvedamUrcchAtIsAravibhramaiH |

vidyAddharitavarNasya pittaprAyaM madAtyayam ||94||

One who consumes sharply acting, hot and sour liquor in larger quantity while consuming sour, hot and sharp food items in diet and angry in nature, has exposure to the fire and the sun; gets affected with the madatyaya predominant in pitta. It either gets easily pacified or proves fatal in vata dominant prakriti persons.

Thirst, burning sensation, fever, sweating, fainting, diarrhea, giddiness and greenish discoloration are the distinct features of pitta dominant type of madatyaya. [92-93]

Etiology and clinical features of kapha dominant madatyaya

तरुणं मधुरप्रायं गौडं पैष्टिकमेव वा |

मधुरस्निग्धगुर्वाशी यः पिबत्यतिमात्रया ||९५||

अव्यायामदिवास्वप्नशय्यासनसुखे रतः |

मदात्ययं कफप्रायं स शीघ्रमधिगच्छति ||९६||

छर्द्यरोचकहृल्लासतन्द्रास्तैमित्यगौरवैः |

विद्याच्छीतपरीतस्य कफप्रायं मदात्ययम् ||९७||

taruṇaṁ madhuraprāyaṁ gauḍaṁ paiṣṭikamēva vā|

madhurasnigdhagurvāśī yaḥ pibatyatimātrayā||95||

avyāyāmadivāsvapnaśayyāsanasukhē rataḥ|

madātyayaṁ kaphaprāyaṁ sa śīghramadhigacchati||96||

chardyarōcakahr̥llāsatandrāstaimityagauravaiḥ|

vidyācchītaparītasya kaphaprāyaṁ madātyayam||97||

taruNaM madhuraprAyaM gauDaM paiShTikameva vA |

madhurasnigdhagurvAshI yaH pibatyatimAtrayA ||95||

avyAyAmadivAsvapnashayyAsanasukhe rataH |

madAtyayaM kaphaprAyaM sa shIghramadhigacchati ||96||

chardyarocakahRullAsatandrAstaimityagauravaiH |

vidyAcchItaparItasya kaphaprAyaM madAtyayam ||97||

One who consumes freshly (prepared), sweet liquor made up of jaggery or flour in excess quantity, with sweet, unctuous and heavy diet, indulging lack of exercise, day sleep, reclining on bed and sitting in comfort leads to kapha predominant madatyaya .

Vomiting, anorexia, nausea, drowsiness, stiffness, heaviness, and sensing cold are the features of madatyaya predominant with kapha.[95-97]

Clinical features of sannipataja madatyaya

विषस्य ये गुणा दृष्टाः सन्निपातप्रकोपणाः |

त एव मद्ये दृश्यन्ते विषे तु बलवत्तराः ||९८||

हन्त्याशु हि विषं किञ्चित् किञ्चिद्रोगाय कल्पते |

यथा विषं तथैवान्त्यो ज्ञेयो मद्यकृतो मदः ||९९||

तस्मात् त्रिदोषजं लिङ्गं सर्वत्रापि मदात्यये |

दृश्यते रूपवैशेष्यात् पृथक्त्वं चास्य [१] लक्ष्यते ||१००||

viṣasya yē guṇā dr̥ṣṭāḥ sannipātaprakōpaṇāḥ|

ta ēva madyē dr̥śyantē viṣē tu balavattarāḥ||98||

hantyāśu hi viṣaṁ kiñcit kiñcidrōgāya kalpatē|

yathā viṣaṁ tathaivāntyō jñēyō madyakr̥tō madaḥ||99||

tasmāt tridōṣajaṁ liṅgaṁ sarvatrāpi madātyayē|

dr̥śyatē rūpavaiśēṣyāt pr̥thaktvaṁ cāsya [1] lakṣyatē||100||

viShasya ye guNA dRuShTAH sannipAtaprakopaNAH |

ta eva madye dRushyante viShe tu balavattarAH ||98||

hantyAshu hi viShaM ki~jcit ki~jcidrogAya kalpate |

yathA viShaM tathaivAntyo j~jeyo madyakRuto madaH ||99||

tasmAt tridoShajaM li~ggaM sarvatrApi madAtyaye |

dRushyate rUpavaisheShyAt pRuthaktvaM cAsya [1] lakShyate ||100||

The properties vitiating tridosha as observed in poisons are also observed in the liquor, which are more potent in the former. Some poisons are fatal with immediate effect, while other causes certain diseases. The last stage of intoxication shall be considered as the poisonous state. Therefore, symptoms of tridosha (vitiation) are observed in all types of alcoholism, the difference among them is identity by their specific features.[98-100]

शरीरदुःखं बलवत् सम्मोहो [१] हृदयव्यथा |

अरुचिः प्रतता [२] तृष्णा ज्वरः शीतोष्णलक्षणः ||१०१||

शिरःपार्श्वास्थिसन्धीनां विद्युत्तुल्या [३] च वेदना |

जायतेऽतिबला जृम्भा स्फुरणं वेपनं श्रमः ||१०२||

उरोविबन्धः कासश्च हिक्का श्वासः प्रजागरः |

शरीरकम्पः कर्णाक्षिमुखरोगस्त्रिकग्रहः ||१०३||

छर्द्यतीसारहृल्लासा वातपित्तकफात्मकाः |

भ्रमः प्रलापो रूपाणामसतां चैव दर्शनम् ||१०४||

तृणभस्मलतापर्णपांशुभिश्चावपूरणम् |

प्रधर्षणं विहङ्गैश्च भ्रान्तचेताः स मन्यते ||१०५||

व्याकुलानामशस्तानां स्वप्नानां दर्शनानि च |

मदात्ययस्य रूपाणि सर्वाण्येतानि लक्षयेत् ||१०६||

śarīraduḥkhaṁ balavat sammōhō [1] hr̥dayavyathā|

aruciḥ pratatā [2] tr̥ṣṇā jvaraḥ śītōṣṇalakṣaṇaḥ||101||

śiraḥpārśvāsthisandhīnāṁ vidyuttulyā [3] ca vēdanā|

jāyatē'tibalā jr̥mbhā sphuraṇaṁ vēpanaṁ śramaḥ||102||

urōvibandhaḥ kāsaśca hikkā śvāsaḥ prajāgaraḥ|

śarīrakampaḥ karṇākṣimukharōgastrikagrahaḥ||103||

chardyatīsārahr̥llāsā vātapittakaphātmakāḥ|

bhramaḥ pralāpō rūpāṇāmasatāṁ caiva darśanam||104||

tr̥ṇabhasmalatāparṇapāṁśubhiścāvapūraṇam|

pradharṣaṇaṁ vihaṅgaiśca bhrāntacētāḥ sa manyatē||105||

vyākulānāmaśastānāṁ svapnānāṁ darśanāni ca|

madātyayasya rūpāṇi sarvāṇyētāni lakṣayēt||106||

sharIraduHkhaM balavat sammoho [1] hRudayavyathA |

aruciH pratatA [2] tRuShNA jvaraH shItoShNalakShaNaH ||101||

shiraHpArshvAsthisandhInAM vidyuttulyA [3] ca vedanA |

jAyate~atibalA jRumbhA sphuraNaM vepanaM shramaH ||102||

urovibandhaH kAsashca hikkA shvAsaH prajAgaraH |

sharIrakampaH karNAkShimukharogastrikagrahaH ||103||

chardyatIsArahRullAsA vAtapittakaphAtmakAH |

bhramaH pralApo rUpANAmasatAM caiva darshanam ||104||

tRuNabhasmalatAparNapAMshubhishcAvapUraNam |

pradharShaNaM viha~ggaishca bhrAntacetAH sa manyate ||105||

vyAkulAnAmashastAnAM svapnAnAM darshanAni ca |

madAtyayasya rUpANi sarvANyetAni lakShayet ||106||

Major physical distress, confusion, cardiac pain, anorexia, persistent thirst, fever, characterized by immense headache, pain in flanks, arthralgia, and joint pain along with yawning, throbbing, tremors , exhaustion, chest congestion, coughing, hiccups, breathlessness, sleeplessness, trembling, disorders of ear, eye, mouth; sacral stiffness, vomiting, diarrhea, nausea, with symptoms of vata, pitta, kapha, giddiness, delirium, hallucinations; self covered by grass, ash, creeper, leaves, and dust; with perverted mind feels assaulted by birds, visualizing fear and inauspicious dreams; are the general symptoms of madatyaya.[101-106]

Management of madatyaya

सर्वं मदात्ययं विद्यात् त्रिदोषमधिकं तु यम् |

दोषं मदात्यये पश्येत् तस्यादौ प्रतिकारयेत् ||१०७||

कफस्थानानुपूर्व्या च क्रिया कार्या मदात्यये |

पित्तमारुतपर्यन्तः प्रायेण हि मदात्ययः ||१०८||

मिथ्यातिहीनपीतेन यो व्याधिरुपजायते |

समपीतेन तेनैव स मद्येनोपशाम्यति ||१०९||

जीर्णाममद्यदोषाय मद्यमेव प्रदापयेत् |

प्रकाङ्क्षालाघवे जाते यद्यदस्मै हितं भवेत् ||११०||

सौवर्चलानुसंविद्धं शीतं सबिडसैन्धवम् |

मातुलुङ्गार्द्रकोपेतं जलयुक्तं प्रमाणवित् [१] ||१११||

sarvaṁ madātyayaṁ vidyāt tridōṣamadhikaṁ tu yam|

dōṣaṁ madātyayē paśyēt tasyādau pratikārayēt||107||

kaphasthānānupūrvyā ca kriyā kāryā madātyayē|

pittamārutaparyantaḥ prāyēṇa hi madātyayaḥ||108||

mithyātihīnapītēna yō vyādhirupajāyatē|

samapītēna tēnaiva sa madyēnōpaśāmyati||109||

jīrṇāmamadyadōṣāya madyamēva pradāpayēt|

prakāṅkṣālāghavē jātē yadyadasmai hitaṁ bhavēt||110||

sauvarcalānusaṁviddhaṁ śītaṁ sabiḍasaindhavam|

mātuluṅgārdrakōpētaṁ jalayuktaṁ pramāṇavit [1] ||111||

sarvaM madAtyayaM vidyAt tridoShamadhikaM tu yam |

doShaM madAtyaye pashyet tasyAdau pratikArayet ||107||

kaphasthAnAnupUrvyA ca kriyA kAryA madAtyaye |

pittamArutaparyantaH prAyeNa hi madAtyayaH ||108||

mithyAtihInapItena yo vyAdhirupajAyate |

samapItena tenaiva sa madyenopashAmyati ||109||

jIrNAmamadyadoShAya madyameva pradApayet |

prakA~gkShAlAghave jAte yadyadasmai hitaM bhavet ||110||

sauvarcalAnusaMviddhaM shItaM sabiDasaindhavam |

mAtulu~ggArdrakopetaM jalayuktaM pramANavit [1] ||111||

Madatyaya, of all types are tridoshaja. Therefore, the dosha observed predominantly affected shall be treated initially.

The treatment of madatyaya shall begin with the site of kapha, as it is predominantly situated lined by pitta and vata.

The diseases caused by the improper, excessive and deficient drinking of liquor are pacified by consumption of the same in appropriate quantity.

Following the metabolized ama, disadvantages of liquor and provoked appetite, feel of agile; liquor suitable to the person shall be given.

It shall be cool, with sauvarchala, bida, and rock salt along with matulunga, fresh ginger, mixed with water and in appropriate quantity. [107-111]

Treatment of acute madatyaya

तीक्षोष्णेनातिमात्रेण पीतेनाम्लविदाहिना |

मद्येनान्नरसोत्क्लेदो विदग्धः क्षारतां गतः ||११२||

अन्तर्दाहं ज्वरं तृष्णां प्रमोहं विभ्रमं मदम् |

जनयत्याशु तच्छान्त्यै मद्यमेव प्रदापयेत् ||११३||

क्षारो हि याति माधुर्यं शीघ्रमम्लोपसंहितः |

श्रेष्ठमम्लेषु मद्यं च यैर्गुणैस्तान् परं शृणु ||११४||

मद्यस्याम्लस्वभावस्य चत्वारोऽनुरसाः स्मृताः |

मधुरश्च कषायश्च तिक्तः कटुक एव च ||११५||

गुणाश्च दश पूर्वोक्तास्तैश्चतुर्दशभिर्गुणैः |

सर्वेषां मद्यमम्लानामुपर्युपरि तिष्ठति ||११६||

tīkṣōṣṇēnātimātrēṇa pītēnāmlavidāhinā|

madyēnānnarasōtklēdō vidagdhaḥ kṣāratāṁ gataḥ||112||

antardāhaṁ jvaraṁ tr̥ṣṇāṁ pramōhaṁ vibhramaṁ madam|

janayatyāśu tacchāntyai madyamēva pradāpayēt||113||

kṣārō hi yāti mādhuryaṁ śīghramamlōpasaṁhitaḥ|

śrēṣṭhamamlēṣu madyaṁ ca yairguṇaistān paraṁ śr̥ṇu||114||

madyasyāmlasvabhāvasya catvārō'nurasāḥ smr̥tāḥ|

madhuraśca kaṣāyaśca tiktaḥ kaṭuka ēva ca||115||

guṇāśca daśa pūrvōktāstaiścaturdaśabhirguṇaiḥ|

sarvēṣāṁ madyamamlānāmuparyupari tiṣṭhati||116||

tIkShoShNenAtimAtreNa pItenAmlavidAhinA |

madyenAnnarasotkledo vidagdhaH kShAratAM gataH ||112||

antardAhaM jvaraM tRuShNAM pramohaM vibhramaM madam |

janayatyAshu tacchAntyai madyameva pradApayet ||113||

kShAro hi yAti mAdhuryaM shIghramamlopasaMhitaH |

shreShThamamleShu madyaM ca yairguNaistAn paraM shRuNu ||114||

madyasyAmlasvabhAvasya catvAro~anurasAH smRutAH |

madhurashca kaShAyashca tiktaH kaTuka eva ca ||115||

guNAshca dasha pUrvoktAstaishcaturdashabhirguNaiH |

sarveShAM madyamamlAnAmuparyupari tiShThati ||116||

When sharply acting, hot, sour and liquor that cause burning sensation is consumed in excess quantity, the excited chyle is burnt and becomes alkaline in nature. It leads to the internal burning sensation, fever, thirst, confusions, giddiness and narcosis. To pacify these symptoms, intake of liquor is only advisable.

Alkali (thus produced within body) gets neutralized in combination of acid and the liquor is superior among the acidic substances. The remaining qualities of liquor are as below.

Liquor is sour with four contributory tastes, such as sweet, astringent, bitter and pungent. These added with the ten qualities described earlier summed to fourteen which exist in the liquor. Among all the sour substances the liquor is superior.[112-116]

Management of vata dominant madatyaya

मद्योत्क्लिष्टेन दोषेण रुद्धः [१] स्रोतःसु मारुतः |

करोति वेदनां तीव्रां शिरस्यस्थिषु सन्धिषु ||११७||

दोषविष्यन्दनार्थं हि तस्मै [२] मद्यं विशेषतः |

व्यवायितीक्ष्णोष्णतया देयमम्ले(न्ये)षु सत्स्वपि ||११८||

स्रोतोविबन्धनुन्मद्यं मारुतस्यानुलोमनम् |

रोचनं दीपनं चाग्नेरभ्यासात् सात्म्यमेव च ||११९||

रुजः [३] स्रोतःस्वरुद्धेषु मारुते चानुलोमिते |

निवर्तन्ते विकाराश्च शाम्यन्त्यस्य मदोदयाः ||१२०||

बीजपूरकवृक्षाम्लकोलदाडिमसंयुतम् |

यवानीहपुषाजाजीशृङ्गवेरावचूर्णितम् ||१२१||

सस्नेहैः शक्तुभिर्युक्तमवदंशैर्विरोचितम् [४] |

दद्यात् सलवणं मद्यं पैष्टिकं वातशान्तये ||१२२||

दृष्ट्वा वातोल्बणं लिङ्गं रसैश्चैनमुपाचरेत् |

लावतित्तिरदक्षाणां स्निग्धाम्लैः शिखिनामपि ||१२३||

पक्षिणां मृगमत्स्यानामानूपानां च संस्कृतैः |

भूशयप्रसहानां च रसैः शाल्योदनेन च ||१२४||

स्निग्धोष्णलवणाम्लैश्च वेशवारैर्मुखप्रियैः |

चित्रैर्गौधूमिकैश्चान्नैर्वारुणीमण्डसंयुतैः [५] ||१२५||

पिशितार्द्रकगर्भाभिः स्निग्धाभिः पूपवर्तिभिः |

माषपूपलिकाभिश्च वातिकं समुपाचरेत् ||१२६||

नातिस्निग्धं न चाम्लेन युक्तं समरिचार्द्रकम् |

मेद्यं प्रागुदितं मांसं दाडिमस्वरसेन वा ||१२७||

पृथक्त्रिजातकोपेतं सधान्यमरिचार्द्रकम् |

रसप्रलेपि [६] सम्पूपैः सुखोष्णैः सम्प्रदापयेत् ||१२८||

भुक्ते [७] तु वारुणीमण्डं दद्यात् पातुं पिपासवे |

दाडिमस्य रसं वाऽपि जलं वा पाञ्चमूलिकम् ||१२९||

धान्यनागरतोयं च दधिमण्डमथापि वा |

अम्लकाञ्जिकमण्डं वा शुक्तोदकमथापि वा ||१३०||

कर्मणाऽनेन सिद्धेन विकार उपशाम्यति |

मात्राकालप्रयुक्तेन बलं वर्णश्च वर्धते ||१३१||

रागषाडवसंयोगैर्विविधैर्भक्तरोचनैः |

पिशितैः शाकपिष्टान्नैर्यवगोधूमशालिभिः ||१३२||

अभ्यङ्गोत्सादनैः स्नानैरुष्णैः प्रावरणैर्घनैः |

घनैरगुरुपङ्कैश्च धूपैश्चागुरुजैर्घनैः ||१३३||

नारीणां यौवनोष्णानां निर्दयैरुपगूहनैः |

श्रोण्यूरुकुचभारैश्च संरोधोष्णसुखावहैः ||१३४||

शयनाच्छादनैरुष्णैरुष्णैश्चान्तर्गृहैः सुखैः |

मारुतप्रबलः शीघ्रं प्रशाम्यति मदात्ययः ||१३५||

madyōtkliṣṭēna dōṣēṇa ruddhaḥ [1] srōtaḥsu mārutaḥ|

karōti vēdanāṁ tīvrāṁ śirasyasthiṣu sandhiṣu||117||

dōṣaviṣyandanārthaṁ hi tasmai [2] madyaṁ viśēṣataḥ|

vyavāyitīkṣṇōṣṇatayā dēyamamlē(nyē)ṣu satsvapi||118||

srōtōvibandhanunmadyaṁ mārutasyānulōmanam|

rōcanaṁ dīpanaṁ cāgnērabhyāsāt sātmyamēva ca||119||

rujaḥ [3] srōtaḥsvaruddhēṣu mārutē cānulōmitē|

nivartantē vikārāśca śāmyantyasya madōdayāḥ||120||

bījapūrakavr̥kṣāmlakōladāḍimasaṁyutam|

yavānīhapuṣājājīśr̥ṅgavērāvacūrṇitam||121||

sasnēhaiḥ śaktubhiryuktamavadaṁśairvirōcitam [4] |

dadyāt salavaṇaṁ madyaṁ paiṣṭikaṁ vātaśāntayē||122||

dr̥ṣṭvā vātōlbaṇaṁ liṅgaṁ rasaiścainamupācarēt|

lāvatittiradakṣāṇāṁ snigdhāmlaiḥ śikhināmapi||123||

pakṣiṇāṁ mr̥gamatsyānāmānūpānāṁ ca saṁskr̥taiḥ|

bhūśayaprasahānāṁ ca rasaiḥ śālyōdanēna ca||124||

snigdhōṣṇalavaṇāmlaiśca vēśavārairmukhapriyaiḥ|

citrairgaudhūmikaiścānnairvāruṇīmaṇḍasaṁyutaiḥ [5] ||125||

piśitārdrakagarbhābhiḥ snigdhābhiḥ pūpavartibhiḥ|

māṣapūpalikābhiśca vātikaṁ samupācarēt||126||

nātisnigdhaṁ na cāmlēna yuktaṁ samaricārdrakam|

mēdyaṁ prāguditaṁ māṁsaṁ dāḍimasvarasēna vā||127||

pr̥thaktrijātakōpētaṁ sadhānyamaricārdrakam|

rasapralēpi [6] sampūpaiḥ sukhōṣṇaiḥ sampradāpayēt||128||

bhuktē [7] tu vāruṇīmaṇḍaṁ dadyāt pātuṁ pipāsavē|

dāḍimasya rasaṁ vā'pi jalaṁ vā pāñcamūlikam||129||

dhānyanāgaratōyaṁ ca dadhimaṇḍamathāpi vā|

amlakāñjikamaṇḍaṁ vā śuktōdakamathāpi vā||130||

karmaṇā'nēna siddhēna vikāra upaśāmyati|

mātrākālaprayuktēna balaṁ varṇaśca vardhatē||131||

rāgaṣāḍavasaṁyōgairvividhairbhaktarōcanaiḥ|

piśitaiḥ śākapiṣṭānnairyavagōdhūmaśālibhiḥ||132||

abhyaṅgōtsādanaiḥ snānairuṣṇaiḥ prāvaraṇairghanaiḥ|

ghanairagurupaṅkaiśca dhūpaiścāgurujairghanaiḥ||133||

nārīṇāṁ yauvanōṣṇānāṁ nirdayairupagūhanaiḥ|

śrōṇyūrukucabhāraiśca saṁrōdhōṣṇasukhāvahaiḥ||134||

śayanācchādanairuṣṇairuṣṇaiścāntargr̥haiḥ sukhaiḥ|

mārutaprabalaḥ śīghraṁ praśāmyati madātyayaḥ||135||

madyotkliShTena doSheNa ruddhaH [1] srotaHsu mArutaH |

karoti vedanAM tIvrAM shirasyasthiShu sandhiShu ||117||

doShaviShyandanArthaM hi tasmai [2] madyaM visheShataH |

vyavAyitIkShNoShNatayA deyamamle(nye)Shu satsvapi ||118||

srotovibandhanunmadyaM mArutasyAnulomanam |

rocanaM dIpanaM cAgnerabhyAsAt sAtmyameva ca ||119||

rujaH [3] srotaHsvaruddheShu mArute cAnulomite |

nivartante vikArAshca shAmyantyasya madodayAH ||120||

bIjapUrakavRukShAmlakoladADimasaMyutam |

yavAnIhapuShAjAjIshRu~ggaverAvacUrNitam ||121||

sasnehaiH shaktubhiryuktamavadaMshairvirocitam [4] |

dadyAt salavaNaM madyaM paiShTikaM vAtashAntaye ||122||

dRuShTvA vAtolbaNaM li~ggaM rasaishcainamupAcaret |

lAvatittiradakShANAM snigdhAmlaiH shikhinAmapi ||123||

pakShiNAM mRugamatsyAnAmAnUpAnAM ca saMskRutaiH |

bhUshayaprasahAnAM ca rasaiH shAlyodanena ca ||124||

snigdhoShNalavaNAmlaishca veshavArairmukhapriyaiH |

citrairgaudhUmikaishcAnnairvAruNImaNDasaMyutaiH [5] ||125||

pishitArdrakagarbhAbhiH snigdhAbhiH pUpavartibhiH |

mAShapUpalikAbhishca vAtikaM samupAcaret ||126||

nAtisnigdhaM na cAmlena yuktaM samaricArdrakam |

medyaM prAguditaM mAMsaM dADimasvarasena vA ||127||

pRuthaktrijAtakopetaM sadhAnyamaricArdrakam |

rasapralepi [6] sampUpaiH sukhoShNaiH sampradApayet ||128||

bhukte [7] tu vAruNImaNDaM dadyAt pAtuM pipAsave |

dADimasya rasaM vA~api jalaM vA pA~jcamUlikam ||129||

dhAnyanAgaratoyaM ca dadhimaNDamathApi vA |

amlakA~jjikamaNDaM vA shuktodakamathApi vA ||130||

karmaNA~anena siddhena vikAra upashAmyati |

mAtrAkAlaprayuktena balaM varNashca vardhate ||131||

rAgaShADavasaMyogairvividhairbhaktarocanaiH |

pishitaiH shAkapiShTAnnairyavagodhUmashAlibhiH ||132||

abhya~ggotsAdanaiH snAnairuShNaiH prAvaraNairghanaiH |

ghanairagurupa~gkaishca dhUpaishcAgurujairghanaiH ||133||

nArINAM yauvanoShNAnAM nirdayairupagUhanaiH |

shroNyUrukucabhAraishca saMrodhoShNasukhAvahaiH ||134||

shayanAcchAdanairuShNairuShNaishcAntargRuhaiH sukhaiH |

mArutaprabalaH shIghraM prashAmyati madAtyayaH ||135||

Vata obstructed in strotas due to dosha vitiated by liquor causes intense pain in head, bones and joints. In such condition for dissolving dosha, specific liquor should be administered since it has quality of quick absorption, sharpness and hot in spite of other remedial measure.

The liquor clears the obstruction in the strotas, carminates the vata, improves delight, stimulate the agni and gets habituated by regular drinking.

Once the strotas in chest get clear, carmination of vata, the diseases due to madatyaya also disappear.

Vata dominant madatyaya is treated with administration of old salty liquor made up of flours, with added sours like beejapura, vrikshamla, kola, dadima and powders of yavani, hapusha, ajaji, shringabera preceded by intake of food with parched gram flour mixed with unctuous substances.

On observing the symptoms indicating the predominance of vata, the patient shall be advised the unctuous and sour meat soup of common quail, partridge, chicken and peacock; shali rice along with seasoned meat soup of marshy birds, animals and fish as well as terrestrial beast or bird of prey; unctuous, hot, salty and sour, palatable veshavaara, various wheat preparations along with Varuni froth; pupavarti quite fatty and filled with flesh and ginger and pupilika made of black gram.

The meat of fatty animals advised for vataja alcoholics shall be not too unctuous, not sour, with black pepper and fresh ginger; or with pomegranate juice, trijataka individual and coriander seed, black pepper and fresh ginger shall be served as thick soup with warm pupa.

Post meal if thirsty, varuni froth, pomegranate juice, boiled and cool water with panchamla, dhanyaka (coriander seed), ginger, froth of curd, froth of sour gruel, vinegar water shall be given to the person.

Undergoing this regimen as per the dosha and time the disorders get pacified and strength and complexion get enhanced.

Vata predominant madatyaya usually gets controlled immediately by various delighting ragas, shadavas, meat preparations, vegetables, flour preparations, barley, wheat, shali rice; massage, anointing, hot baths, thick swathe, thick agaru pastes, thick essence of agaru, affectionate hug to women to the bosom with warmth of youthfulness, pleasant touch of their hips, thighs, breasts due to fondling, warm bedding and swaddling with warm comfortable home.[117-135]

Management of pitta dominant madatyaya

भव्यखर्जूरमृद्वीकापरूषकरसैर्युतम् [१] |

सदाडिमरसं शीतं सक्तुभिश्चावचूर्णितम् ||१३६||

सशर्करं शार्करं वा मार्द्वीकमथवाऽपरम् |

दद्याद्बहूदकं काले पातुं पित्तमदात्यये ||१३७||

शशान् कपिञ्जलानेणाँल्लावानसितपुच्छकान् |

मधुराम्लान् प्रयुञ्जीत भोजने शालिषष्टिकान् ||१३८||

पटोलयूषमिश्रं वा छागलं कल्पयेद्रसम् |

सतीनमुद्गमिश्रं वा दाडिमामलकान्वितम् ||१३९||

द्राक्षामलकखर्जूरपरूषकरसेन वा |

कल्पयेत्तर्पणान् यूषान् रसांश्च विविधात्मकान् ||१४०||

आमाशयस्थमुत्क्लिष्टं कफपित्तं मदात्यये |

विज्ञाय बहुदोषस्य दह्यमानस्य [२] तृष्यतः ||१४१||

मद्यं द्राक्षारसं तोयं दत्त्वा तर्पणमेव वा |

निःशेषं वामयेच्छीघ्रमेवं रोगाद्विमुच्यते ||१४२||

काले पुनस्तर्पणाद्यं क्रमं कुर्यात् प्रकाङ्क्षिते |

तेनाग्निर्दीप्यते तस्य दोषशेषान्नपाचकः ||१४३||

कासे सरक्तनिष्ठीवे पार्श्वस्तनरुजासु च |

तृष्यते सविदाहे च सोत्क्लेशे हृदयोरसि ||१४४||

गुडूचीभद्रमुस्तानां पटोलस्याथवा भिषक् |

रसं सनागरं दद्यात् तित्तिरिप्रतिभोजनम् [३] ||१४५||

तृष्यते चातिबलवद्वातपित्ते समुद्धते |

दद्याद्द्राक्षारसं पातुं शीतं दोषानुलोमनम् ||१४६||

जीर्णे समधुराम्लेन छागमांसरसेन तम् |

भोजनं भोजयेन्मद्यमनुतर्षं च पाययेत् ||१४७||

अनुतर्षस्य मात्रा सा यया नो दूष्यते [४] मनः |

तृष्यते मद्यमल्पाल्पं प्रदेयं स्याद्बहूदकम् ||१४८||

तृष्णा येनोपशाम्येत मदं येन च नाप्नुयात् |

परूषकाणां पीलूनां रसं शीतमथापि [५] वा ||१४९||

पर्णिनीनां चतसॄणां पिबेद्वा शिशिरं जलम् |

मुस्तदाडिमलाजानां [६] तृष्णाघ्नं वा पिबेद्रसम् ||१५०||

कोलदाडिमवृक्षाम्लचुक्रीकाचुक्रिकारसः |

पञ्चाम्लको मुखालेपः सद्यस्तृष्णां नियच्छति ||१५१||

शीतलान्यन्नपानानि शीतशय्यासनानि [७] च |

शीतवातजलस्पर्शाः शीतान्युपवनानि च ||१५२||

क्षौमपद्मोत्पलानां च मणीनां मौक्तिकस्य च |

चन्दनोदकशीतानां स्पर्शाश्चन्द्रांशुशीतलाः ||१५३||

हेमराजतकांस्यानां पात्राणां शीतवारिभिः |

पूर्णानां हिमपूर्णानां दृतीनां पवनाहताः ||१५४||

संस्पर्शाश्चन्दनार्द्राणां नारीणां च समारुताः |

चन्दनानां च मुख्यानां शस्ताः पित्तमदात्यये [८] ||१५५||

शीतवीर्यं यदन्यच्च तत् सर्वं विनियोजयेत् |

कुमुदोत्पलपत्राणां सिक्तानां चन्दनाम्बुना ||१५६||

हिताः स्पर्शा मनोज्ञानां दाहे मद्यसमुत्थिते |

कथाश्च विविधाः शस्ताः [९] शब्दाश्च शिखिनां शिवाः ||१५७||

तोयदानां च शब्दा हि शमयन्ति मदात्ययम् |

जलयन्त्राभिवर्षीणि वातयन्त्रवहानि च ||१५८||

कल्पनीयानि भिषजा दाहे धारागृहाणि च |

फलिनीसेव्यलोध्राम्बुहेमपत्रं कुटन्नटम् ||१५९||

कालीयकरसोपेतं दाहे शस्तं प्रलेपनम् |

बदरीपल्लवोत्थश्च तथैवारिष्टकोद्भवः ||१६०||

फेनिलायाश्च यः फेनस्तैर्दाहे लेपनं शुभम् |

सुरा समण्डा दध्यम्लं मातुलुङ्गरसो मधु ||१६१||

सेके प्रदेहे शस्यन्ते दाहघ्नाः साम्लकाञ्जिकाः |

परिषेकावगाहेषु व्यञ्जनानां च सेवने ||१६२||

शस्यते शिशिरं तोयं दाहतृष्णाप्रशान्तये |

मात्राकालप्रयुक्तेन कर्मणाऽनेन शाम्यति [१०] ||१६३||

धीमतो वैद्यवश्यस्य शीघ्रं पित्तमदात्ययः |१६४|

bhavyakharjūramr̥dvīkāparūṣakarasairyutam [1] |

sadāḍimarasaṁ śītaṁ saktubhiścāvacūrṇitam||136||

saśarkaraṁ śārkaraṁ vā mārdvīkamathavā'param|

dadyādbahūdakaṁ kālē pātuṁ pittamadātyayē||137||

śaśān kapiñjalānēṇāmँllāvānasitapucchakān|

madhurāmlān prayuñjīta bhōjanē śāliṣaṣṭikān||138||

paṭōlayūṣamiśraṁ vā chāgalaṁ kalpayēdrasam|

satīnamudgamiśraṁ vā dāḍimāmalakānvitam||139||

drākṣāmalakakharjūraparūṣakarasēna vā|

kalpayēttarpaṇān yūṣān rasāṁśca vividhātmakān||140||

āmāśayasthamutkliṣṭaṁ kaphapittaṁ madātyayē|

vijñāya bahudōṣasya dahyamānasya [2] tr̥ṣyataḥ||141||

madyaṁ drākṣārasaṁ tōyaṁ dattvā tarpaṇamēva vā|

niḥśēṣaṁ vāmayēcchīghramēvaṁ rōgādvimucyatē||142||

kālē punastarpaṇādyaṁ kramaṁ kuryāt prakāṅkṣitē|

tēnāgnirdīpyatē tasya dōṣaśēṣānnapācakaḥ||143||

kāsē saraktaniṣṭhīvē pārśvastanarujāsu ca|

tr̥ṣyatē savidāhē ca sōtklēśē hr̥dayōrasi||144||

guḍūcībhadramustānāṁ paṭōlasyāthavā bhiṣak|

rasaṁ sanāgaraṁ dadyāt tittiripratibhōjanam [3] ||145||

tr̥ṣyatē cātibalavadvātapittē samuddhatē|

dadyāddrākṣārasaṁ pātuṁ śītaṁ dōṣānulōmanam||146||

jīrṇē samadhurāmlēna chāgamāṁsarasēna tam|

bhōjanaṁ bhōjayēnmadyamanutarṣaṁ ca pāyayēt||147||

anutarṣasya mātrā sā yayā nō dūṣyatē [4] manaḥ|

tr̥ṣyatē madyamalpālpaṁ pradēyaṁ syādbahūdakam||148||

tr̥ṣṇā yēnōpaśāmyēta madaṁ yēna ca nāpnuyāt|

parūṣakāṇāṁ pīlūnāṁ rasaṁ śītamathāpi [5] vā||149||

parṇinīnāṁ catasr̥̄ṇāṁ pibēdvā śiśiraṁ jalam|

mustadāḍimalājānāṁ [6] tr̥ṣṇāghnaṁ vā pibēdrasam||150||

kōladāḍimavr̥kṣāmlacukrīkācukrikārasaḥ|

pañcāmlakō mukhālēpaḥ sadyastr̥ṣṇāṁ niyacchati||151||

śītalānyannapānāni śītaśayyāsanāni [7] ca|

śītavātajalasparśāḥ śītānyupavanāni ca||152||

kṣaumapadmōtpalānāṁ ca maṇīnāṁ mauktikasya ca|

candanōdakaśītānāṁ sparśāścandrāṁśuśītalāḥ||153||

hēmarājatakāṁsyānāṁ pātrāṇāṁ śītavāribhiḥ|

pūrṇānāṁ himapūrṇānāṁ dr̥tīnāṁ pavanāhatāḥ||154||

saṁsparśāścandanārdrāṇāṁ nārīṇāṁ ca samārutāḥ|

candanānāṁ ca mukhyānāṁ śastāḥ pittamadātyayē [8] ||155||

śītavīryaṁ yadanyacca tat sarvaṁ viniyōjayēt|

kumudōtpalapatrāṇāṁ siktānāṁ candanāmbunā||156||

hitāḥ sparśā manōjñānāṁ dāhē madyasamutthitē|

kathāśca vividhāḥ śastāḥ [9] śabdāśca śikhināṁ śivāḥ||157||

tōyadānāṁ ca śabdā hi śamayanti madātyayam|

jalayantrābhivarṣīṇi vātayantravahāni ca||158||

kalpanīyāni bhiṣajā dāhē dhārāgr̥hāṇi ca|

phalinīsēvyalōdhrāmbuhēmapatraṁ kuṭannaṭam||159||

kālīyakarasōpētaṁ dāhē śastaṁ pralēpanam|

badarīpallavōtthaśca tathaivāriṣṭakōdbhavaḥ||160||

phēnilāyāśca yaḥ phēnastairdāhē lēpanaṁ śubham|

surā samaṇḍā dadhyamlaṁ mātuluṅgarasō madhu||161||

sēkē pradēhē śasyantē dāhaghnāḥ sāmlakāñjikāḥ|

pariṣēkāvagāhēṣu vyañjanānāṁ ca sēvanē||162||

śasyatē śiśiraṁ tōyaṁ dāhatr̥ṣṇāpraśāntayē|

mātrākālaprayuktēna karmaṇā'nēna śāmyati [10] ||163||

dhīmatō vaidyavaśyasya śīghraṁ pittamadātyayaḥ|164|

bhavyakharjUramRudvIkAparUShakarasairyutam [1] |

sadADimarasaM shItaM saktubhishcAvacUrNitam ||136||

sasharkaraM shArkaraM vA mArdvIkamathavA~aparam |

dadyAdbahUdakaM kAle pAtuM pittamadAtyaye ||137||

shashAn kapi~jjalAneNA@mllAvAnasitapucchakAn |

madhurAmlAn prayu~jjIta bhojane shAliShaShTikAn ||138||

paTolayUShamishraM vA chAgalaM kalpayedrasam |

satInamudgamishraM vA dADimAmalakAnvitam ||139||

drAkShAmalakakharjUraparUShakarasena vA |

kalpayettarpaNAn yUShAn rasAMshca vividhAtmakAn ||140||

AmAshayasthamutkliShTaM kaphapittaM madAtyaye |

vij~jAya bahudoShasya dahyamAnasya [2] tRuShyataH ||141||

madyaM drAkShArasaM toyaM dattvA tarpaNameva vA |

niHsheShaM vAmayecchIghramevaM rogAdvimucyate ||142||

kAle punastarpaNAdyaM kramaM kuryAt prakA~gkShite |

tenAgnirdIpyate tasya doShasheShAnnapAcakaH ||143||

kAse saraktaniShThIve pArshvastanarujAsu ca |

tRuShyate savidAhe ca sotkleshe hRudayorasi ||144||

guDUcIbhadramustAnAM paTolasyAthavA bhiShak |

rasaM sanAgaraM dadyAt tittiripratibhojanam [3] ||145||

tRuShyate cAtibalavadvAtapitte samuddhate |

dadyAddrAkShArasaM pAtuM shItaM doShAnulomanam ||146||

jIrNe samadhurAmlena chAgamAMsarasena tam |

bhojanaM bhojayenmadyamanutarShaM ca pAyayet ||147||

anutarShasya mAtrA sA yayA no dUShyate [4] manaH |

tRuShyate madyamalpAlpaM pradeyaM syAdbahUdakam ||148||

tRuShNA yenopashAmyeta madaM yena ca nApnuyAt |

parUShakANAM pIlUnAM rasaM shItamathApi [5] vA ||149||

parNinInAM catasRUNAM pibedvA shishiraM jalam |

mustadADimalAjAnAM [6] tRuShNAghnaM vA pibedrasam ||150||

koladADimavRukShAmlacukrIkAcukrikArasaH |

pa~jcAmlako mukhAlepaH sadyastRuShNAM niyacchati ||151||

shItalAnyannapAnAni shItashayyAsanAni [7] ca |

shItavAtajalasparshAH shItAnyupavanAni ca ||152||

kShaumapadmotpalAnAM ca maNInAM mauktikasya ca |

candanodakashItAnAM sparshAshcandrAMshushItalAH ||153||

hemarAjatakAMsyAnAM pAtrANAM shItavAribhiH |

pUrNAnAM himapUrNAnAM dRutInAM pavanAhatAH ||154||

saMsparshAshcandanArdrANAM nArINAM ca samArutAH |

candanAnAM ca mukhyAnAM shastAH pittamadAtyaye [8] ||155||

shItavIryaM yadanyacca tat sarvaM viniyojayet |

kumudotpalapatrANAM siktAnAM candanAmbunA ||156||

hitAH sparshA manoj~jAnAM dAhe madyasamutthite |

kathAshca vividhAH shastAH [9] shabdAshca shikhinAM shivAH ||157||

toyadAnAM ca shabdA hi shamayanti madAtyayam |

jalayantrAbhivarShINi vAtayantravahAni ca ||158||

kalpanIyAni bhiShajA dAhe dhArAgRuhANi ca |

phalinIsevyalodhrAmbuhemapatraM kuTannaTam ||159||

kAlIyakarasopetaM dAhe shastaM pralepanam |

badarIpallavotthashca tathaivAriShTakodbhavaH ||160||

phenilAyAshca yaH phenastairdAhe lepanaM shubham |

surA samaNDA dadhyamlaM mAtulu~ggaraso madhu ||161||

seke pradehe shasyante dAhaghnAH sAmlakA~jjikAH |

pariShekAvagAheShu vya~jjanAnAM ca sevane ||162||

shasyate shishiraM toyaM dAhatRuShNAprashAntaye |

mAtrAkAlaprayuktena karmaNA~anena shAmyati [10] ||163||

dhImato vaidyavashyasya shIghraM pittamadAtyayaH |164|

In paitta dominant madatyaya, cool, well suitable liquor prepared of sharkara, mridvika (dried grapes) added with sugar and juice of cassia fistula, dates, grapes, parushaka or pomegranate and mixed with parched grain flour shall be administered.

The diet to be consumed is the meat of rabbit, grey partridge, ena (black deer), common quail, asita puchhaka (a type of deer); sweetened and soured along with shali and shashtika rice. The goat meat shall be prepared with peas, green gram or dadima (Pomegranate) and amalaka (Indian Goose berry). Preparation of various saturating drinks, vegetable and meat soups with juice of grapes, Indian Gooseberry, dates and parushaka is advisable.

In paittika madatyaya if kapha and pitta situated in stomach are vitiated, then considering the state of excess aggravation leading to burning and thirst, the liquor or grapes juice or water or tarpana shall be advised to induce complete emesis. This will relieve the illness rapidly.

If yearning to drink again, tarpana shall be given in appropriate time, which leads digestion of remaining toxins by stimulating agni.

Cough with hemoptysis, pain in flanks and breasts, thirst, burning, vitiated dosha in heart and chest shall be treated with decoction of guduchi (Tinospora cordifolia), devdaru, Cyprus rotundus, or patola mixed with dry ginger followed by the partridge food.

For intense thirst and aggravated vata pitta cold grape juice is advisable which helps for toxin elimination.

After observation of complete digestion the person shall be fed with sweet and sour goat meat soup along with the liquor to satiate the thirst. The quantity of liquor to satiate thirst shall be optimum enough and shall not affect the mind. If thirst persists, liquor diluted in plenty of water shall be given repeatedly to pacify it, yet not intoxicating.

Otherwise, cold juice of parushaka, pilu or cool water or water boiled with four leaved herbs or decoction of musta, dadima, and parched paddy shall be given to pacify thirst.

Kola, dadima, vrikshamla, chkrika, chukrika juice of this panchamla can be applied locally in oral cavity to pacify the thirst.

Cold food and drinks, cool residence, exposure to cool air and water, cool gardens, and the touch of cool linen, hued lotus, water lily, pearl, sandal water, moon beam; golden, silver, bronze vessels with cold water, breeze, and ice bags; touch of women bathed with sandal water and cool breeze from sandal trees are advised in paittika madatyaya. Whatever is sheetaveerya dominant shall be used.

Feel of lotus leaves, water lily, gravel, sandal water is beneficial in alcohol induced burning sensation. Anecdotes, variety of pictures, pure tone of voice of peacock, sound of clouds reduce the impact of intoxication.

Physician shall conceptualize the showers of cool water, air conditioning for cool air, and sprinkling cabinets for treating burning sensation in alcoholism.

Priyangu, usheera, lodhra, hribera, nagakeshara flowers and shyonaka mixed with kaleyaka juice are advisable in burning sensation. Application of froth oozing from pounded leaves of badara, nimba and fenila are advisable in burning sensation of pittaja alcoholism.

Liquor with the froth, sour curd, matulunga juice, honey, and sour gruel is used for sprinkling and pasting for pacification of burning sensation.

Cool water, is preferable for shower, bathing and drinking helps in pacifying thirst and burning sensation.

Learned physician implement these regimens with consideration of matra (optimum quantity) and kaala (appropriate time) to pacify pittaja madatyaya.[136-163]

Management of kapha dominant madatyaya

उल्लेखनोपवासाभ्यां जयेत् कफमदात्ययम् ||१६४||

तृष्यते सलिलं चास्मै दद्याद्ध्रीबेरसाधितम् |

बलया पृश्निपर्ण्या वा कण्टकार्याऽथवा शृतम् ||१६५||

सनागराभिः सर्वाभिर्जलं वा शृतशीतलम् |

दुःस्पर्शेन समुस्तेन मुस्तपर्पटकेन वा ||१६६||

जलं मुस्तैः शृतं वाऽपि दद्याद्दोषविपाचनम् |

एतदेव च पानीयं सर्वत्रापि मदात्यये ||१६७||

निरत्ययं पीयमानं पिपासाज्वरनाशनम् |

निरामं काङ्क्षितं काले सक्षौद्रं [१] पाययेत्तु तम् ||१६८||

शार्करं मधु वा जीर्णमरिष्टं सीधुमेव वा |

रूक्षतर्पणसंयुक्तं [२] यवानीनागरान्वितम् ||१६९||

यावगौधूमिकं चान्नं रूक्षयूषेण भोजयेत् |

कुलत्थानां सुशुष्काणां मूलकानां रसेन वा ||१७०||

तनुनाऽल्पेन लघुना कट्वम्लेनाल्पसर्पिषा |

पटोलयूषमम्लं वा यूषमामलकस्य वा ||१७१||

प्रभूतकटुसंयुक्तं सयवान्नं प्रदापयेत् |

व्योषयूषमथाम्लं वा यूषं वा साम्लवेतसम् ||१७२||

छागमांसरसं रूक्षमम्लं वा जाङ्गलं रसम् |

स्थाल्यां वाऽथ कपाले वा भृष्टं निर्द्रववर्तितम् [३] ||१७३||

कट्वम्ललवणं मांसं भक्षयन् वृणुयान्मधु |

व्यक्तमारीचकं मांसं मातुलुङ्गरसान्वितम् ||१७४||

प्रभूतकटुसंयुक्तं यवानीनागरान्वितम् |

भृष्टं दाडिमसाराम्लमुष्णपूपोपवेष्टितम् ||१७५||

यथाग्नि भक्षयेत् काले प्रभूतार्द्रकपेशिकम् |

पिबेच्च निगदं मद्यं कफप्राये मदात्यये ||१७६||

सौवर्चलमजाजी च वृक्षाम्लं साम्लवेतसम् |

त्वगेलामरिचार्धांशं शर्कराभागयोजितम् ||१७७||

एतल्लवणमष्टाङ्गमग्निसन्दीपनं परम् |

मदात्यये कफप्राये दद्यात् स्रोतोविशोधनम् ||१७८||

एतदेव पुनर्युक्त्या मधुराम्लैर्द्रवीकृतम् |

गोधूमान्नयवान्नानां मांसानां चातिरोचनम् ||१७९||

पेषयेत् कटुकैर्युक्तां श्वेतां बीजविवर्जिताम् |

मृद्वीकां मातुलुङ्गस्य दाडिमस्य रसेन वा ||१८०||

सौवर्चलैलामरिचैरजाजीभृङ्गदीप्यकैः |

स रागः क्षौद्रसंयुक्तः श्रेष्ठो रोचनदीपनः [४] ||१८१||

मृद्वीकाया विधानेन कारयेत् कारवीमपि |

शुक्तमत्स्यण्डिकोपेतं रागं दीपनपाचनम् ||१८२||

आम्रामलकपेशीनां रागान् कुर्यात् पृथक् पृथक् |

धान्यसौवर्चलाजाजीकारवीमरिचान्वितान् ||१८३||

गुडेन [५] मधुयुक्तेन व्यक्ताम्ललवणीकृतान् |

तैरन्नं रोचते दिग्धं सम्यग्भुक्तं च जीर्यति ||१८४||

रूक्षोष्णेनान्नपानेन [६] स्नानेनाशिशिरेण च |

व्यायामलङ्घनाभ्यां च युक्त्या जागरणेन च ||१८५||

कालयुक्तेन रूक्षेण स्नानेनोद्वर्तनेन च |

प्राणवर्णकराणां च [७] प्रघर्षाणां च सेवया ||१८६||

सेवया वसनानां च गुरूणामगुरोरपि |

सङ्कोचोष्णसुखाङ्गीनामङ्गनानां च सेवया ||१८७||

सुखशिक्षितहस्तानां स्त्रीणां संवाहनेन च |

मदात्ययः कफप्रायः शीघ्रमेवोपशाम्यति ||१८८||

ullēkhanōpavāsābhyāṁ jayēt kaphamadātyayam||164||

tr̥ṣyatē salilaṁ cāsmai dadyāddhrībērasādhitam|

balayā pr̥śniparṇyā vā kaṇṭakāryā'thavā śr̥tam||165||

sanāgarābhiḥ sarvābhirjalaṁ vā śr̥taśītalam|

duḥsparśēna samustēna mustaparpaṭakēna vā||166||

jalaṁ mustaiḥ śr̥taṁ vā'pi dadyāddōṣavipācanam|

ētadēva ca pānīyaṁ sarvatrāpi madātyayē||167||

niratyayaṁ pīyamānaṁ pipāsājvaranāśanam|

nirāmaṁ kāṅkṣitaṁ kālē sakṣaudraṁ [1] pāyayēttu tam||168||

śārkaraṁ madhu vā jīrṇamariṣṭaṁ sīdhumēva vā|

rūkṣatarpaṇasaṁyuktaṁ [2] yavānīnāgarānvitam||169||

yāvagaudhūmikaṁ cānnaṁ rūkṣayūṣēṇa bhōjayēt|

kulatthānāṁ suśuṣkāṇāṁ mūlakānāṁ rasēna vā||170||

tanunā'lpēna laghunā kaṭvamlēnālpasarpiṣā|

paṭōlayūṣamamlaṁ vā yūṣamāmalakasya vā||171||

prabhūtakaṭusaṁyuktaṁ sayavānnaṁ pradāpayēt|

vyōṣayūṣamathāmlaṁ vā yūṣaṁ vā sāmlavētasam||172||

chāgamāṁsarasaṁ rūkṣamamlaṁ vā jāṅgalaṁ rasam|

sthālyāṁ vā'tha kapālē vā bhr̥ṣṭaṁ nirdravavartitam [3] ||173||

kaṭvamlalavaṇaṁ māṁsaṁ bhakṣayan vr̥ṇuyānmadhu|

vyaktamārīcakaṁ māṁsaṁ mātuluṅgarasānvitam||174||

prabhūtakaṭusaṁyuktaṁ yavānīnāgarānvitam|

bhr̥ṣṭaṁ dāḍimasārāmlamuṣṇapūpōpavēṣṭitam||175||

yathāgni bhakṣayēt kālē prabhūtārdrakapēśikam|

pibēcca nigadaṁ madyaṁ kaphaprāyē madātyayē||176||

sauvarcalamajājī ca vr̥kṣāmlaṁ sāmlavētasam|

tvagēlāmaricārdhāṁśaṁ śarkarābhāgayōjitam||177||

ētallavaṇamaṣṭāṅgamagnisandīpanaṁ param|

madātyayē kaphaprāyē dadyāt srōtōviśōdhanam||178||

ētadēva punaryuktyā madhurāmlairdravīkr̥tam|

gōdhūmānnayavānnānāṁ māṁsānāṁ cātirōcanam||179||

pēṣayēt kaṭukairyuktāṁ śvētāṁ bījavivarjitām|

mr̥dvīkāṁ mātuluṅgasya dāḍimasya rasēna vā||180||

sauvarcalailāmaricairajājībhr̥ṅgadīpyakaiḥ|

sa rāgaḥ kṣaudrasaṁyuktaḥ śrēṣṭhō rōcanadīpanaḥ [4] ||181||

mr̥dvīkāyā vidhānēna kārayēt kāravīmapi|

śuktamatsyaṇḍikōpētaṁ rāgaṁ dīpanapācanam||182||

āmrāmalakapēśīnāṁ rāgān kuryāt pr̥thak pr̥thak|

dhānyasauvarcalājājīkāravīmaricānvitān||183||

guḍēna [5] madhuyuktēna vyaktāmlalavaṇīkr̥tān|

tairannaṁ rōcatē digdhaṁ samyagbhuktaṁ ca jīryati||184||

rūkṣōṣṇēnānnapānēna [6] snānēnāśiśirēṇa ca|

vyāyāmalaṅghanābhyāṁ ca yuktyā jāgaraṇēna ca||185||

kālayuktēna rūkṣēṇa snānēnōdvartanēna ca|

prāṇavarṇakarāṇāṁ ca [7] pragharṣāṇāṁ ca sēvayā||186||

sēvayā vasanānāṁ ca gurūṇāmagurōrapi|

saṅkōcōṣṇasukhāṅgīnāmaṅganānāṁ ca sēvayā||187||

sukhaśikṣitahastānāṁ strīṇāṁ saṁvāhanēna ca|

madātyayaḥ kaphaprāyaḥ śīghramēvōpaśāmyati||188||

ullekhanopavAsAbhyAM jayet kaphamadAtyayam ||164||

tRuShyate salilaM cAsmai dadyAddhrIberasAdhitam |

balayA pRushniparNyA vA kaNTakAryA~athavA shRutam ||165||

sanAgarAbhiH sarvAbhirjalaM vA shRutashItalam |

duHsparshena samustena mustaparpaTakena vA ||166||

jalaM mustaiH shRutaM vA~api dadyAddoShavipAcanam |

etadeva ca pAnIyaM sarvatrApi madAtyaye ||167||

niratyayaM pIyamAnaM pipAsAjvaranAshanam |

nirAmaM kA~gkShitaM kAle sakShaudraM [1] pAyayettu tam ||168||

shArkaraM madhu vA jIrNamariShTaM sIdhumeva vA |

rUkShatarpaNasaMyuktaM [2] yavAnInAgarAnvitam ||169||

yAvagaudhUmikaM cAnnaM rUkShayUSheNa bhojayet |

kulatthAnAM sushuShkANAM mUlakAnAM rasena vA ||170||

tanunA~alpena laghunA kaTvamlenAlpasarpiShA |

paTolayUShamamlaM vA yUShamAmalakasya vA ||171||

prabhUtakaTusaMyuktaM sayavAnnaM pradApayet |

vyoShayUShamathAmlaM vA yUShaM vA sAmlavetasam ||172||

chAgamAMsarasaM rUkShamamlaM vA jA~ggalaM rasam |

sthAlyAM vA~atha kapAle vA bhRuShTaM nirdravavartitam [3] ||173||

kaTvamlalavaNaM mAMsaM bhakShayan vRuNuyAnmadhu |

vyaktamArIcakaM mAMsaM mAtulu~ggarasAnvitam ||174||

prabhUtakaTusaMyuktaM yavAnInAgarAnvitam |

bhRuShTaM dADimasArAmlamuShNapUpopaveShTitam ||175||

yathAgni bhakShayet kAle prabhUtArdrakapeshikam |

pibecca nigadaM madyaM kaphaprAye madAtyaye ||176||

sauvarcalamajAjI ca vRukShAmlaM sAmlavetasam |

tvagelAmaricArdhAMshaM sharkarAbhAgayojitam ||177||

etallavaNamaShTA~ggamagnisandIpanaM param |

madAtyaye kaphaprAye dadyAt srotovishodhanam ||178||

etadeva punaryuktyA madhurAmlairdravIkRutam |

godhUmAnnayavAnnAnAM mAMsAnAM cAtirocanam ||179||

peShayet kaTukairyuktAM shvetAM bIjavivarjitAm |

mRudvIkAM mAtulu~ggasya dADimasya rasena vA ||180||

sauvarcalailAmaricairajAjIbhRu~ggadIpyakaiH |

sa rAgaH kShaudrasaMyuktaH shreShTho rocanadIpanaH [4] ||181||

mRudvIkAyA vidhAnena kArayet kAravImapi |

shuktamatsyaNDikopetaM rAgaM dIpanapAcanam ||182||

AmrAmalakapeshInAM rAgAn kuryAt pRuthak pRuthak |

dhAnyasauvarcalAjAjIkAravImaricAnvitAn ||183||

guDena [5] madhuyuktena vyaktAmlalavaNIkRutAn |

tairannaM rocate digdhaM samyagbhuktaM ca jIryati ||184||

rUkShoShNenAnnapAnena [6] snAnenAshishireNa ca |

vyAyAmala~gghanAbhyAM ca yuktyA jAgaraNena ca ||185||

kAlayuktena rUkSheNa snAnenodvartanena ca |

prANavarNakarANAM ca [7] pragharShANAM ca sevayA ||186||

sevayA vasanAnAM ca gurUNAmagurorapi |

sa~gkocoShNasukhA~ggInAma~gganAnAM ca sevayA ||187||

sukhashikShitahastAnAM strINAM saMvAhanena ca |

madAtyayaH kaphaprAyaH shIghramevopashAmyati ||188||

Therapeutic emesis and fasting can successfully treat kaphaja alcoholism.

Water boiled with hribera, bala, prishniparni, kantakari, or boiled and cooled water with these herbs with dry ginger shall be given in thirsty due to kaphaja madatyaya.

Water boiled with duralabha , musta or musta, parpata or only musta which metabolizes the toxins; shall only be used for drinking in all types of alcoholism. This is harmless and pacifies thirst and fever.

Liquor made up of sharkara or honey or old arishta or sidhu mixed with the honey shall be administered in nirama phase on desired time.

Food prepared of barley or wheat added with arid parched grain flour, yavani and dry ginger with soup of arid vegetable or with horse gram, well dried radish; the soup being clear and less in quantity, agile, spiced, sour with less ghee shall be given.

Sour soup of patola, soup of amalaka added with several pungent shall be given with barley food. In the same way, soured soup of trikatu or soup mixed with amlavetasa, arid meat, soup of goat or soured meat soup of jangala animals shall be given. Meat roasted in a plate or in an earthen plate without adding any liquid and added with pungent, sour, and salt shall be consumed along with madhu (a type of liquor).

Meat roasted while adding ample of black pepper, matulunga juice, other pungents in ample quantity, yavani and dry ginger and souring with pomegranate shall be consumed with hot pupa and plenty of fresh ginger pieces according to the agni on proper time followed by drinking discoursed liquor in kaphaja madatyaya.

Sauvarchala, jeeraka, vrikshamla, amlavetasa each one part, twak, ela, maricha each half part and sugar one part; all together powdered to formulate ashtanga lavana is an excellent appetizer and cleanser for strotas; shall be administered in kaphaja madatyaya.

This formulation made into liquid by addition of sweet and sour juices in optimum quantity shall be advised as adjuvant to the preparation of wheat and barley as well as meat to make more palatable.

The whitish seedless grapes added with trikatu shall be pounded with the juice of matulunga or pomegranate and added with sauvarchala, ela, maricha, jeeraka, twak, and yavani with honey, made into raga which is the best for relishing and appetite.

Similar preparation is recommended for raga of karavi prepared by adding vinegar and (matysyandika) solidified juice of sugarcane, which is appetizer and digestive.

Ragas can be prepared individually by the pulp of amalaka (Indian Gooseberry), adding dhanyaka (coriander seeds), sauvarchala, jeeraka, karavi and maricha (Black pepper) along with jaggery and madhu(honey); so that it becomes clear, sour and sweet; which makes food palatable and easy to digest.

Madatyaya predominant in kapha gets pacified early by the use of arid, hot food and drinks, hot water bath, physical exercise, agile things, awakening till late night, anointing, scrubbing of the body which improves prana (vitality) and complexion.

Kaphaja madatyaya gets quickly pacified with use of heavy and even light weight garments, with samvahana (deep massage) created contraction (and relaxation) with warmth, pleasurable to the body by well trained female masseur. [164-188]

Management of sannipata

यदिदं कर्म निर्दिष्टं पृथग्दोषबलं प्रति |

सन्निपाते दशविधे तद्विकल्प्यं भिषग्विदा ||१८९||

यस्तु दोषविकल्पज्ञो यश्चौषधिविकल्पवित् |

स साध्यान्साधयेद्व्याधीन् साध्यासाध्यविभागवित् ||१९०||

yadidaṁ karma nirdiṣṭaṁ pr̥thagdōṣabalaṁ prati|

sannipātē daśavidhē tadvikalpyaṁ bhiṣagvidā||189||

yastu dōṣavikalpajñō yaścauṣadhivikalpavit|

sa sādhyānsādhayēdvyādhīn sādhyāsādhyavibhāgavit||190||

yadidaM karma nirdiShTaM pRuthagdoShabalaM prati |

sannipAte dashavidhe tadvikalpyaM bhiShagvidA ||189||

yastu doShavikalpaj~jo yashcauShadhivikalpavit |

sa sAdhyAnsAdhayedvyAdhIn sAdhyAsAdhyavibhAgavit ||190||

This regimen is described here according to individual dosha severity. The same with permutation and combinations can be applied by physician in ten types of sannipata( mixed variety of dosha aggravation).

One who understands permutations and combinations of dosha, medicines, and prognosis can differentiate between curable and non-curable diseases and treat. [189-190]

Harshana chikitsa (Exhileration treatment)

वनानि रमणीयानि सपद्माः सलिलाशयाः |

विशदान्यन्नपानानि सहायाश्च प्रहर्षणाः ||१९१||

माल्यानि गन्धयोगाश्च वासांसि विमलानि च |

गान्धर्वशब्दाः कान्ताश्च गोष्ठ्यश्च हृदयप्रियाः ||१९२||

सङ्कथाहास्यगीतानां विशदाश्चैव योजनाः |

प्रियाश्चानुगता नार्यो नाशयन्ति मदात्ययम् ||१९३||

नाक्षोभ्य हि मनो मद्यं शरीरमविहत्य च |

कुर्यान्मदात्ययं तस्मादेष्टव्या हर्षणी क्रिया ||१९४||

vanāni ramaṇīyāni sapadmāḥ salilāśayāḥ|

viśadānyannapānāni sahāyāśca praharṣaṇāḥ||191||

mālyāni gandhayōgāśca vāsāṁsi vimalāni ca|

gāndharvaśabdāḥ kāntāśca gōṣṭhyaśca hr̥dayapriyāḥ||192||

saṅkathāhāsyagītānāṁ viśadāścaiva yōjanāḥ|

priyāścānugatā nāryō nāśayanti madātyayam||193||

nākṣōbhya hi manō madyaṁ śarīramavihatya ca|

kuryānmadātyayaṁ tasmādēṣṭavyā harṣaṇī kriyā||194||

vanAni ramaNIyAni sapadmAH salilAshayAH |

vishadAnyannapAnAni sahAyAshca praharShaNAH ||191||

mAlyAni gandhayogAshca vAsAMsi vimalAni ca |

gAndharvashabdAH kAntAshca goShThyashca hRudayapriyAH ||192||

sa~gkathAhAsyagItAnAM vishadAshcaiva yojanAH |

priyAshcAnugatA nAryo nAshayanti madAtyayam ||193||

nAkShobhya hi mano madyaM sharIramavihatya ca |

kuryAnmadAtyayaM tasmAdeShTavyA harShaNI kriyA ||194||

Beautiful gardens, ponds with lotus flowers, good food and drinks, pleasing companion, garlands, perfumes, clean clothing, melodious music, amusing gathering, liberal anecdotes, laughter, singing and beloved submissive women pacify madatyaya.

Liquor cannot lead to intoxication without distressing mind and affecting the body, therefore exhilaration treatment (by above measures) shall be observed (to stabilize mind and body).[191-194]

Treatment of madatyaya with milk

आभिः क्रियाभिः सिद्धाभिः शमं याति मदात्ययः |

न चेन्मद्यविधिं मुक्त्वा क्षीरमस्य प्रयोजयेत् ||१९५||

लङ्घनैः पाचनैर्दोषशोधनैः शमनैरपि |

विमद्यस्य कफे क्षीणे जाते दौर्बल्यलाघवे ||१९६||

तस्य मद्यविदग्धस्य वातपित्ताधिकस्य च |

ग्रीष्मोपतप्तस्य तरोर्यथा वर्षं तथा पयः ||१९७||

पयसाऽभिहृते रोगे बले जाते निवर्तयेत् |

क्षीरप्रयोगं मद्यं च क्रमेणाल्पाल्पमाचरेत् ||१९८||

ābhiḥ kriyābhiḥ siddhābhiḥ śamaṁ yāti madātyayaḥ|

na cēnmadyavidhiṁ muktvā kṣīramasya prayōjayēt||195||

laṅghanaiḥ pācanairdōṣaśōdhanaiḥ śamanairapi|

vimadyasya kaphē kṣīṇē jātē daurbalyalāghavē||196||

tasya madyavidagdhasya vātapittādhikasya ca|

grīṣmōpataptasya tarōryathā varṣaṁ tathā payaḥ||197||

payasā'bhihr̥tē rōgē balē jātē nivartayēt|

kṣīraprayōgaṁ madyaṁ ca kramēṇālpālpamācarēt||198||

AbhiH kriyAbhiH siddhAbhiH shamaM yAti madAtyayaH |

na cenmadyavidhiM muktvA kShIramasya prayojayet ||195||

la~gghanaiH pAcanairdoShashodhanaiH shamanairapi |

vimadyasya kaphe kShINe jAte daurbalyalAghave ||196||

tasya madyavidagdhasya vAtapittAdhikasya ca |

grIShmopataptasya taroryathA varShaM tathA payaH ||197||

payasA~abhihRute roge bale jAte nivartayet |

kShIraprayogaM madyaM ca krameNAlpAlpamAcaret ||198||

In case madatyaya does not get pacified with these explained regimens in methods of liquor consumption, milk shall be prescribed.

With withdrawal of liquor, when kapha is diminished and debility and agility occurs due to fasting, and purifying metabolism of toxins, alleviating measures and vata pitta get dominant in the person wreaked with liquor, the milk acts as a boon like the rains for the tree in intense summer.

When the disease is removed by the use of milk and strength is regained the use of milk shall be discontinued and liquor consumption can be resumed in smaller quantities gradually.[195-198]

Dwansaka and Vikshaya diseases due to madatyaya

विच्छिन्नमद्यः सहसा योऽतिमद्यं निषेवते |

ध्वंसको [१] विक्षयश्चैव रोगस्तस्योपजायते ||१९९||

व्याध्युपक्षीणदेहस्य दुश्चिकित्स्यतमौ हि तौ |

तयोर्लिङ्गं चिकित्सा च यथावदुपदेक्ष्यते ||२००||

श्लेष्मप्रसेकः कण्ठास्यशोषः शब्दासहिष्णुता |

तन्द्रानिद्रातियोगश्च ज्ञेयं ध्वंसकलक्षणम् ||२०१||

हृत्कण्ठरोगः सम्मोहश्छर्दिरङ्गरुजा ज्वरः |

तृष्णा कासः शिरःशूलमेतद्विक्षयलक्षणम् ||२०२||

तयोः कर्म तदेवेष्टं वातिके यन्मदात्यये |

तौ हि प्रक्षीणदेहस्य जायेते दुर्बलस्य वै ||२०३||

बस्तयः सर्पिषः पानं प्रयोगः क्षीरसर्पिषोः |

अभ्यङ्गोद्वर्तनस्नानान्यन्नपानं च वातनुत् ||२०४||

ध्वंसको विक्षयश्चैव कर्मणाऽनेन शाम्यति |

युक्तमद्यस्य मद्योत्थो न व्याधिरुपजायते ||२०५||

vicchinnamadyaḥ sahasā yō'timadyaṁ niṣēvatē|

dhvaṁsakō [1] vikṣayaścaiva rōgastasyōpajāyatē||199||

vyādhyupakṣīṇadēhasya duścikitsyatamau hi tau|

tayōrliṅgaṁ cikitsā ca yathāvadupadēkṣyatē||200||

ślēṣmaprasēkaḥ kaṇṭhāsyaśōṣaḥ śabdāsahiṣṇutā|

tandrānidrātiyōgaśca jñēyaṁ dhvaṁsakalakṣaṇam||201||

hr̥tkaṇṭharōgaḥ sammōhaśchardiraṅgarujā jvaraḥ|

tr̥ṣṇā kāsaḥ śiraḥśūlamētadvikṣayalakṣaṇam||202||

tayōḥ karma tadēvēṣṭaṁ vātikē yanmadātyayē|

tau hi prakṣīṇadēhasya jāyētē durbalasya vai||203||

bastayaḥ sarpiṣaḥ pānaṁ prayōgaḥ kṣīrasarpiṣōḥ|

abhyaṅgōdvartanasnānānyannapānaṁ ca vātanut||204||

dhvaṁsakō vikṣayaścaiva karmaṇā'nēna śāmyati|

yuktamadyasya madyōtthō na vyādhirupajāyatē||205||

vicchinnamadyaH sahasA yo~atimadyaM niShevate |

dhvaMsako [1] vikShayashcaiva rogastasyopajAyate ||199||

vyAdhyupakShINadehasya dushcikitsyatamau hi tau |

tayorli~ggaM cikitsA ca yathAvadupadekShyate ||200||

shleShmaprasekaH kaNThAsyashoShaH shabdAsahiShNutA |

tandrAnidrAtiyogashca j~jeyaM dhvaMsakalakShaNam ||201||

hRutkaNTharogaH sammohashchardira~ggarujA jvaraH |

tRuShNA kAsaH shiraHshUlametadvikShayalakShaNam ||202||

tayoH karma tadeveShTaM vAtike yanmadAtyaye |

tau hi prakShINadehasya jAyete durbalasya vai ||203||

bastayaH sarpiShaH pAnaM prayogaH kShIrasarpiShoH |

abhya~ggodvartanasnAnAnyannapAnaM ca vAtanut ||204||

dhvaMsako vikShayashcaiva karmaNA~anena shAmyati |

yuktamadyasya madyottho na vyAdhirupajAyate ||205||

The one who starts consumption of the liquor in excess quantity after stopping, suffers from the diseases called as dhwansaka and vikshaya. These can be treated with difficulty in debilitated person. Now its symptoms and the treatment will be described.

Excess salivation, parched throat and mouth, intolerance to sound, excess drowsiness, as well as sleepiness are the symptoms of the dhwansaka.

Cardiac disorders, throat disorders, confusions, vomiting, body ache, fever, thirst, cough and headache are the symptoms of vikshaya. It occurs in debilitated and emaciated person.

The management of these is similar to the management of vatika madatyaya.

Basti, consumption of ghee and milk with ghee, massage, bath suitable food and drink are vata pacifying. Dhwansaka and Vikshaya subside by this regimen. The drinking disorders will not occur in the person who drinks liquor properly.[199-205]

Prevention of diseases

निवृत्तः सर्वमद्येभ्यो नरो यश्च जितेन्द्रियः |

शारीरमानसैर्धीमान् विकारैर्न स युज्यते ||२०६||

nivr̥ttaḥ sarvamadyēbhyō narō yaśca jitēndriyaḥ|

śārīramānasairdhīmān vikārairna sa yujyatē||206||

nivRuttaH sarvamadyebhyo naro yashca jitendriyaH |

shArIramAnasairdhImAn vikArairna sa yujyate ||206||

Diseases of body and mind do not occur in the person who wisely stays away from all liquors, who has controlled all his senses. [206]

Summary

तत्र श्लोकाः-

यत्प्रभावा भगवती सुरा पेया यथा च सा |

यद्द्रव्या यस्य या चेष्टा योगं चापेक्षते यथा ||२०७||

यथा मदयते यैश्च गुणैर्युक्ता महागुणा |

यो मदो मदभेदाश्च ये त्रयः स्वस्वलक्षणाः ||२०८||

ये च मद्यकृता दोषा गुणा ये च मदात्मकाः |

यच्च त्रिविधमापानं यथासत्त्वं च लक्षणम् ||२०९||

ये सहायाः सुखाः पाने [१] चिरक्षिप्रमदा नराः |

मदात्ययस्य यो हेतुर्लक्षणं यद् यथा च यत् ||२१०||

मद्यं मद्योत्थितान् रोगान् हन्ति यश्च क्रियाक्रमः |

सर्वं तदुक्तमखिलं मदात्ययचिकित्सिते ||२११||

tatra ślōkāḥ-

yatprabhāvā bhagavatī surā pēyā yathā ca sā|

yaddravyā yasya yā cēṣṭā yōgaṁ cāpēkṣatē yathā||207||

yathā madayatē yaiśca guṇairyuktā mahāguṇā|

yō madō madabhēdāśca yē trayaḥ svasvalakṣaṇāḥ||208||

yē ca madyakr̥tā dōṣā guṇā yē ca madātmakāḥ|

yacca trividhamāpānaṁ yathāsattvaṁ ca lakṣaṇam||209||

yē sahāyāḥ sukhāḥ pānē [1] cirakṣipramadā narāḥ|

madātyayasya yō hēturlakṣaṇaṁ yad yathā ca yat||210||

madyaṁ madyōtthitān rōgān hanti yaśca kriyākramaḥ|

sarvaṁ taduktamakhilaṁ madātyayacikitsitē||211||

tatra shlokAH-

yatprabhAvA bhagavatI surA peyA yathA ca sA |

yaddravyA yasya yA ceShTA yogaM cApekShate yathA ||207||

yathA madayate yaishca guNairyuktA mahAguNA |

yo mado madabhedAshca ye trayaH svasvalakShaNAH ||208||

ye ca madyakRutA doShA guNA ye ca madAtmakAH |

yacca trividhamApAnaM yathAsattvaM ca lakShaNam ||209||

ye sahAyAH sukhAH pAne [1] cirakShipramadA narAH |

madAtyayasya yo heturlakShaNaM yad yathA ca yat ||210||

madyaM madyotthitAn rogAn hanti yashca kriyAkramaH |

sarvaM taduktamakhilaM madAtyayacikitsite ||211||

In this chapter on the diagnosis and treatment of alcoholism, the following topics are expounded at length:

1. The powers of sura, the liquor for the Gods.
2. The standard methods of drinking liquor.
3. The ingredients for liquor and the dietary components with which liquor is to be taken.
4. Wholesomeness of different varieties of alcohol for different types of the person
5. The method of appropriate use of the liquor
6. The process by which intoxication is caused
7. The properties of liquor which is endowed with great attributes
8. Signs and symptoms of intoxication
9. Different stages of intoxication
10. Adverse effects of liquor
11. Good effects of alcohol
12. Use of alcohol keeping in the view of three varities of eight factors
13. Signs and symptoms manifested in persons having three types of psyches
14. Characteristics of good companions while drinking
15. Characteristics of the persons who get drunk gradually and rapidly
16. Etiology, symptomatology of madatyaya
17. The type of liquor and the manner in which the liquor cures the intoxication
18. Line of treatments for drunkenness and intoxication at various levels. [207-211]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सास्थाने

मदात्ययचिकित्सितं नाम चतुर्विंशोऽध्यायः ||२४||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē

madātyayacikitsitaṁ nāma caturviṁśō'dhyāyaḥ||24||

ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne

madAtyayacikitsitaM nAma caturviMsho~adhyAyaH ||24||

This concludes the 24th chapter named as madatyaya, written by Agnivesha and commented by Charak.[24]

Tattva Vimarsha / Fundamental Principles

• The degree of effect and duration of intoxication due to liquor consumption will be extensive if the person consumes liquor similar to his constitution. The principle which has been described in the first chapter of Sutra Sthana emphasizes the use of opposite (viruddha guna) quality substances to pacify the agitated state of dosha. Therefore, it is advised to drink liquor of opposite quality for respective (prakriti)constitution.
• Liquor prepared by multiple ingredients carry multiple qualities and multiple actions, characterized by advantages and disadvantages.
• Liquor by nature is similar to food. It is like ambrosia for the one who drinks as per the guidelines, in optimum quantity, at suitable time, with advisable diet, as per the capacity and with exhilaration. On the contrary, it will be like poison for the one who indulges in excessive drinking any kind of liquor.
• Appropriate madya for vatika person is that which is prepared predominantly by jaggery and flour. For kapha and pitta predominant person madya prepared by grapes and honey is appropriate (to drink) respectively.
• Liquor counteracts the qualities of ojas (vital essence of body).
• It affects the mental strength, intellect and senses.
• The liquor shall always be consumed with understanding of six triads of the food, drink, age, disease, strength, and time; as well as tridosha and three psyches (described in earlier chapters).
• While drinking, one should know the people following sattvika, rajasika and tamasika way of drinking and try to be at distance from such companions due to whom one may suffer by bad effects of liquor consumption.
• Alcoholism, of all types is tridoshaja. Therefore, the dosha observed to be affected predominantly shall be treated initially. The treatment of alcoholism shall begin with the site of kapha.
• Vata obstructed in strotas due to dosha vitiated by liquor causes intense pain in head, bones and joints. In such condition for dissolving dosha, specific liquor should be administered since it has quality of quick absorption, sharpness and hot in spite of other remedial measure.
• The liquor clears the obstruction in the strotas, carminates the vata, improves delight, stimulates the agni and gets habituated by regular drinking.
• Once the strotas in chest get clear, carmination of vata, the diseases due to alcoholism also disappear.
• Directives for drinking:
• An individual of vatika prakriti shall imbibe madya after abhyanga (massage), utsadana (rubbing with herbs), bathing, dressed up, holy incense, anulepanam (unguent) and unctuous hot food.
• An individual of paittika prakriti shall undergo various cooling regimens; sweet, unctuous & cooling food to not get affected by madya, the liquor.
• An individual of kaphaja prakriti shall imbibe madya (the liquor) with warm regimens; drink yava (barley), wheat, meat of wild animals along with black pepper.

Vidhi Vimarsha / Applied Inferences

Sura and its varieties in present era

Sura, is the liquor prepared with shalidhanya which is nutritionally superior type of rice grain. Sura, if consumed as per the standard directives of limited consumption, leads to pleasure; otherwise it leads to the undesirable conditions like hangover, intoxication and the state of unconsciousness.

Depending upon the methods of preparation followed alcoholic drinks are of different types like sura, madhu and maitreya. The term sautramani has two meanings in different contexts, the former emphasizes the use of alcohol for the purpose of oblation, while the later as sacrificial soma.

The advice to use utensils made up of gold and silver for serving liquor is due to their property of being highly non-reactive. In present era metals have been replaced by glass, which is also an inert substance to serve liquor. The principle is to serve liquor in utensils made up of inert substances.

Qualities of good liquor

The liquor consumption must be in optimal amount suitable to individual’s body constitution and should not cause vitiation of dosha.

Good liquor is prepared from multiple ingredients of varied qualities which have diverse actions to help regulate the three doshas and prevent their vitiation, which may occur in case of use of single ingredient. Sushruta mentioned that the increase or decrease of the dosha is mainly influenced by the ingredients (dravya) of liquor. Therefore, manufacturing liquor with multi-component of varied quality substances will help to maintain state of homeostasis.

Features of intoxication

Hangovers are a frequent, though unpleasant, experience among people who drink to intoxication. Multiple possible factors to cause hangover state by liquor have been investigated, and evidence suggests that hangover symptoms depend upon its effects on urine production, the state of gastrointestinal tract, blood sugar concentrations, sleep patterns, and biological rhythms. In addition, researchers postulate that effects related to alcohol withdrawal depend upon, alcohol metabolism, biologically active non alcohol compounds in beverages; the use of other drugs; certain personality traits; and a family history of alcoholism may contribute to the hangover condition as shown in table 2 below.

Table 1: Symptoms of hangover

Class of Symptoms	Type
Constitutional	Fatigue, weakness, and thirst
Pain	Headache and muscle aches
Gastrointestinal	Nausea, vomiting, and stomach pain
Sleep and biological rhythms	Decreased sleep, decreased REM, and increased slow-wave sleep
Sensory	Vertigo and sensitivity to light and sound
Cognitive	Decreased attention and concentration
Mood	Depression, anxiety, and irritability
Sympathetic hyperactivity	Tremor, sweating, increased pulse, and systolic BP

Table 2: Possible Contributing Factors to Hangover

1. Direct effects of alcohol
   1. Dehydration
   2. Electrolyte imbalance
   3. Gastrointestinal disturbances
   4. Low blood sugar
   5. Sleep and biological rhythm disturbances
2. Alcohol withdrawal
3. Alcohol metabolism (i.e., acetaldehyde toxicity)
4. Non-alcohol effects
   1. Compounds other than alcohol in beverages, especially methanol
   2. Use of other drugs, especially nicotine
   3. Personality type
   4. Family history for alcoholism

Table 3: Dubowski’s stages of Alcoholic influence

BAC gms/100ml	Stages of Alcoholic Influence	Clinical Signs /Symptoms
0.01 to 0.05	Subclinical	Influence / effects usually not apparent or obvious;Behaviour nearly normal by ordinary observation;Impairment detectable by special tests
0.03 to 0.12	Euphoria	Mild Euphoria, Socialbility, Talkativeness;Increased self confidence, Decreased inhibitions;Diminished attention, Judgement and control;Some sensory motor impairment;Slowed information processing;Loss of efficiency in critical performance tests
0.09 to 0.25	Excitement	Emotional instability, Loss of critical judgement;Impairment of perception, memory and comprehension;Decreased sensory response, Increased reaction time;Reduced visual acuity and peripheral vision& slow glare recovery;Sensory motor incoordination, Impaired Balance;Slurred speech, Vomiting, Drowsiness
0.18 to 0.30	Confusion	Disorientation, Confusion, Vertigo, Dysphoria;Exaggerated emotional states (fear, rage, grief etc.);Disturbances of vision (Diplopia) & 0f color, form, motion & dimensions;Increased pain threshold;Increased muscular incoordination, staggering gait and ataxia;Apathy, Lethargy
0.25 to 0.40	Stupor	General inertia, approaching loss of motor functions;Markedly decreased response to stimuli;Marked muscular incoordination, inability to stand or walk;Vomiting, incontinence of urine and feces;Impaired consciousness, sleep or stupor
0.35 to 0.50	Coma	Complete unconciousness, Coma, Anesthesia;Depressed or abolished reflexes;Subnormal temperature;Impairment of circulation and respiration;Possible death
0.45 +	Death	Death from respiratory arrest

Role of olfaction in intoxication

Alcoholic beverages provoke massive orthonasal and retronasal stimulations (Bragulat et al., 2008) which constitute strong appetitive cues (Bienkowski et al., 2004) and might be involved in causing alcohol-dependence as they rapidly lead to conditioned alcohol-seeking behaviors (Pautassi et al., 2009). Olfactory stimulations elicit strong drinking desires (Schneider et al., 2001), this olfactory craving being even stronger than those provoked by visual–auditory cues, particularly during withdrawal (Kareken et al., 2004; Little et al., 2005) and thus being potentially involved in relapse.

The olfactory system relates to cognitive and emotional brain regions, and exploring olfaction might improve the understanding of emotional-cognitive deficits in alcohol- dependence (up to now explore with visio–auditory stimulations). Olfaction is indeed directly connected with limbic (Soudry et al., 2011) and fronto-temporal regions (Rolls, 2004).

The orbitofrontal cortex is a crucial area in this perspective, being simultaneously involved in emotional, executive, and olfactory processing (Rolls, 2008). Strong correlations between olfactory and cognitive abilities have been shown (Purdon, 1998; Schubert et al., 2008; Sohrabi et al., 2012), underlining their common cerebral basis. Olfaction thus constitutes an interesting way to renew the exploration of emotional-executive deficits in alcohol-dependence.

In view of the above research, the consumption of liquor in pleasant atmosphere, with perfumes, essence and garlands has a reason to avoid false stimulation of olfactory nerve and to maintain the consciousness during and after liquor intake.

The intention of using perfumes etc is based upon the understanding of its effect on olfaction and there by on the cerebral functions; which otherwise termed as gandha-jnana, meaning knowledge of olfaction. The most preferred aromas will help maintaining the psycho-neuro axis well in control and it prevents the intoxicating effects on human body.

Factors affecting addictive behavior: Addictive behavior associated with alcoholism is characterized by compulsive preoccupation with obtaining alcohol, loss of control over consumption, and development of tolerance and dependence, as well as impaired social and occupational functioning. Like other addictive disorders, alcoholism is characterized by chronic vulnerability to relapse after cessation of drinking.

More recently, increasing attention has been directed toward the understanding of neurobiological and environmental factors in susceptibility to relapse.

The BACs showed in the following tables are the maximum attainable concentrations for a specific amount of alcohol consumed.

Table 4: Factors determining maximum BAC

The calculations are based on Widmark’s Formula:

A = Amount of alcohol measured in grams

P = Mass of the individual in kilograms

C = Blood Alcohol Concentration in gram/100ml

R = Distribution Factor (f=0.7 =0.6)

10 = Conversion Factor from g/1000 ml to g/100ml

A = P x C x R x 10

In a fat person the r-factor will be less than in a muscular one. Theoretically a fat person with the same mass as a muscular one will become more intoxicated on the same amount of alcohol consumed over the same period. (alcohol is not fat soluble but water soluble)

The given blood alcohol concentration is a reflection of the minimum alcohol that was absorbed in the gut.

It does not reflect the:

1. Alcohol remaining in the
2. Alcohol already metabolized
3. Alcohol excreted in the urine and still in the bladder
4. Alcohol perspired
5. Alcohol exhaled

Alcoholism jointly leads to olfactory and memory source impairment and these two categories of deficits are associated. These results strongly support the proposition that olfactory and confabulation measures both index orbitofrontal functioning, and suggests that olfaction could become a reliable cognitive marker in psychiatric disorders.

Table 5: ICD classification (ICD 11 – Alcohol)

Y91 categories in ICD-10	Evidence of alcohol involvement determined by level of intoxication
Y91.0	Mild alcohol intoxication; Smell of alcohol on breath, slight behavioural disturbance in functions and responses, or slight difficulty in coordination
Y91.1	Moderate alcohol intoxication; Smell of alcohol on breath, moderate behavioral disturbance in functions and responses, or moderate difficulty in coordination
Y91.2	Severe alcohol intoxication; Severe disturbances in functions and responses, severe difficulty in coordination, or impaired ability to cooperate
Y91.3	Very severe alcohol intoxication; Very severe disturbance in functions and responses, very severe difficulty in coordination, or loss of ability to cooperate
Y91.4	Alcohol involvement, not otherwise specified;Suspected alcohol involvement

Effects of alcohol

Alcohol consumption can interfere with the function of all parts of the gastrointestinal tract. Acute alcohol ingestion induces changes in the motility of the esophagus and stomach that favor gastro-esophageal reflux and, probably, the development of reflux esophagitis.

Alcohol abuse may lead to damage of the gastric mucosa, including hemorrhagic lesions. Beverages with low alcohol content stimulate gastric acid secretion, whereas beverages with high alcohol content do not. In the small intestine, alcohol inhibits the absorption of numerous nutrients. The importance of these absorption disorders for the development of nutritional disturbances in alcoholics, however, is unclear. In alcoholics with other digestive disorders (e.g., advanced liver disease or impaired pancreatic function), impaired digestion likely is more significant. Acute alcohol consumption also damages the mucosa in the upper region of the small intestine and may even lead to the destruction of the tips of the villi.

Qualities of different types of liquors and uses

The Ashtang Hridaya has elaborated peculiarities of liquor prepared by various sources. The superiority though has been mentioned; the liquor prepared by respective components have specific qualities, which can be considered therapeutically important.

Table 6: Types of liquors

Name of liquor	Main Quality	Indication	Correlation
Sura	Snehani(unctuous)	Gulma, udara, arsha, grahani, lactating, diuretic	Tumor, ascitis, hemorrhoids, colitis, and digestive disorders
Varuni	Agile, sharp, hridya	Shool, kasa, vomiting, asthma, vibandha, adhmana, peenasa	Gastric erosions, cough, bloating, rhinitis
Baibhitaki	Agile, pathya	Wounds, anemia, skin diseases	-
Yava-sura	Guru, arid, vishtambhi	-	-
Mardwika	Sweet, Sara, lekhana, not to hot	Anemia, meha, worms	All types of urine disorders	-
Kharjura	Vatala, Guru	-	-
Sharkara	Sweet, hridya, agile	-	-
Gaudika	Tarpana, deepana	Diuresis, laxative	-
Seedhu	Stimulates vata, pitta	Obesity, anasarca, ascitis, hemorrhoids	-
Madhvasava	Chhedana	Meha, peenas, kasa	Urinary disorders, rhinitis, cough
Shuktam	Utkledi, hot, sharp, sour, palatable, laxative, cool on touch	Anemia, visual disorders, worms	-

Time needed to absorb and metabolize different amounts of alcohol

Factors such as food intake and its constituent profile, gender and age have been reported to influence the kinetics of alcohol absorption and metabolism.

It is widely accepted that the rate of alcohol absorption can be decreased by consuming food along with the alcoholic drink. The rate at which alcohol is absorbed depends on how quickly the stomach empties its contents into the intestine.

The higher the dietary fat content, the more time this emptying will require and the longer the process of absorption will take.

One study found that subjects who drank alcohol after a meal that included fat, protein, and carbohydrates, absorbed the alcohol about three times more slowly than when they consumed alcohol on an empty stomach. Need citation

Role of fructose and carbohydrates in alcohol absorption

Rogers et al, showed that carbohydrates significantly increased the rate of alcohol metabolism in fasting humans while protein and fat failed to show the same effect. In this context it is interesting to mention that for a long time (prior to controlled scientific interventions) a common nonscientific experience existed claiming that consumption of honey may shorten the period of alcohol intoxication (honey is an excellent rich source of nutritional fructose). The honey significantly increased blood alcohol disappearance and elimination rates by 32.4 and 28.6 percent, respectively, and reduced the intoxication time (that is, the time taken to attain zero blood alcohol level) and its degree (the peak blood alcohol level) by 30 and 4.4 percent.

Fructose, also known as “fruit Sugar”, is naturally-occurring, is characterized by “clean” non-lingering sweet taste. Fructose is highly soluble, and is characterized by a Relative Sweetening Value (RSV) of 1.1-1.7 (where sucrose = 1.0), depending on temperature and pH.

With regards to the possible mechanism by which fructose accelerates ethanol metabolism, a literature review indicates a possible shift in the metabolism of fructose in the presence of alcohol. This shift has been linked to the production in the liver of NAD+ which facilitates alcohol oxidation. Therefore, in the presence of alcohol, the metabolism of fructose in the liver is diverted from NAD+ to NADH requiring pathways, which in turn generates the NAD+ needed for alcohol oxidation.

Guidelines for treatment of Alcohol-use disorder

An alcohol use disorder is a highly prevalent and disabling condition. It is associated with high rates of medical and psychiatric comorbidity as well as early mortality. The psychiatric diagnoses, alcohol abuse and alcohol dependence has been labelled as alcohol use disorder, in DSM-5. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines "at risk" drinking (which suggests that the person is at risk for adverse consequences):

• Greater than 14 drinks per week or 4 drinks per occasion for healthy men under age 65.
• Greater than 7 drinks per week or 3 drinks per occasion for non-pregnant, healthy women under age 65 and healthy men over age 65.

A standard drink contains approximately 0.5 ounces (~30 ml) of alcohol as defined by Department of Health and Human Services and the United States Department of Agriculture. This corresponds to 12 fluid ounce of regular beer, 5 fluid ounce of wine, and 1.5 fluid ounce of 80-proof distilled spirit. Criteria for at-risk drinking may be modified by comorbidities, especially in the older population. Increased mortality risk has been demonstrated for older patients who are at-risk drinkers, as defined by the CARET (Comorbidity-Alcohol Risk Evaluation Tool). Any drinking can be considered “at-risk” for pregnant women, for those who take medications that interact with alcohol, or for those with a health condition that can be caused or exacerbated by alcohol (eg, hepatitis C)[15].

Principles of non-pharmacological treatment in Madatyayaya & Satvavajaya

In madatyayaya the effects of Madya usually have been observed at physical as well as psychological levels. To treat the ill-effects of alcohol physician has to address Psychological aspects on personal. Familial & social level by various settings of counseling with the patient. As per the concept of mind in Ayurveda, Rajas & Tamas are the Dosha, the pathologies related to the mind or psyche and the imbalances in these two doshas lead to simple psychological disorders to complex psychiatric diseases. Satva, on the other hand is the quality of mind, which if dominated, can control the two Raja & Tama. Therefore, Satvavajaya is one of the treatments for Madatyayaya; where controlling of Dharaneeya vega (Urges to be controlled) is recommended to achieve balance in Raja & Tamo guna; which eventually can achieve the balance of mind in Alcohol withdrawal phase.

Conventional aspects of non-pharmacological treatments

Short-term goals of treatment include:

• Encouraging abstinence or reduction of alcohol use
• Promoting participation in counseling programs and mutual help groups
• Increasing pleasant, sober activities
• Involving family, community, and employment resources, including Employee Assistance Programs

Long-term goals include:

• Restoration of self-esteem
• Resolution of alcohol-related social problems
• Improvement in physical health
• Lasting abstinence from alcohol use

Research studies suggest that a small but significant proportion of patients may be able to resume normal or controlled drinking. Controlled drinking is probably more likely for people with a mild disorder (or at-risk drinking) and not for a more severe disorder. Advocates for a “harm reduction” approach as an alternative to abstinence may acknowledge that abstinence is the best outcome, but that not every individual achieves this end, and that controlled drinking for some individuals is an achievable aim which reduces risk to patients.

Principles of pharmacological management in Madatyaya

The qualities of “Oja” are mentioned in this same chapter where the elaboration of madya has been done. The reasoning behind this if tried to understand with Tantrayukti suggests that since the Oja & Madya are opposite in qualities; the treatment of Madatyaya should be done on the guidelines of Ojo-vardhana.

The Madhura rasa among the six tastes has been identified as the one which enhances the Oja and maintains it, as described in Chapter 26th of Sutra sthana (Cha. Su. 26/42(1)). Charaka further in consecutive chapter 27th, mentioned all 12 classes of Dietary components where Madhura rasa dravyas of each class has been mentioned including the plant derived as well as animal derived products.

The medicinal plants of pharmacological importance with madhura rasa & vipaka shall be preferred for treatment of Madatyaya, as per the principle, where the treatment with Viruddha Guna has been advised.

Concept of Santarpana & Alcohol related Malnutrition

Alcohol, if consumed in excess, can cause malnutrition which can lead to nutritional disorders as well as organ damage. The initial phase nutritional imbalances particularly depletion can be very well controlled with the concept of Santarpana, as described by Charaka (Cha.Su. 23/31-38). Various pharmacological, dietary products have been discussed here along with use of liquor prepared from Grain for Santarpana. This principle later used in this chapter 24th, where in some cases treatment of Madatyayaya with Madya itself has been described.

Recent Researches

• In a study on 38 patients suffering from madatyaya,it is observed that Ashtanga lavana is effective followed by vamana (therapeutic emesis).