Charak Samhita

Stambhana

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The word stambhana literally means stiffening, making rigid or immovable. It also represents stopping, arresting, checking, restraining etc.[1] In Ayurveda stambhana denotes a symptom and as a treatment method also. This article deals with stambhana as a treatment.

Etymology and derivation

Stambhana is derived from the root word ‘stambha’ by adding ‘lyut’ suffix, which means ‘to make stiff’ or ‘to stop’. [Vachaspatyam]

Definition

The therapy which causes inhibition of mobility, flow of bodily substances and stabilizes is called stambhana. [Cha.Sa.Sutra Sthana 22/12]

Synonyms

Stambhana, upastambhana, grahi [Arunadatta on A.Hr Sutrasthana 27/48][2]

Contextual meanings

The term stambhana represents the following meanings in different contexts

  • To restrict the flow of blood (styptic/haemostatic)
  • To restrict the flow of stools (constipating)
  • Stiffness/restrictions in movement of a particular body part

Methods to arrest bleeding

4 procedures are mentioned to arrest the excessive bleeding.

  1. Sandana
  2. Skandana
  3. Pachana
  4. Dahana

Sandana: By using decoctions which have predominance of astringent taste

Skandana: By the application of cold

Pachana: By powdering over the bleeding site

Dahana: By constricting the blood vessel through cauterization [Su.Sa.Sutra Sthana 14/39-40][3]

Methods for stambhana

  • Use of substances having sweet, bitter and astringent tastes
  • Use of drugs with liquid, thin, stable and cold properties.[Cha.Sa.Sutra Sthana 22/32]

Properties of stambhana drugs

The drugs which possess cold, sluggish, soft, smooth, dry, minute (subtle), liquid, stable and light qualities can produce stambhana. [Cha.Sa.Sutra Sthana 22/17]

The drug which increases the vata dosha due to its dry property (ruksha), cold potency (shita virya), astringent taste (kashaya rasa) and light in digestion (laghu paka) is called stambhana drug. [Sha.Pu.04/12][4]

The taste (rasa) with stambhana property : Astringent (kashaya) [Cha.Sa.Sutra Sthana 26/43]

Stambhana action is attributed to these drugs

  • The best stambhana material is water. [Cha.Sa.Sutra Sthana 25/40]
  • Alkali [Su.Sa.Sutra Sthana 11/5][3]
  • Symplocos racemosa (lodra), savaralodra, Butea monosperma (palasa), Cyperus rotundus (kutanata), Saraca asoca (ashoka), Rotheca serrata (bargi), Gmelina arborea (katphala), Prunus avium (elavaluka), Boswellia serrata (shallaki),Lannea coromandelica (jingini), Neolmarckia cadamba (kadambha), Shorea robusta (sala), Musa paradisiaca (kadali) (Lodradigana) [Su.Sa.Sutra Sthana 38/15][3]
  • Holarrhena pubescens(kutaja)[Sha.Pu.04/12][4]
  • Oroxylum indicum (shyonaka)[Sha.Pu.04/12][4]

Indications

  • Patients afflicted with pitta, alkali and fire
  • Those who are afflicted with vomiting and diarrhea
  • Those who are afflicted with poison
  • During excessive fomentation.[Cha.Sa.Sutra Sthana 22/33]
  • If the patient is having less strength [A.S Chikitsa Sthana 10/26][5]

Signs and symptoms of optimum stambhana

By proper stambhana therapy the diseases like excessive vomiting, diarrhea etc gets cured and patient regains the strength of the body. [Cha.Sa.Sutra Sthana 22/39]

Signs and symptoms of excessive administration of stambhana

Excessive administration of stambhana may lead to the appearance of blackish discoloration, stiffness of body parts including jaw, catching type of pain in cardiac region, feeling of uneasiness and constipation.[Cha.Sa.Sutra Sthana 22/40]

Importance of Stambhana

Stambhana as different treatment modalities

Stambhana is one among the major six therapies in Ayurveda.[Cha.Sa.Sutra Sthana 22/04]

It is a type of expressed nasal medication (avapida nasya). [Cha.Sa.Siddhi Sthana 9/90]

It is one among the sixty types of treatment (shasti upakrama) mentioned for the wound. [Su.Sa.Chikitsa Sthana 1/48]

It is one among the ten types of topical applications (alepa). [A.S. Uttara Sthana 30/08]

Importance in management of disease

Whenever there is excessive expulsion of body fluids stambhana can be used mainly in the following conditions

As an emergency management:

  • If there is excessive bleeding from a wound it should be arrested immediately.
  • Bleeding due to hemorrhoids with pitta dosha in summer season should be arrested immediately. [Cha.Sa.Chikitsa Sthana 14/184]
  • If vomiting or diarrhea happens to an extremely weak person then also irrespective of stage of disease stambhana should be done to protect that person.

As final line of treatment:

  • If the evacuation of fecal matter happens without the association of toxic waste materials (ama), stambhana can be adopted as treatment. [Su.Sa.Uttara sthana 40/68][3]
  • In chronic vomiting stambhana medications should be used [Cha.Sa.Chikitsa Sthana 20/46] otherwise it may results in depletion of body tissues (dhatu) and may leads to the increase of vata dosha.

As a measure to manage complications arising out of other treatments:

  • In excessive vomiting, purgation, sudation [A.S. Sutra Sthana 26/19] and bloodletting stambhana is the treatment of choice.

Current researches

Even though stambhana is the term used commonly for the treatment of diarrhea (atisara), vomiting (chchardi), bleeding, hyperhydrosis etc. the mode of action is different in each pathological condition. Since in every above mentioned condition the treatment principle is to stop the excessive flow of fluid, stambhana is considered as a treatment of choice.

The anti-diarrheal activity can be achieved either by altering the motor function of the intestine or by increasing the absorption of fluid by the intestinal mucosa.[6] Change in motor function of intestine results in increased capacitance of the gut and delay in passage of fluid through the intestine.[7] Decoction prepared out of Guava leaves is reported to be effective in treating infectious diarrhea. The anti infective and anti virulent activity along with gut microflora modulation capability might be the cause for anti diarrheal action.[8]

Among the four methods mentioned for treating the bleeding, application of cold (skandana) and cautery (dahana) may arrest the bleeding by constriction of the blood vessels by cold and heat stimulus respectively. Gelatin is a hemostatic agent which can be used in various forms including powder form. It is believed to act as a physical inhibitor than chemically.[9] This type of physical barrier action might be provided through the application of topical powders as in case of pachana.

The mode of action of various stambhana drugs are still unknown. More research works are needed to explore the concept of stambhana.

List of theses done

  1. Gunsai Kishangiri Kirtigiri (2017): An experimental evaluation of medohara (Hypolipidemic) and raktapratiskandana (Anticoagulant) activity of Kusha (Desmostachya Bipinnata Stapf.) and Darbha (Imperata Cylindrica Beauv.). Department of Dravyaguna Vigyan. IPGT&RA Jamnagar
  2. Prasad Kulkarni (2012): A clinical study on Shukragata vata w.s.r premature ejaculation and its management by stambanakarak yoga. Department of Kayachikitsa. IPGT&RA Jamnagar.

More information

Langhanabrimhaniya Adhyaya

References

  1. ↑ Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Stambhana, Page 1258.
  2. ↑ Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.
  3. ↑ 3.0 3.1 3.2 3.3 Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.
  4. ↑ 4.0 4.1 4.2 Sharangadhara. Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.
  5. ↑ Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.
  6. ↑ Lawrence r. Schiller, Carol a. Santa Ana et al. Mechanism of the Antidiarrheal Effect of Loperamide, GASTROENTEROLOGY 1984;86;1475-80 Available from https://www.gastrojournal.org/article/S0016-5085(84)80161-4/pdf
  7. ↑ Schiller LR, Santa Ana CA, Morawski SG, Fordtran JS. Mechanism of the antidiarrheal effect of loperamide. Gastroenterology. 1984;86(6):1475-1480
  8. ↑ Tannaz Bardi, G. Geetha K et al. A randomized open label efficacy clinical trial of guava leaf decoction in patients with acute infectious diarrhoea. Journal of Ayurveda and Integrative Medicine 11 (2020) 163e172
  9. ↑ Pereira BM, Bortoto JB, Fraga GP. Topical hemostatic agents in surgery: review and prospects. Agentes hemostáticos tópicos em cirurgia: revisão e perspectivas. Rev Col Bras Cir. 2018;45(5):e1900. Published 2018 Oct 18. doi:10.1590/0100-6991e-20181900
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