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===== ''Skanda graha'' and ''Skandapasmara'' =====

===== ''Skanda graha'' and ''Skandapasmara'' =====

Per [https://en.wikipedia.org/wiki/Ayurveda Ayurveda], children get afflicted by ''apasmara'' due to the effects of any of ''grahas'' (Sanskrit, means seizing) such as ''skandapasmara'' (due to the effects of ''graha''.), ''skanda'', etc. knowledge of features of nine evil spirits which seize children is described, ''skanda'' and ''skandapasmara'' are the first two evil spirits which when affect a child, the clinical presentation is similar to that of epilepsy as narrated below.  

Per [https://en.wikipedia.org/wiki/Ayurveda Ayurveda], children get afflicted by ''apasmara'' due to the effects of any of ''grahas'' (Sanskrit, means seizing) such as ''skandapasmara'' (due to the effects of ''graha''<ref> Sushruta, ‘Sushruta Samhita’, edited by Vaidya Jadavaji Trikamaji Acharya and Sharma PV, Eighth edition, Chaukhamba Orientalia, Varanasi; 2005 Uttara tantra 27/ 8-9.pg.659 </ref>  <ref>Vagbhata, Ashtanga Hridayam, with the commentaries, ‘Sarvangasundara’ of Arunadatta and ‘Ayurvedarasayana’ of Hemadri collated by Dr.Anna Moreshvara Kunte, and Krishna Ramachandra  Shastri Navre, edited by Pt. Harishastri Paradakar Vaidya, Krishanadas Academy, Varanasi. Reprint 2000.3/6-11.pg.786-7  </ref>.), ''skanda'', etc. knowledge of features of nine evil spirits which seize children is described, ''skanda'' and ''skandapasmara'' are the first two evil spirits which when affect a child, the clinical presentation is similar to that of epilepsy as narrated below.  

A child seized by ''skanda graha'' has swelling of the eyes, smells like blood, has aversion to the breasts, distorted face, and eyelids or one eye having either loss of movement or more movements. The child could also be restless or irritable, have closed eyes, cry very little, hold its fists tight, and have hard bowel movement.  

A child seized by ''skanda graha'' has swelling of the eyes, smells like blood, has aversion to the breasts, distorted face, and eyelids or one eye having either loss of movement or more movements. The child could also be restless or irritable, have closed eyes, cry very little, hold its fists tight, and have hard bowel movement.  

When the child is seized by ''skandapasmara'', it loses and regains consciousness, is irritable, makes dancing like movements with arms and legs, eliminates stools and passes urine accompanied with sound (crying), yawns more and emits froth from the mouth. These are the features of a child seized by the “friend of skanda graham”, i.e., ''skandapasmara''.

When the child is seized by ''skandapasmara'', it loses and regains consciousness, is irritable, makes dancing like movements with arms and legs, eliminates stools and passes urine accompanied with sound (crying), yawns more and emits froth from the mouth. These are the features of a child seized by the “friend of skanda graham”, i.e., ''skandapasmara''.

Similar to this, Vagbhata in Ashtanga Hridayam, has described the variants of the disease caused due to demons/evil spirits possessing the children. The cardinal signs of ''graha'' possession (or affliction) include continuous fever and crying. The general features are fear, too much yawning, movement of eyebrows, timidity, discharge of froth from mouth, upward gaze, biting of lips and teeth (grinding), wakefulness (absence of sleep), crying, moaning, aversion for the breast, change of voice, and scratching its own body or that of the mother by nails without any reason.

Similar to this, Vagbhata in Ashtanga Hridayam, has described the variants of the disease caused due to demons/evil spirits possessing the children. The cardinal signs of ''graha'' possession (or affliction) include continuous fever and crying. The general features are fear, too much yawning, movement of eyebrows, timidity, discharge of froth from mouth, upward gaze, biting of lips and teeth (grinding), wakefulness (absence of sleep), crying, moaning, aversion for the breast, change of voice, and scratching its own body or that of the mother by nails without any reason.<ref> Ibid Ashtanga Hrudayam Uttar Sthana.3/3-5. pp.786 </ref>

In conventional medicine, epilepsy in children is described in detail. However, the etiology of some variants of epilepsy is mentioned to be idiopathic. As described in context of ''skanda'' and ''skandapasmara'', the involvement of supernatural powers in causing ''apasmara'' is a matter of debate and falls in the purview of theology. Considering its importance and prevalence, ''apasmara'' of unknown etiology can be categorized as of the fifth type i.e. ''agantu apasmara''. Sushruta and his commentator Dallhana support this view that any variant of the disease which occurs without any reason, acutely and without any rational pathology shall be considered as ''agantu''. Per Charaka [Chikitsa 10/53], the etiopathology, clinical features and management of this fifth type are on the lines of ''agantu unmada''. As commented by Chakrapani, in case of ''agantu'' or ''bhutapasmara'', the etiology of being seized by some external factors is considered primary and the involvement (''anubabdha'') of ''dosha'' as secondary. It is important to note here that since clinical patho-physiology cannot take place without the involvement of ''doshas'', therefore ''agantu'' should technically be considered as one of the four doshic variants of ''apasmara'' mentioned earlier, in order to follow the ''sankhya niyam''a i.e. rules of numeral classification.  

In conventional medicine, epilepsy in children is described in detail. However, the etiology of some variants of epilepsy is mentioned to be idiopathic. As described in context of ''skanda'' and ''skandapasmara'', the involvement of supernatural powers in causing ''apasmara'' is a matter of debate and falls in the purview of theology. Considering its importance and prevalence, ''apasmara'' of unknown etiology can be categorized as of the fifth type i.e. ''agantu apasmara''. Sushruta and his commentator Dallhana support this view that any variant of the disease which occurs without any reason, acutely and without any rational pathology shall be considered as ''agantu''. Per Charaka [Chikitsa 10/53], the etiopathology, clinical features and management of this fifth type are on the lines of ''agantu unmada''. As commented by Chakrapani, in case of ''agantu'' or ''bhutapasmara'', the etiology of being seized by some external factors is considered primary and the involvement (''anubabdha'') of ''dosha'' as secondary. It is important to note here that since clinical patho-physiology cannot take place without the involvement of ''doshas'', therefore ''agantu'' should technically be considered as one of the four doshic variants of ''apasmara'' mentioned earlier, in order to follow the ''sankhya niyam''a i.e. rules of numeral classification.

==== Premonitory signs of ''apasmara'' ====

==== Premonitory signs of ''apasmara'' ====