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अथात उन्मादचिकित्सितं व्याख्यास्यामः||१||
अथात उन्मादचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
athāta unmādacikitsitaṁ vyākhyāsyāmaḥ||1||
athāta unmādacikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||
iti ha smāha bhagavānātrēyaḥ||2||
Now (I) shall expound the chapter on the treatment of unmada. Thus said Lord Atreya. (1-2)
athAta unmAdacikitsitaM vyAkhyAsyAmaH||1||
iti ha smAha bhagavAnAtreyaH||2||
Now (I) shall expound the chapter on the treatment of ''unmada''. Thus said Lord Atreya. [1-2]
बुद्धिस्मृतिज्ञानतपोनिवासः पुनर्वसुः प्राणभृतां शरण्यः|
बुद्धिस्मृतिज्ञानतपोनिवासः पुनर्वसुः प्राणभृतां शरण्यः|
उन्मादहेत्वाकृतिभेषजानि कालेऽग्निवेशाय शशंस पृष्टः||३||
उन्मादहेत्वाकृतिभेषजानि कालेऽग्निवेशाय शशंस पृष्टः||३||
buddhismr̥tijñānatapōnivāsaḥ punarvasuḥ prāṇabhr̥tāṁ śaraṇyaḥ|
buddhismr̥tijñānatapōnivāsaḥ punarvasuḥ prāṇabhr̥tāṁ śaraṇyaḥ|
unmādahētvākr̥tibhēṣajāni kālē'gnivēśāya śaśaṁsa pr̥ṣṭaḥ||3||
unmādahētvākr̥tibhēṣajāni kālē'gnivēśāya śaśaṁsa pr̥ṣṭaḥ||3||
buddhismRutij~jAnataponivAsaH punarvasuH prANabhRutAM sharaNyaH|
buddhismRutij~jAnataponivAsaH punarvasuH prANabhRutAM sharaNyaH|
unmAdahetvAkRutibheShajAni kAle~agniveshAya shashaMsa pRuShTaH||3||
unmAdahetvAkRutibheShajAni kAle~agniveshAya shashaMsa pRuShTaH||3||
==== Causes of unmada ====
Punarvasu, the abode of intellect, memory, knowledge, penance and saviour of living beings, timely described the etiology, symptoms and treatment of ''unmada'' to Agnivesha as queried. [3]
==== Causes of ''unmada'' ====
विरुद्धदुष्टाशुचिभोजनानि प्रधर्षणं देवगुरुद्विजानाम्|
विरुद्धदुष्टाशुचिभोजनानि प्रधर्षणं देवगुरुद्विजानाम्|
उन्मादहेतुर्भयहर्षपूर्वो मनोऽभिघातो विषमाश्च चेष्टाः||४||
उन्मादहेतुर्भयहर्षपूर्वो मनोऽभिघातो विषमाश्च चेष्टाः||४||
viruddhaduṣṭāśucibhōjanāni pradharṣaṇaṁ dēvagurudvijānām|
viruddhaduṣṭāśucibhōjanāni pradharṣaṇaṁ dēvagurudvijānām|
unmādahēturbhayaharṣapūrvō manō'bhighātō viṣamāśca cēṣṭāḥ||4||
unmādahēturbhayaharṣapūrvō manō'bhighātō viṣamāśca cēṣṭāḥ||4||
viruddhaduShTAshucibhojanAni pradharShaNaM devagurudvijAnAm|
viruddhaduShTAshucibhojanAni pradharShaNaM devagurudvijAnAm|
unmAdaheturbhayaharShapUrvo mano~abhighAto viShamAshca ceShTAH||4||
unmAdaheturbhayaharShapUrvo mano~abhighAto viShamAshca ceShTAH||4||
Food with incompatible, contaminated & unclean properties; possession by spirits like gods, teachers and brahmanas; mental trauma due to recurrent exposure to fear or exhilaration and adopting difficult posture are the general causes of unmada. (4)
Food with incompatible, contaminated and unclean properties; possession by spirits like gods, teachers and ''brahmanas''; mental trauma due to recurrent exposure to fear or exhilaration and adopting difficult posture are the general causes of ''unmada''.[4]
==== Pathogenesis of unmada ====
==== Pathogenesis of ''unmada'' ====
तैरल्पसत्त्वस्य मलाः प्रदुष्टा बुद्धेर्निवासं हृदयं प्रदूष्य|
तैरल्पसत्त्वस्य मलाः प्रदुष्टा बुद्धेर्निवासं हृदयं प्रदूष्य|
srotAMsyadhiShThAya manovahAni pramohayantyAshu narasya cetaH||5||
srotAMsyadhiShThAya manovahAni pramohayantyAshu narasya cetaH||5||
By the above causative factors, the doshas get vitiated in the person posessing low level of sattva guna (weak minded people) in turn vitiate hridaya (mind), which is the seat of intellect. There from the channels carrying mental factors (mano- vaha srotasas), quickly delude the mind of the person. (5)
By the above causative factors, the ''doshas'' get vitiated in the person possessing low level of ''sattva guna'' (weak minded people) in turn vitiate ''hridaya'' (mind), which is the seat of intellect. There from the channels carrying mental factors (''mano-vaha srotasas''), quickly delude the mind of the person. [5]
==== Clinical features ====
==== Clinical features ====
धीविभ्रमः सत्त्वपरिप्लवश्च पर्याकुला दृष्टिरधीरता च|
धीविभ्रमः सत्त्वपरिप्लवश्च पर्याकुला दृष्टिरधीरता च|
अबद्धवाक्त्वं हृदयं च शून्यं सामान्यमुन्मादगदस्य लिङ्गम्||६||
अबद्धवाक्त्वं हृदयं च शून्यं सामान्यमुन्मादगदस्य लिङ्गम्||६||
स मूढचेता न सुखं न दुःखं नाचारधर्मौ कुत एव शान्तिम्|
स मूढचेता न सुखं न दुःखं नाचारधर्मौ कुत एव शान्तिम्|
विन्दत्यपास्तस्मृतिबुद्धिसञ्ज्ञो भ्रमत्ययं चेत इतस्ततश्च||७||
विन्दत्यपास्तस्मृतिबुद्धिसञ्ज्ञो भ्रमत्ययं चेत इतस्ततश्च||७||
dhīvibhramaḥ sattvapariplavaśca paryākulā dr̥ṣṭiradhīratā ca|
dhīvibhramaḥ sattvapariplavaśca paryākulā dr̥ṣṭiradhīratā ca|
abaddhavāktvaṁ hr̥dayaṁ ca śūnyaṁ sāmānyamunmādagadasya liṅgam||6||
abaddhavāktvaṁ hr̥dayaṁ ca śūnyaṁ sāmānyamunmādagadasya liṅgam||6||
sa mūḍhacētā na sukhaṁ na duḥkhaṁ nācāradharmau kuta ēva śāntim|
sa mūḍhacētā na sukhaṁ na duḥkhaṁ nācāradharmau kuta ēva śāntim|
vindatyapāstasmr̥tibuddhisañjñō bhramatyayaṁ cēta itastataśca||7||
vindatyapāstasmr̥tibuddhisañjñō bhramatyayaṁ cēta itastataśca||7||
dhIvibhramaH sattvapariplavashca paryAkulA dRuShTiradhIratA ca|
dhIvibhramaH sattvapariplavashca paryAkulA dRuShTiradhIratA ca|
abaddhavAktvaM hRudayaM ca shUnyaM sAmAnyamunmAdagadasya li~ggam||6||
abaddhavAktvaM hRudayaM ca shUnyaM sAmAnyamunmAdagadasya li~ggam||6||
sa mUDhacetA na sukhaM na duHkhaM nAcAradharmau kuta eva shAntim|
sa mUDhacetA na sukhaM na duHkhaM nAcAradharmau kuta eva shAntim|
vindatyapAstasmRutibuddhisa~jj~jo bhramatyayaM ceta itastatashca||7||
vindatyapAstasmRutibuddhisa~jj~jo bhramatyayaM ceta itastatashca||7||
Perverted intellect, psychic agitation, restlessness in eyes, impatience, incoherent speech and feeling of emptiness in hridaya (mind), these are the general features of unmada.
Perverted intellect, psychic agitation, restlessness in eyes, impatience, incoherent speech and feeling of emptiness in ''hridaya'' (mind), these are the general features of ''unmada''.
==== Types of unmada ====
Thus, the person with deranged mind does not know pleasures, pain, ethics and eternal duties and does not get peace anywhere. Therefore, he lets the mind wander here and there due to loss of memory, intellect and perceptions. [6-7]
==== Types of ''unmada'' ====
समुद्भ्रमं बुद्धिमनःस्मृतीनामुन्मादमागन्तुनिजोत्थमाहुः|
समुद्भ्रमं बुद्धिमनःस्मृतीनामुन्मादमागन्तुनिजोत्थमाहुः|
तस्योद्भवं पञ्चविधं पृथक् तु वक्ष्यामि लिङ्गानि चिकित्सितं च||८||
तस्योद्भवं पञ्चविधं पृथक् तु वक्ष्यामि लिङ्गानि चिकित्सितं च||८||
samudbhramaṁ buddhimanaḥsmr̥tīnāmunmādamāgantunijōtthamāhuḥ|
samudbhramaṁ buddhimanaḥsmr̥tīnāmunmādamāgantunijōtthamāhuḥ|
tasyōdbhavaṁ pañcavidhaṁ pr̥thak tu vakṣyāmi liṅgāni cikitsitaṁ ca||8||
tasyōdbhavaṁ pañcavidhaṁ pr̥thak tu vakṣyāmi liṅgāni cikitsitaṁ ca||8||
samudbhramaM buddhimanaHsmRutInAmunmAdamAgantunijotthamAhuH|
samudbhramaM buddhimanaHsmRutInAmunmAdamAgantunijotthamAhuH|
tasyodbhavaM pa~jcavidhaM pRuthak tu vakShyAmi li~ggAni cikitsitaM ca||8||
tasyodbhavaM pa~jcavidhaM pRuthak tu vakShyAmi li~ggAni cikitsitaM ca||8||
==== Vata dominant unmada ====
''Unmada'' refers to excessive affliction of intellect, mind and memory. This is of two types – ''nija'' (endogenous) and ''agantuja'' (exogenous). According to origin, it is of five types.(I) will describe their symptoms and treatment separately.[8]
==== ''Vata'' dominant ''unmada'' ====
रूक्षाल्पशीतान्नविरेकधातुक्षयोपवासैरनिलोऽतिवृद्धः|
रूक्षाल्पशीतान्नविरेकधातुक्षयोपवासैरनिलोऽतिवृद्धः|
चिन्तादिजुष्टं हृदयं प्रदूष्य बुद्धिं स्मृतिं चाप्युपहन्ति शीघ्रम्||९||
चिन्तादिजुष्टं हृदयं प्रदूष्य बुद्धिं स्मृतिं चाप्युपहन्ति शीघ्रम्||९||
अस्थानहासस्मितनृत्यगीतवागङ्गविक्षेपणरोदनानि|
अस्थानहासस्मितनृत्यगीतवागङ्गविक्षेपणरोदनानि|
पारुष्यकार्श्यारुणवर्णताश्च जीर्णे बलं चानिलजस्य रूपम्||१०||
पारुष्यकार्श्यारुणवर्णताश्च जीर्णे बलं चानिलजस्य रूपम्||१०||
rūkṣālpaśītānnavirēkadhātukṣayōpavāsairanilō'tivr̥ddhaḥ|
rūkṣālpaśītānnavirēkadhātukṣayōpavāsairanilō'tivr̥ddhaḥ|
cintādijuṣṭaṁ hr̥dayaṁ pradūṣya buddhiṁ smr̥tiṁ cāpyupahanti śīghram||9||
cintādijuṣṭaṁ hr̥dayaṁ pradūṣya buddhiṁ smr̥tiṁ cāpyupahanti śīghram||9||
asthānahāsasmitanr̥tyagītavāgaṅgavikṣēpaṇarōdanāni|
asthānahāsasmitanr̥tyagītavāgaṅgavikṣēpaṇarōdanāni|
pāruṣyakārśyāruṇavarṇatāśca jīrṇē balaṁ cānilajasya rūpam||10||
pāruṣyakārśyāruṇavarṇatāśca jīrṇē balaṁ cānilajasya rūpam||10||
rUkShAlpashItAnnavirekadhAtukShayopavAsairanilo~ativRuddhaH|
rUkShAlpashItAnnavirekadhAtukShayopavAsairanilo~ativRuddhaH|
cintAdijuShTaM [1] hRudayaM pradUShya buddhiM smRutiM cApyupahanti shIghram||9||
cintAdijuShTaM [1] hRudayaM pradUShya buddhiM smRutiM cApyupahanti shIghram||9||
asthAnahAsasmitanRutyagItavAga~ggavikShepaNarodanAni|
asthAnahAsasmitanRutyagItavAga~ggavikShepaNarodanAni|
pAruShyakArshyAruNavarNatAshca jIrNe balaM cAnilajasya rUpam||10||
pAruShyakArshyAruNavarNatAshca jIrNe balaM cAnilajasya rUpam||10||
Vayu gets aggravated by the intake of rough, deficient in quantity and cold in property food, excessive evacuation of doshas, depletion of body tissues and fasting. This aggravated vayu affects the hrudaya (site of mind), which is already afflicted with anxiety etc. and thus quickly deranges intellect and memory.
''Vayu'' gets aggravated by the intake of rough, deficient in quantity and cold in property food, excessive evacuation of ''doshas,'' depletion of body tissues and fasting. This aggravated ''vayu'' affects the ''hridaya'' (site of mind), which is already afflicted with anxiety etc. and thus quickly deranges intellect and memory.
Laughing, smiling, dancing, singing, speaking, abnormal movement of body parts, weeping at improper places & improper time, roughness, emaciation, reddish discolouration of body parts and aggravation of the disease after digestion of food; are the clinical features of the vata dominant unmada .(9-10)
Laughing, smiling, dancing, singing, speaking, abnormal movement of body parts, weeping at improper places and improper time, roughness, emaciation, reddish discoloration of body parts and aggravation of the disease after digestion of food; are the clinical features of the ''vata'' dominant ''unmada'' .[9-10]
==== Pitta dominant unmada ====
==== ''Pitta'' dominant ''unmada'' ====
अजीर्णकट्वम्लविदाह्यशीतैर्भोज्यैश्चितं पित्तमुदीर्णवेगम्|
अजीर्णकट्वम्लविदाह्यशीतैर्भोज्यैश्चितं पित्तमुदीर्णवेगम्|
उन्मादमत्युग्रमनात्मकस्य हृदि श्रितं पूर्ववदाशु कुर्यात्||११||
उन्मादमत्युग्रमनात्मकस्य हृदि श्रितं पूर्ववदाशु कुर्यात्||११||
अमर्षसंरम्भविनग्नभावाः सन्तर्जनातिद्रवणौष्ण्यरोषाः |
अमर्षसंरम्भविनग्नभावाः सन्तर्जनातिद्रवणौष्ण्यरोषाः |
प्रच्छायशीतान्नजलाभिलाषाः पीता च भाः पित्तकृतस्य लिङ्गम्||१२||
प्रच्छायशीतान्नजलाभिलाषाः पीता च भाः पित्तकृतस्य लिङ्गम्||१२||
ajīrṇakaṭvamlavidāhyaśītairbhōjyaiścitaṁ pittamudīrṇavēgam|
ajīrṇakaṭvamlavidāhyaśītairbhōjyaiścitaṁ pittamudīrṇavēgam|
unmādamatyugramanātmakasya hr̥di śritaṁ pūrvavadāśu kuryāt||11||
unmādamatyugramanātmakasya hr̥di śritaṁ pūrvavadāśu kuryāt||11||
amarṣasaṁrambhavinagnabhāvāḥ santarjanātidravaṇauṣṇyarōṣāḥ |
amarṣasaṁrambhavinagnabhāvāḥ santarjanātidravaṇauṣṇyarōṣāḥ |
pracchāyaśītānnajalābhilāṣāḥ pītā ca bhāḥ pittakr̥tasya liṅgam||12||
pracchāyaśītānnajalābhilāṣāḥ pītā ca bhāḥ pittakr̥tasya liṅgam||12||
ajIrNakaTvamlavidAhyashItairbhojyaishcitaM pittamudIrNavegam|
ajIrNakaTvamlavidAhyashItairbhojyaishcitaM pittamudIrNavegam|
unmAdamatyugramanAtmakasya hRudi shritaM pUrvavadAshu kuryAt||11||
unmAdamatyugramanAtmakasya hRudi shritaM pUrvavadAshu kuryAt||11||
amarShasaMrambhavinagnabhAvAH santarjanAtidravaNauShNyaroShAH |
amarShasaMrambhavinagnabhAvAH santarjanAtidravaNauShNyaroShAH |
pracchAyashItAnnajalAbhilAShAH pItA ca bhAH pittakRutasya li~ggam||12||
pracchAyashItAnnajalAbhilAShAH pItA ca bhAH pittakRutasya li~ggam||12||
Intolerance, agitation, nakedness, terrorizing, excessive movements, (running), heat, wrath (anger), yellowish luster and desire for dense shady places, cold food - are the clinical features of pitta dominant unmada. (11-12)
The already accumulated ''pitta'' gets aggravated due to indigestion, by the intake of pungent, sour food, those articles causing burning sensation, and hot in potency. It takes shelter in the ''hridaya'' (site of mind) in the person without self restraint and thus suddenly gives rise to severe episode of ''unmada'' as per the above mentioned pathogenesis.
Intolerance, agitation, nakedness, terrorizing, excessive movements, (running), heat, wrath (anger), yellowish luster and desire for dense shady places, cold food - are the clinical features of pitta dominant ''unmada''. [11-12]
==== Kapha dominant unmada ====
==== ''Kapha'' dominant ''unmada'' ====
सम्पूरणैर्मन्दविचेष्टितस्य सोष्मा कफो मर्मणि सम्प्रवृद्धः|
सम्पूरणैर्मन्दविचेष्टितस्य सोष्मा कफो मर्मणि सम्प्रवृद्धः|
बुद्धिं स्मृतिं चाप्युपहत्य चित्तं प्रमोहयन् सञ्जनयेद्विकारम्||१३||
बुद्धिं स्मृतिं चाप्युपहत्य चित्तं प्रमोहयन् सञ्जनयेद्विकारम्||१३||
वाक्चेष्टितं मन्दमरोचकश्च नारीविविक्तप्रियताऽतिनिद्रा|
वाक्चेष्टितं मन्दमरोचकश्च नारीविविक्तप्रियताऽतिनिद्रा|
छर्दिश्च लाला च बलं च भुङ्क्ते नखादिशौक्ल्यं च कफात्मकस्य||१४||
छर्दिश्च लाला च बलं च भुङ्क्ते नखादिशौक्ल्यं च कफात्मकस्य||१४||
sampūraṇairmandavicēṣṭitasya sōṣmā kaphō marmaṇi sampravr̥ddhaḥ|
sampūraṇairmandavicēṣṭitasya sōṣmā kaphō marmaṇi sampravr̥ddhaḥ|
buddhiṁ smr̥tiṁ cāpyupahatya cittaṁ pramōhayan sañjanayēdvikāram||13||
buddhiṁ smr̥tiṁ cāpyupahatya cittaṁ pramōhayan sañjanayēdvikāram||13||
vākcēṣṭitaṁ mandamarōcakaśca nārīviviktapriyatā'tinidrā|
vākcēṣṭitaṁ mandamarōcakaśca nārīviviktapriyatā'tinidrā|
chardiśca lālā ca balaṁ ca bhuṅktē nakhādiśauklyaṁ ca kaphātmakasya||14||
chardiśca lālā ca balaṁ ca bhuṅktē nakhādiśauklyaṁ ca kaphātmakasya||14||
sampUraNairmandaviceShTitasya soShmA kapho marmaNi sampravRuddhaH|
sampUraNairmandaviceShTitasya soShmA kapho marmaNi sampravRuddhaH|
buddhiM smRutiM cApyupahatya cittaM pramohayan sa~jjanayedvikAram||13||
buddhiM smRutiM cApyupahatya cittaM pramohayan sa~jjanayedvikAram||13||
vAkceShTitaM mandamarocakashca nArIviviktapriyatA~atinidrA|
vAkceShTitaM mandamarocakashca nArIviviktapriyatA~atinidrA|
chardishca lAlA ca balaM ca bhu~gkte nakhAdishauklyaM ca kaphAtmakasya||14||
chardishca lAlA ca balaM ca bhu~gkte nakhAdishauklyaM ca kaphAtmakasya||14||
==== Sannipata unmada (due to vitiation of all doshas) ====
In the persons taking excessive food and doing slow activities (having sedentary habits), ''kapha'' along with heat (''pitta'') increases in their vital organ (''hridaya''), impairing intellect and memory and thereby deranging their mind produces insanity.
Slow speech and movements, anorexia, and liking for women and loneliness, excessive sleep, vomiting, salivation, aggravation of the disease after taking meals and whiteness of nails etc.– these are the clinical features of the ''kapha'' dominant ''unmada''. [13-14]
==== ''Sannipata unmada'' (due to vitiation of all ''doshas'') ====
यः सन्निपातप्रभवोऽतिघोरः सर्वैः समस्तैः स च हेतुभिः स्यात्|
यः सन्निपातप्रभवोऽतिघोरः सर्वैः समस्तैः स च हेतुभिः स्यात्|