Charak Samhita

Stambhana

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The word ‘stambhana’ literally means to stop or to stiffen, making it rigid or immovable. It denotes the actions of blocking, arresting, checking, restraining etc.[1] It is one of six important therapies. [Cha.Sa.Sutra Sthana 22/04] This therapy is indicated to stop excess discharges of body fluids.

Contributors
Section/Chapter/topic Chikitsa / Stambhana
Authors Aneesh E.G., Deole Yogesh S.
Reviewed and Edited by Basisht G.
Affiliations Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India,
Correspondence email: carakasamhita@gmail.com
Date of first publication: April 30, 2021
DOI Awaited

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 inhibits or stops mobile, flowing body constituents and stabilizes them is called ‘stambhana’. [Cha.Sa.Sutra Sthana 22/12]

Synonyms

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

Contextual meanings

The term ‘stambhana’denotes the following meanings in different contexts:

  • To check the bleeding e.g.raktastambhana (styptic/hemostatic)
  • To restrict the flow of stools (constipating) e.g.malavashtambha (constipation)
  • Stiffness/restrictions in movement of a particular body part e.g.urustambha (stiffness of thigh)

Stambhana therapy

The therapy is done by use of food or medicines having sweet, bitter, and astringent tastes. Those with liquid, thin, stable and cold properties are also applied in stambhana therapy.[Cha.Sa.Sutra Sthana 22/32]

Properties

The substance having cooling effect, slow acting, softness, smoothness, dryness, minuteness (subtleness), liquid state, stability and lightness qualities can produce stambhana effect. [Cha.Sa.Sutra Sthana 22/17]

Dryness (ruksha guna), cold potency (shita virya), astringent taste (kashayaa rasa) and light in digestion (laghu paka) are essential properties for stambhana effect. [Sha.Purvakhanada 04/12][3]

  • Taste (rasa): Astringent (kashaya) [Cha.Sa.Sutra Sthana 26/43], sweet (madhura), bitter (tikta) [Cha.Sa.Sutra Sthana 22/32]

Food and medicines

  • Water is the best for stambhana effect [Cha.Sa.Sutra Sthana 25/40]
  • Alkali [Su.Sa.Sutra Sthana 11/5][4]
  • Lodhradigana [Su.Sa.Sutra Sthana 38/15][4]
  • Kutaja (Holarrhena pubescens)[Sha.Purvakhanda 04/12][3]
  • Shyonaka (Oroxylum indicum)[Sha.Purvakhanda 04/12][3]

Indications

  • Persons afflicted with corrosive actions of pittadosha, alkali and fire
  • Vomiting and diarrhea
  • Poisoning
  • Complications of excessive sudation (swedana)[Cha.Sa.Sutra Sthana 22/33]
  • Weak individuals [A.S.Chikitsa Sthana 10/26][5]

Assessment of therapy

Clinical features of optimum stambhana

The optimal effect of stambhana is assessed based on clinical observations as below:

  • Pacification of diseases like vomiting, diarrhea etc.
  • Regaining strength and normal state of body tissues [Cha.Sa.Sutra Sthana 22/39]

Clinical features of excessive stambhana

Following are clinical features of excessive administration of stambhana:

  • Blackish discoloration
  • Stiffness of body parts including jaw
  • Congestion in chest or bradycardia
  • Feeling of uneasiness
  • Constipation [Cha.Sa.Sutra Sthana 22/40]

The stambhana therapy is stopped immediately after observing above untoward effects.

Importance of Stambhana

Stambhana acts as a regulator or controller of various processes and activities. It increases kaphadosha and pacifies vata and pitta dosha. It is indicated in the treatment of disorders due to excess mobility of vatadosha for stability. It soothes the excess heat or acute effects of pitta dosha. Moreover, the astringent and dryness help to bind the tissues.

Stambhana is a type of expressed nasal medication (avapida nasya). [Cha.Sa.Siddhi Sthana 9/90] It is one of the sixty types of treatment (shastiupakrama) mentioned for the wound. [Su.Sa.Chikitsa Sthana 1/48][4] It is one of the ten types of topical applications (alepa). [A.S. Uttara Sthana 30/08][5]

Importance in management of disease

Whenever there is an excessive discharge of body fluids, stambhana is the prime treatment.

Management of acute conditions

  • Excessive bleeding from a wound
  • Bleeding hemorrhoids with pitta dosha dominance and in summer season [Cha.Sa.Chikitsa Sthana 14/184]
  • Vomiting or diarrhea or bleeding in weak persons.

Management of chronic conditions

  • In chronic diarrhea without the presence of ama (undigested food or metabolic wastes) [Su.Sa.Uttara sthana 40/68][4]
  • In chronic vomiting, depleted state of body tissues [Cha.Sa.Chikitsa Sthana 20/46]

Management of iatrogenic complications

  • If there is depletion of patient strength after excessive administration of therapeutic vomiting, purgation, sudation [A.S. Sutra Sthana 26/19][5] and bloodletting, stambhana is the treatment of choice.

Contemporary views and current researches

The medicines that stop, block, or inhibit any biological activities can be viewed from the stambhana effect perspective. Thus, the medicines given as anti-diarrheal, anti-emetics, styptic medicines can be included in the stambhana category. The mechanism of action involves blocking the respective receptor at the site and reducing the motility. The coagulating factors or agents can also be included. The stambhana medicines may cause vasoconstriction due to astringent and cold properties. The delayed or extended medicine response can be related to the slow-acting (manda) and stable (sthira) properties of stambhana medicine.

Antidiarrheal action

The anti-diarrheal activity is achieved either by altering the intestinal motility or by increasing the absorption of fluid by the intestinal mucosa.[6] Change in motor function and reduced intestinal motility results in 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]

Bleeding disorders

Various methods are used to check bleeding. Application of cold (skandana) and cautery (dahana) arrests 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 the 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.

Other disorders:

The stambhana therapy is used in acid peptic disorders, ulcers, esophageal varices, menorrhagia, diabetes insipidus, urethral bleeding, hematemesis, per rectal bleeding. Stambhana activity of Terminalia arjuna is used to treat cardio-vascular disorders hypertension and tachycardia. The stable property of Bacopa helps to reduce excessive thoughts and calm mind. Thus, stambhana therapy is applied to treat psychiatric disorders caused due to excess mental activities like anxiety, insomnia.

The exact mechanism of action of various stambhana drugs need to be studied. More research works are required to explore the beneficial effects of stambhana therapy.

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 Shukragatavata w.s.r premature ejaculation and its management by stambanakarak yoga. Department of Kayachikitsa. IPGT&RA Jamnagar.

More information

Langhanabrimhaniya Adhyaya

Abbreviations

Cha. = Charak, Su. = Sushruta, A. = Ashtanga, S. = Sangraha, Hr. = Hridayam, Sha = Sharangadara, Sa. = Samhita.

List of references

The list of references for stambhana in Charak Samhita can be seen here

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 Sharangadhara. Sharangadhara Samhita. Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Chaukhambha orientalia;2016.
  4. ↑ 4.0 4.1 4.2 4.3 Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.
  5. ↑ 5.0 5.1 5.2 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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