Changes

Thus, ends the eighth chapter on the ‘diagnosis of ''apasmara''” of the section “Diagnosis of diseases” ([[Nidana Sthana]]) of Agnivesha , as redacted by Charaka.

Thus, ends the eighth chapter on the ‘diagnosis of ''apasmara''” of the section “Diagnosis of diseases” ([[Nidana Sthana]]) of Agnivesha , as redacted by Charaka.

=== Tattva Vimarsha ===

=== ''Tattva Vimarsha'' ===

   

   

• Apasmara is a disease due to vitiation of three sharira doshas and two manas doshas.  

*''Apasmara'' is a disease due to vitiation of three ''sharira doshas'' and two ''manas doshas''.  

• The causative factors of apasmara mainly include consuming unhygenic, impure, decomposed food and encountering inauspicious things that are not compatible with one’s sensibilities.  

*The causative factors of ''apasmara'' mainly include consuming unhygienic, impure, decomposed food and encountering inauspicious things that are not compatible with one’s sensibilities.  

• Diet is important for sustaining physical and psychological health. Improper dietary habits can lead to various psychosomatic disorders associated with apasmara.

*Diet is important for sustaining physical and psychological health. Improper dietary habits can lead to various psychosomatic disorders associated with ''apasmara''.

• Apasmara originates from the heart, which is the center of consciousness and emotions per Vedic texts. The clinical presentation includes impaired heart-brain coordination leading to transient loss of memory, erratic movements, and blackouts. Analysis of the heart-brain connection is very important in the pathology of apasmara.  

*''Apasmara'' originates from the heart, which is the center of consciousness and emotions per Vedic texts. The clinical presentation includes impaired heart-brain coordination leading to transient loss of memory, erratic movements, and blackouts. Analysis of the heart-brain connection is very important in the pathology of ''apasmara''.  

• Psychological stressors like excessive passion, anger, fear, greed, attachment, excitement, grief, anxiety, worry, perturbation etc. precipitate episodes of apasmara in a person afflicted with excessively aggravated dosha.

*''Psychological'' stressors like excessive passion, anger, fear, greed, attachment, excitement, grief, anxiety, worry, perturbation etc. precipitate episodes of ''apasmara'' in a person afflicted with excessively aggravated ''dosha''.

• Apasmara, depending upon the predominant dosha, can be diagnosed on the basis of frequency of episodes, duration of loss of consciousness, pattern of abnormal movments, and types of objects perceived (in aura phase) prior to the occurrence of an actual episode.  

*''Apasmara'', depending upon the predominant ''dosha'', can be diagnosed on the basis of frequency of episodes, duration of loss of consciousness, pattern of abnormal movements, and types of objects perceived (in aura phase) prior to the occurrence of an actual episode.  

• Purification therapies using strong medicines, observing a healthy diet and lifestyle are considered the primary forms of treatment of apasmara. Non-pharmacological measures like mantra (holy chants) and sattvavajaya chikitsa (mind training for restraint,  such as cognitive behavior therapy) aid in the treatment of apasmara.  

*Purification therapies using strong medicines, observing a healthy diet and lifestyle are considered the primary forms of treatment of ''apasmara''. Non-pharmacological measures like ''mantra'' (holy chants) and ''sattvavajaya chikitsa'' (mind training for restraint,  such as cognitive behavior therapy) aid in the treatment of ''apasmara''.  

• One disease can cause other disease, therefore it is important to track the history of ailments to prescribe the most effective course (or courses) of treatment.   

*One disease can cause other disease, therefore it is important to track the history of ailments to prescribe the most effective course (or courses) of treatment.   

• There can be one causative factor for many diseases or multiple causative factors for single disease.  

*There can be one causative factor for many diseases or multiple causative factors for single disease.  

• Similarly one symptom can be common in many diseases and one symptom can be seen in a single disease alone.  

*Similarly one symptom can be common in many diseases and one symptom can be seen in a single disease alone.  

• There could be a single treatment for many diseases or many treatments for a single disease.  

*There could be a single treatment for many diseases or many treatments for a single disease.  

• The duration of treatment depends upon prognosis of the disease. A disease at the onset may be curable but if not treated, could worsen into a palliable or incurable variant.   

*The duration of treatment depends upon prognosis of the disease. A disease at the onset may be curable but if not treated, could worsen into a palliable or incurable variant.   

• The subtle changes in dosha, and the three states of a disease (aggravated, normal, or diminished) should be carefully observed along with proper assessment of body strength, digestive power and mental ability .  

*The subtle changes in ''dosha'', and the three states of a disease (aggravated, normal, or diminished) should be carefully observed along with proper assessment of body strength, digestive power and mental ability .  

• The doshas that spread obliquely (in the transverse direction) afflict patient for a longer time. These doshas should be managed first, or they should be carefully drawn to koshtha (bowel) by proper measures. After analyzing them in koshtha, the physician should eliminate them through the nearest route.

*The ''doshas'' that spread obliquely (in the transverse direction) afflict patient for a longer time. These ''doshas'' should be managed first, or they should be carefully drawn to ''koshtha'' (bowel) by proper measures. After analyzing them in ''koshtha'', the physician should eliminate them through the nearest route.

=== Vidhi Vimarsha ===

=== Vidhi Vimarsha ===