In as much as (in this disease) the deranged bodily Doshas traversing the upper part of the body affect the up-coursing nerves and produce thereby a distracting state of the mind, it is called Unma'da (Insanity), and it is a disease of the Manas (mind). 2.
This disease is divided into five different types according to the nature of their origin - viz., the three types due to the several actions of the three deranged and aggravated Doshas, the one due to their concerted actions and the one due to grief, etc. (real or imagitnry). There is a sixth kind also, viz., that due to the effects of poison, which should be treated according to the nature and intensity of the deranged Dosha or Doshas lying at the root and which in its early stage, if not abnormally aggravated, goes by the name of Mada. 3.
Fits of un consciousness, agitated state of the mind, ringing of the ears, emaciation of the body, excessive energy of action aversion to food, eating filthy things in dreams, perturbation i.e palpitation (of the heart) due to Vayu and vertigo or giddiness are the symptoms in a patient which forebode a speedy and impending attack of insanity. 4.
Shaggy appearance, use of harsh language, appearance of a number of Dhamanis (nerves) over the body, laboured breathing (D. R. experience of excessive coldness), emaciation of the body and throbbing of the joints of the limbs are the specific features of a case of the Vataja type (of Unmada) and the patient in such a case reads clapping his hands, or sings while dancing, or shouts or wanders about. Excessive thirst, perspiration, burning sensation, voracious eating, insomnia, desire for shade, cold, wind and walks on the banks (of rivers or tanks), fits of anger, fancying fire in cold water and fancied sight of stars in the heavens in the day are the symptoms which characterise a case of the Pittaja type. Vomiting, dulness of appetite, lassitude or gone-feeling in the limbs, aversion to food, fondness for sexual propulsion and loveliness, stupidity, somnolence, reservedness in speech, eating little, fondness for warm things and aggravation of the disease in the night mark a case of the Kaphaja type of insanity. 5-7.
A case of Sannipatika insanity exhibits all the symptoms belonging to the three aforesaid types origined from the three Doshas, viz., Vata, Pitta and Kapha. A case in which the specific symptoms of the disease are manifested in full should be deemed as incurable. Several authorities, however, hold the Sannipatika type to be sometimes curable. 8.
A person frightened by a thief, a king's officers or his own enemy or any such person, or suffering from any distracted state of the mind owing to a loss of wealth, or from any grief (Soka) or bereavement or from any disappointed love would likely have an attack of mental distraction (insanity). In such cases he would unconsciously talk incoherently about subjects uppermost in his mind or would sing in a stupid fashion or laugh or weep. (These are the symptoms of Sokaja insanity). Redness of the eyes, dulness of complexion and of the perceptive faculties, diminution of bodi'y strength, extreme dejection, blush on face and loss of consciousness are the symptoms which mark a case of insanity-due to the effects of poisoning. 9-10.
A patient suffering from insanity should be first treated with Sneha and Sveda and then subjected to a course of emetics, puiga-tives and head-purgatives (Siro-Virechana). Powders of various sorts of (drugs used in) Avapida snuffing should be mixed with mustard oil and employed for the purpose of snuffing). Fumigation with burnt putrid beef or dog's flesh should be constantly employed. Snuffing and unguents of mustard oil are also efficacious in all cases. The patient should be surprised with wonderful sights and the news of the death of any of his dear ones should be related to him. He should be constantly frightened with sights of fierce-looking men, well-trained elephants or non-venomous snakes. The patient should be threatened with being fastened with ropes or being flogged, or frightened with bundles of blazing hay, after being fastened, while asleep. He should also be pierced in his body with pointed instruments, avoiding, however, the vulnerable parts*, or he should be made to reside constantly in a dry well with a cover over it. Barley gruel, powders of parched barley mixed with water alone should be given to him on every third day by an intelligent physician. The diet of the patient should consist also of palatable and appetising articles. II.
The patient should likewise be threatened with being forced into a burning hut. He should be also kept immersed in water or threatened with the fall of a thunder bolt.