Discussion On Its Cause

The sudden appearance of the disease without any apparent cause and also its sudden and spontaneous disappearance after a short while without any apparent treatment, have induced several medical authorities to hold that Apasmara is not due to any (aggravation of the) Dosha. Several authorities, on the contrary, have described, on the authority of other works on the subject, the gradual aggravation of the (suddenly) deranged Doshas as well as the concomitant symptoms of the disease in its various phases with the spontaneous and speedy nature of its abatement (though only temporary). Hence it may be presumed that as seeds sprout in autumn only, when the rains make the ground ready to receive them, the shortness of time being counted as no factor potent enough to obstruct the process (of sprouting), so the deranged Doshas of the body though gradually aggravated bring on, as a matter of fact, an attack of Apasmara with all its concomitant symptoms, only under conditions favourable to its appearance which may, however, be short and transitory in its duration. Hence this dreadful Apasmara is certainly a disease of idiopathic origin, 11.

General Treatment

Medicinal agents and remedies to be mentioned in connection with insanity (Unmada} may be as well employed in the present disease. The use of matured clarified butter both internally and as unguents is recommended. Medicinal measures and compounds mentioned under the head of possession by the Grahas are also specially beneficial in the present disease. Oil duly cooked with S'igru, Katvanga, (Syonnka), Kinna (sediment of wine) and with the expressed juice of Nimba-barks and with cow's urine weiging four times as much, should be employed as unguents. Draughts and embrocations of oil duly cooked (separately) with the biles of a lizard, a mongoose, an elephant (or snake), a deer of the Prishata class, a bear and a cow, are recommended. Strong medicinal errhines (Siro-virechana) as well as strong emetics and purgatives should be administered. The divine Rudra god and the host of his followers should be regularly worshipped and propitiated every day. 12 - 15.

Specific Treatment

Clarified butter duly cooked with goat's urine and with the decoction of Kulattha, Yava, Kola, S'ana-seeds, Palankasha (Guggulir, Jatamamsi, Das'a-mula and Pathya may be given with advantage in a case of the Va'taja type (of Apasmara). Clarified butter duly cooked with the decoction of the drugs of the first {i.e. Vidari-gandhadi) group and with the drugs of Kakolyadi group (as Kalka) if administered with milk, honey and sugar would be beneficial in a case of the Pittaja type. The use of (the medicated) Ghrita duly cooked with Ktishna, Vacha and the drugs of the Mustakadi group (as Kalka) and with the decoc-tion of the drugs of the Aragvadhadi group* and with the five officinal kinds of animal urine is recommended in cases of the Kaphaja type of Apasmara. 16 - 18.

Siddharthaka Ghrita

Clarified butter duly cooked with (the Kalka of) Sura-druma, Vacha, Kushtha, Siddhartha, Vyosha, Hingu, Manjishtha, the two kinds of Rajani, Samangd, Tri-phald, Ambuda (Musta), Karanja-seeds, S'irish-seeds, Giri-karna (white Aparajita and Hutas'ana (Chitraka) and with four times as much of cow's urine is called Siddharthaka Ghrita, which proves curative in cases of poisoning, worms (in the intestines), Kushtha, asthma, derangements of Kapha, Vishama-Jvara, Bhuta-graha, insanity and Apasmara. 19.

* According to Dallana, the Ghrita should be cooked with the decoc-tion of Krishna and Vacha, while the drugs of the Aragvadhadi group should be used as Kalka.

Pancha-Gavya Ghrita

Clarified butter duly cooked with the Kalka of Das'a-mula, barks of Indra-vriksha* Murva, Bhargi †, Tri-phala, Sampaka, (Aragvadha), S'reyasi (Gaja-pippali), Sapta-parni, Apa-marga and Pilu, and with the decoction of Bhu-nimba, Putika (Karanja), Vyosha, Chitraka, Trivrit, Patha, the two kinds of Haridra, the two kinds of Sariva, Push-kara-rooxs Katuka, Madayanti (Mallika), Ugra (Vacha), Nilini and Vidanga, and with the milk, curd (Dadhi), urine and the expressed liquid of dung of a cow is called Pancha-gavya Ghrita. It proves curative in all forms of Apasmara, Bhuta-graha, Chaturthaka (quar-tian) fever, Phthisis, Asthma and Insanity. 20.

General Treatment

Vastis should be applied in the Vataja, purgatives, in the Pittaja and emetics, in the Kaphaja types of Apasmara. 21.

Milk should be duly cooked with Bhargi and Payasa (porridge) should be prepared by cooking grains of Sail rice with this milk. This preparation should be given to a boar kept fasting for three days. When it is assured that the food taken has acquired a sweet taste (i.e. that the process of digestion has begun in the stomach of the boar) and when the symptoms of poisoning come to be exhibited in the boar, the contents should be taken out (of the boar's stomach) and (should be dried and) powdered. Three parts of this powder and one part of Kinva (the sediment of wine) should be mixed together and made to ferment in a cleansed earthen pitcher with the addition of the cooled decoction of Bhargi. The wine (Sura) thus prepared should be given in proper doses to the patient as soon as it would acquire its (particular) taste and aroma. Venesection (in the forehead) as recommended before (Sarira-sthana, Chap. VIII, 25-26) should be resorted to and prophylactic and auspicious articles should be used (by the patient). 22-23.

* By the term 'Indra-vriksha-twak' some mean (barks of) Kutaja and Twak (cinnamon).

† Bhargi - Dallana explains it as Goshthodumbara - the wild fig.

Thus ends the sixty-first chapter in the Uttara Tantra of the Sus'ruta Samhita which deals with the (symptoms and) treatment of Apasmara.