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Indian Medicine (Medicin), translated by C. G. Kashikar c15: VIII. Nervous & Mental diseases, Toxicology

Indian Medicine (Medicin), translated by C. G. Kashikar c15

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VIII. Nervous & Mental diseases, Toxicology

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§ 89. Diseases of Vata (*vātavyādhi*) :—These mostly nervous diseases are caused by filling of the empty canals of vāta either in the whole body or in particular parts, when it is deranged by unsuitable or insufficient diet, overexertion, loss of blood, anxiety, grief etc. Symptoms : contraction and stiffness of the joints, the bones as broken down, goose-skin, phantasy, pain in the arms, in back and in head, the limbs shrunk up, sleeplessness, abortion and loss of menses in women, of sperm in men, convulsion and numbness of limbs etc. The deranged vāta can further cause the most varied other diseases according to the part in which it comes, thus in the bowels it causes constipation, heart-disease, swelling of the body, hemorrhoids etc. The five kinds of vāta, if accompanied by pitta, also cause different troubles. Special vātarogas are :— *ākṣepaka*—convulsions; *apatantraka*—apoplectic convulsions; *dāruṇa apatānaka*—hysteric convulsions (?) *daṇḍapatānaka*—the body is stiff like a stick; *dhanuḥstambha*—the body is crooked like a bow, tetanus; *abhyantarāyāma*—the body is bent inside like a bow; *bāhyāyāma*—curving outside, an incurable form; *pakṣavadha*—hemiplegia (vedic *pakṣahata*); *sarvāṅgaroga*—paralysis of the whole body; *tetanus universalis*; *ardita*—facial paralysis; *hanugraha*—lockjaw, trismus; *manyāstambha*—stiff neck, *jihvāstambha*—tongue-paralysis, *śirograha*—brain paralysis (?), *gṛdhrasī*—Ischias (sciatica); *viśvācī*—paralysis of the arms and hands; *kroṣṭukaśīrṣa*—inflammation of the knee joints; *kalāyakhañja*—St. Vitus' dance (?) *vātakantaka*—dislocation of the foot-joint; *pādadāha*—burning in the feet particularly while walking¹: *pādaharṣa*—numbness of the feet; *avabāhuka*—convulsion or stiffness in the arm; *vepathu*—paralysis agitans etc. Limping and complete paralysis, dumbness and stammering and other sufferings are also enumerated among *vātavyādhis* (MN 171-87 and Dutt 1. c. 95-102; cf. Car 6.28; Su 2.1; AS 3.15; AHr 3.15; Vang 344 ff.; Bhav 2.2).

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As treatment, anointing, perspiring and nourishing remedies, enemeta, purgative are mentioned in general (Vr 22.¹). Even a dry wood can be made flexible by greasing and warming, then what of a living part (AHr 4.21.5 f.) ? Firm bandages are also expedient. In lockjaw the physician should forcibly open the mouth (Su 4.4; AS 4.23; AHr 4.21; Car; Vang; Bhāv 1. c.; Vr 22).

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¹ *pādadāha*—burning in the feet particularly while walking

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¹ Probably a form of ergotism (raphania) is meant by this dangerous disease. Cf. Heusinger, *Burning of the feet*, January 1, 257-95 (1846).

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§ 90. Rheumatism :—Many of the *vātavyādhis* have a rheumatic character. This is pronouncedly the case with thigh-paralysis (*ūrustambha*), also named *ādhyavāta*. The deranged *vāta* enters the hips and thighs and fills them with *kapha* whereby they become stiff, cold, senseless, felt as not of oneself and very painful. Preliminary signs are : sleepiness, fever, goose-skin, nausea, vomiting, weakness in upper and nether thighs etc. Then excessive weariness in all parts and continual heat and pain in the thighs are felt, the foot aches while sitting down and is insensitive to cold, one cannot stand nor walk. The disease is fatal if there is heat, severe pain and shivering. The treatment, according to Caraka, falls into two kinds : internal and external. The latter consists of smearing, plastering, anointing and the like (Car 6.27; Su 4.5; AHr 3.15; MN 191 f.; Vang 426; Bhāv 2.2; Vr 24).

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Along with *ūrustambha* is mentioned *āmavāta*—joint rheumatism, so named because it occurs chiefly by indigestion. The pain is first felt in the hips, then the whole body becomes stiff. Gout, loss of appetite, thirst, weakness, heaviness, fever, indigestion, numbness of limbs are the general symptoms. According to the *dosa* there arise further painful swellings in the joints of the hands, feet, joints, knees, thighs etc., with pain as by scorpion-sting, indigestion, nausea, heat, abundant urine-secretion, pain in the heart and other allied signs, or particularly heat and redness, or stiffness and itching. Fasting, perspiration, bitter and appetite-promoting and pungent medicines, purgative, nourishing substances and enemata are recommended for cure (MN 192-4; Bhāv 2.2; Vang 4.29 ff.; Vr 25). Cf. also *vātarakta*, § 68.

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§ 91. Faint, Giddiness and Apoplexy :—When the canals conducting consciousness are constipated by deranged *dosas*, man suddenly becomes senseless and falls to the ground as a piece of wood. General signs of the faint (*mūrcchā*) are : pain in the chest, yawning, weariness and mental weakness. Further signs vary according to the kind of the origination of the *mūrcchā*. Thus blue, black or red appears before the eyes of a man ill by *vāta*, he loses sense, but again comes to senses quickly, shudders, has joint-pains and pain in the chest, is thin and the colour of his skin becomes brown-red. By seeing or smelling blood one becomes fainted and has stiff limbs, fixed sight and deep breathing. The drunk lies on the ground, speaks wrongly, is without senses or crazed and rolls about on the ground until the drink is digested. In poisoning there is shivering, sleepiness, thirst and loss of consciousness. If the body is felt as turning in a circle like a wheel and the patient falls continually on the ground, it is called "giddiness" (*bhramaroga*). In apoplexy (*samnyāsa*) the dosas become predominant and hamper all functions of the speech, body and mind, so that the patient becomes stiff like a piece of wood, resembles a corpse and dies on the spot if immediate remedies are not resorted to (Su 6.46; AS 3.6; AHr 3.6; Vang 312 ff.; Bhāv 2.2).

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§ 92. Intoxication and Delirium tremens :-Spirituous drinks (*madya*) act like ambrosia by proper use, and like poison by improper use. Of the three or four stages of intoxication (*mada*) the first sharpens intelligence, memory and appetite, causes serenity etc., the second produces weakness of mind and memory, indistinctness of speech, sleepiness and the like, by the third stage a person does not remain responsible for his actions, so that he lets out secret, eats prohibited things, commits incests and the like, at the fourth stage he lies senseless on the ground like a piece of wood or a corpse. From drunkenness the diseased condition *madātyaya* arises with the following general symptoms : deafness, pain in the chest, diarrhoea, continuous thirst, fever, loss of appetite, trembling of the head, sides, bones and the heart, phantasy, bad dreams etc. As special signs by vāta Mādhava mentions : hiccup, breathlessness.

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For faint cold sprinklings and baths, cooling precious stones like the *candrakānta* and necklaces, sandal and other cooling ointments, fanning with a fan, cold and fragrant drinks are generally to be applied. For giddiness pills and medicines are to be given. For apoplexy ointment and nasal remedy should be given, the patient should be fumigated, he should be pricked with needle in the flesh under the nails, his beard and hair should be pulled out, he should be bitten by teeth and the like. If he is not awakened by such stimulants, there is no remedy for him (Su; Vang; Bhāv l. c.; AS 4.9; AHr 4.7; Vr 17).

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tottering of the head, pain in the sides, sleeplessness and much phantasy. According to Dutt, Delirium tremens is meant by this, yet the above general signs are common. Medicines, liquor with different additions, cold water drunk until the pacification of thirst, milk, ointments, smearings, baths, warm clothing, enemeta etc. are prescribed. According to Bhāv, the affections due to liquor can only be cured by liquor just as in burning wounds cauterizing and perspiring remedies are advantageous (Car 6.24; Su 6.47; AS 3.6; 4.9; AHr 3.6; 4.7; Vang 318 ff.; Bhāv 2.2; Vr 18.7).

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§ 93. Epilepsy :—*Apasmāra* arises in the canals of the heart, particularly by grief, anger, greed, fear, joy and other mental excitations and is known by the throbbing of the eye-brows, twisting of the eyes, palpitation, deafness, discharge of saliva and phlegm from the mouth and nose, numbness, swooning, giddiness, sweat, flatulence, weakness and other signs. Four kinds are distinguished according to the dosas with symptoms : frequent change between senselessness and sudden return of consciousness, or prolonged attack by long intervals, frequent depression, foam from the mouth, delirium, groaning, trembling, biting the teeth, crookedness of the fingers, thirst, cold feeling, shuddering, to the patient everything appears black, white, or fiery etc. Old epilepsy is incurable, as well as *apasmāra* from tridosas, or if the patient frequently tugs with the limbs, becomes thin, the eye-brows are pulled upwards and the eyes roll. The attacks come after a pause of 10 or 12 days or a month or even oftener. For cure different medicines should be given, particularly decoctions in ghee or oil, enemeta, emetic and purgative, the bile of a dog as an ointment or smearing substance, nasal remedy, blood-letting; the patient should be brought to senses by pungent substances, he should be branded etc. The treatment should be like that for madness. When the attack is over, one should not rebuke the patient for what he had done during the same, but should attempt to cheer his soul (Car 2.8; 6.10; Su 6.61; AS 6.10; AHr 6.7; MN 169 f.; Vang 337 ff.; Bhāv 2.2; Vr 21).

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§ 94. Madness and Possession:—Madness (*unmāda*) in its first stage is called *mada*, intoxication, excitation, and is caused by reasons similar to those for *apasmāra*. General symptoms are : delirium, uneasiness, rolling of eyes, despondency, irrelevant speech, a feeling

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of emptiness in the heart. There are six kinds of unmāda. By vāta there is laughing without reason, crying, singing, dancing, jesticulating without reason, foam from the mouth, constant walking, talkativeness, adorning oneself with unsuitable things, desire to eat and nausea after eating, thinness, the skin is rough and red-brown, after digestion the signs are worse. By pitta there is especially violence, violent possession, desire to attack, predilection for nakedness and for shade and bath and the like. By kapha there is loss of intelligence and memory, loss of appetite, vomiting, salivation, taciturnity, predilection for loneliness, sleepiness, uncleanliness etc. By the three doṣas the condition is incurable. By painful excitation e. g., by the loss of property or beloved wife there is melancholia with unintentional weeping, lamenting and the like, or the patient sings, laughs, speaks pell-mell and the like. By poison the eyes become red, the face red-brown, there is feebleness and senselessness. Unmāda is fatal if the lunatic looks towards the ground, or in the height, becomes thin, void of strength and cannot sleep. Curable lunatics should be given medicines, especially decoctions with oil and ghee, purgative and emetic, enemeta, ointment, nasal remedy, fumigation, or blood should be let out. Otherwise the patient should be thrown in a well without water and let to remain hungry there, or he should be tied with his face upwards in the Sun, or he should be branded with glowing iron, or he should be scalded with boiling oil or water, or should be chastised with lashes and then should be thrown in a grove, or should be left in a dark and empty place or should be frightened with serpents whose poison-tooth is extracted, or with tamed lions or elephants, or the death of a relative should be announced to him, or the servants of the king should take him in open air and threaten him with death. Along with these violent remedies, it is also recommended to cheer the lunatic with friendly talk ( Car 6.9; Su 6.62; AS 6.9; AHr 6.6; MN 160-4; Bhāv 2.2; Vang 326 ff.; Vṛ 20 )

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The worse forms of madness are attributed to demoniac influence and are, therefore, denoted as possession (bhūtonmāda). There are 8 or 18 or 20 or "innumerable" demons and gods of insanity who attack the man if he acts against the religion, stays alone in a vacant house or in a burial place at night and the like. One can gather from his way of acting as to which spirit had attacked the patient. Thus one possessed by Daitya is malicious, wrathful, haughty, gives himself out to be a god, likes spirituous drink and flesh. One possessed by a *Gandharva* sings and dances, adorns himself, bathes and anoints himself. One possessed by a serpent-demon has red eyes, fixed sight, crooked and staggering walking, stretches out the tongue, licks his mouth-angle, likes milk, honey and sweets. One possessed by a *yakṣa* seeks joy, is lavicious, prodigal, generous, talkative, staggers like a drunkard while walking. One possessed by a *piśāca* is uneasy, voracious, unclean, without memory, runs about, tears the flesh with nails, goes naked. For possession are prescribed various medicines to be taken internally, to be used as ointments, nasal remedy, fumigating remedy and the like. The treatment, however, especially conforms to the appeasement of the demons by different oblations, appeasing ceremonies, penances, religious donations, worship of Brahmans and the like rather than to the medicinal substances which are effective against demons. Every demon or god has his particular time when he attacks men. At this time the physician should offer him oblations consisting of milk, flesh, sugar, liquor and other food-articles, clothes, jewels and the like, on the place where the demon is accustomed to dwell (Car; Bhav; Vang l. c.; Su 6.60; MN 164-68; AS 6.7 f.). On children-demons of. § 50.

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§ 95. Poisons and Antidotes :-The knowledge of poisons and antidotes (*kalpa*) forms one of the eight main subjects of medicine. According to Viṣṇu 3.88 the king should not take the food until it is ascertained by experiment whether it contains poison. According to Su 5.1 (cf. AS 1.8) these trials consist of various experiments on animals by giving them the food prepared for the king. If it is poisonous, crows, flies and other animals fall to the ground, the cuckoo becomes hoarse, the crane becomes mad, the parrot groans, the peacock rejoices, the monkey excretes, the eyes of a partridge change their natural colour by simply looking at the poison. Danger also threatens the king by the death-bringing embrace of a poisonous maiden (*viṣakanyā*) according to Su 5.1.6, a superstition which is particularly known from the drama Mudrārākṣasa and is also transferred to the European literature¹. Therefore, it is the chief duty of the court-physician to protect the king from poisoning, and the inspection of the cooking house (*mahānasa*) is especially entrusted to him. A poisoner can be recognised by his speech and gestures. The special cultivation of toxicology can be explained partly on such grounds partly by the frequency of poisonous serpents and dangerous insects.

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According to Madhava there are two kinds of poison : sthāvara from stable things i. e. plants and animals, and jaṅgama from animals. The latter causes sleepiness, weakness, atony, heat, indigestion, goose-skin, tumour, diarrhoea; the former causes fever, hiccup, sensitiveness of teeth, throat-aching, foam from the mouth, nausea, difficult breathing and faint. From root-poison especially there is pain in the limbs, delirium and numbness; from leaf-poison there is yawning, shivering and difficult breathing; by fruit poison there is swelling of testicles, heat and loss of appetite; by flower poison there is vomiting, flatulence and difficult breathing; from bark juice or resin of poisonous trees there is bad smell from the mouth, roughness of the skin and headache; from chyle there is foam from the mouth, diarrhoea and heaviness in the limbs; from mineral poison there is pain in the chest, faint and heat in the palate. These poisons mostly cause death in course of time. If anybody is hit with a poisonous arrow, the wound suppurates immediately and successively becomes black, moist and very bad smelling, the flesh shrinks up, besides there is thirst, faint, fever and heat. The effects of serpent-bite are varied. Quickly fatal is the bite of the cobra or hooded serpent (darvikara). In the heat and cachetic conditions serpent-bites are particularly dangerous. Bad symptoms are : after the bite no blood comes out, no stripes are caused by strokes, bathing with cold water causes no goose-skin, a black and red tumour appears on the bitten place, there is lockjaw, blood flows from the mouth and the anus, there is loss of speech etc. Duṣīviṣa, i. e. the poison that is old, dried out by fire, Sun or wind or decomposed by antidote or does not possess normal strength, acts mildly inasmuch as it never brings death, but has an after-effect for years together and brings about diarrhoea, bad smell and bad taste in the mouth and other troubles, difficult breathing, thirst, fever etc., in other cases madness or constipation or impotency or tongue-paralysis or leprosy and other diseases. Bites of 16 poisonous spiders are described in detail; they cause different kinds of boils with fever, heat, diarrhoea and other symptoms; so also the bites of rats and mice, scorpions, gad-flies, poisonous frogs, fish and leeches, house-lizards, hundred-footed and other insects and the poison in the claws and teeth of the tiger, apes and other animals (MN 429-42). Su, AS and AHr deal with poison in more details. Yet, of the mineral poisons Suśruta mentions only phenāśmabhasman—a burnt stone, that is burnt orpiment and Haritāla. AS besides mentions rakta (Cinnabar or copper?). Among the numerous vegetable poisons mentioned in Su, AS and AHr, strychnine, vomiting nut (kupilu), opium (ahiphena) and Datura (dhūstūra, unmatta)* which are very much in vogue in India* are not met with. On the other hand, Su, AS and AHr also describe the madness of jackals, dogs, hyenas, bears, panthers, tigers and wolves and the disease jalatrāsa—hydrophobia arising from their bite (Su 5; AS 6.40-8; AHr 6.35-38; cf. Car 6.23; Bhāv 2.4; Vang 922 ff.).

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The Vedic medicine is rich in spells against poisoning, arrow-poison and the bites of serpents, scorpions and insects and the Bower MS 6 contains a long incantation which the Buddha is said to have recommended for the cure of a bhikṣu bitten by a black serpent (king cobra) and which bears analogy with Car, AS, AHr where, however, it only serves as an accompanying recital while giving the antidote (agada)³. The medical works give in a large number recipes for such agada. They differ in vegetable and mineral poisons according to the stages in the effect of poison (vega), of which seven are distinguished :- 1. The tongue becomes black and stiff, simultaneously there is faint, shivering, oppression of breathing, exhaustion and vomiting. The poisoned person should be given an emetic, he should be sprinkled with cold water and an agada mixed with ghee and honey should be at once given to him to drink. 2. Shivering, perspiration, heat, pain in the throat, and pain in the chest if the poison had entered the stomach. As before, an emetic should be given first, then a purgative and an antidote. 3. Inflammation of the palate, violent pain in the stomach, the eyes become weak, pale and swollen, and there is pain, hiccup, cough and rolling in the body, if the poison has reached the bowels. An antidote should be given internally, as a nasal remedy and ointment. 4. The head is very heavy. An antidote with oil should be given. 5. Salivation from the mouth, decolourisation, pain in joints and body, derangement of all doṣas. An antidote in a decoction of liquorice and honey. 6. Senselessness and severe diarrhoea. Treatment as for diarrhoea. 7. Paralysis of shoulders, back and hips, and death. Nasal remedy (Su 5.2.40-49; AHr 6.35). In serpent-bites also seven vegas are distinguished. A bandage of cloth, leather or inner bark of a tree is to be fastened above the bitten place, so that the poison may not penetrate in the body; or the place should be cut and branded if it cannot be fastened. Sucking, cutting and branding of the place is in any case expedient. While fastening the bandage spells are to be recited; the above-mentioned spell in the Bower MS 6 refers to the dressing of the wound. Antidotes, blood-letting, emetic, nasal remedy, anointing, purgative, cold bath, leeches, scarification with a horn and other remedies are also recommended. Insect-prickings are particularly to be treated with warming, plaster and bath in lukewarm water. In difficult cases, the procedure in serpent-bite is to be followed. A wound caused by mad animals is to be treated with blood-letting and hot ghee, then it should be smeared with antidotes and the poisoned person should be made to drink old ghee. Among other remedies, the prescriptions to be used in madness are prominent (Car; Su; AS; AHr; Bhāv; Vang l.c.; Vr 68).

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(1) Cf. Hertz, *Die Sage vom Giftmädchen*, Abhand. d. philos-philol. Cl. d. k. bayer. Akademie des Wissenschaften, XX, 89-166 (Munchen, 1898). (2) Dutt, Mat. Med. 39. 41. (3) Dutt, l. c. 198, 111, 207. (4) Chevers, *A manual of judicial jurisprudence in India* (Calcutta 1870), 108 ff. (5) Cf. Hoernle, Bower MS, p. 226 ff. note; AS. 6:40.

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