Madatyaya (alcoholism)

 

Nidana.

 

Alcoholic intoxication is of four kinds, Vata, Pitta and Kapha and Sannipatika. All varieties of intoxication arise from all the doshas (together undergoing increase) but the naming (of each kind as vataja etc.) Is based on the predominance of the doshas. (Astanga p.60).

 

 

Poorvarupa/rupa.

 

The general (common) symptoms of them are profound delusion, discomfort in the region of the heart, diarrhoea, constant thirst, mild or severe fever, loss of taste and appetite, pain in the head, flanks and bones, tremors, cutting pain in the vital spots, cutting pain in the vital spots, catching pain in the upper back and constriction in the chest, blindness or coma, cough, swelling, disorders of the mind, irrelevant talk, vomiting, nausea, dizziness and seeing bad dreams. (Astanga p.60).

 

Loss of sleep, dyspnoea, tremors, headache seeing dreams such as roaming from place to place, falling from the sky and talking to devils are especially of vataja kind.

 

Burning sensation, fever, perspiration, delusion, diarrhoea, thirst, dizziness, green or yellow discolouration of the body, red colour of the eyes and cheeks are especially of the pittaja kind.

 

Vomiting, nausea, sleep, appearance of rashes on the skin and feeling of heaviness of the body are especially of the kaphaja type.

 

All the symptoms will be found in that caused by all the doshas (sannipatika). (Astanga p.61).

 

Three diseases, mada, (intoxication), murcha (fainting) and sannyasa (total loss of consciousness) each succeeding one stronger than its preceding, affect persons who are constantly engaged in rajas (over activity) , moha (indiscriminate actions) and unsuitable foods; these arise from the obstruction of the channels of rasa (plasma), asrk (blood), and cetana (consciousness). (Astanga p.62).

 

One of vatika constitution should take wine after massage, anointing, bath, dressing, incense and after paste and having eaten unctuous hot food.

 

One of pittika constitution having passed through various cooling regimens and taken sweet, ununctuous and cold food does not get affected by drinking.

 

One of kaphaja constitution should drink observing hot regimens, taking (preparations of) barley and wheat and with meat of wild animals flavoured with black pepper.

This is the method prescribed for the rich or would be rich who should drink wholesome wine in proper quantity according to necessity.

 

For those of vatika constitution, wine made of jaggery and of flour and for those of kaphaja and pittika constitution that made of grapes and honey is wholesome.

 

Samprapti.

 

All types of alcoholism are tridoshaja, hence the physician should first treat the dosha which is predominant therein. In alcoholism the treatment should be started with kapha because it is predominantly situated flanked by pitta and vata. The disorder, which is caused by faulty, excessive or deficient drinking, is pacified by wine itself taken in the proper quantity. After digestion of ama and demerits of wine and arising of appetite and lightness, the patient should be given the wine itself whatever is suitable to him. This should be cold added with sauvarcala, bida and rock salt along with matulunga and fresh ginger, mixed with water and in proper quantity. (Susruta p.400).

 

When sharp, hot, sour and burning wine is taken in excessive quantity the exited chyle is burnt and acquires an alkaline character. This produces internal burning, fever, thirst, mental confusion, giddiness and narcosis. For pacifying this syndrome on should prescribe intake of wine itself. Alkali gets neutralised immediately in combination of acid, and wine is the best among the acidic substances, the other properties of wine are as under.

Wine is sour having four subsidiary tastes such as sweet, astringent, bitter and pungent. These added with the ten properties mentioned earlier become fourteen which reside in wine and because of this, wine stands at the top of all the sour substances.

 

Madya (wine) having entered into the heart counteracts the ten properties of ojas with its corresponding ten properties and thus upsets the mind. Wine possesses ten properties such as light, hot, sharp, finely entering, sour, quickly absorbed, quick acting, rough, depressant and non slimy. (On the other hand), ojas possesses ten properties of heavy, cold, soft, smooth, viscous, sweet, stable, clear, slimy and ununctuous. Wine counteracts the properties of ojas by its own properties such as heaviness by lightness, coldness by hotness, sweetness by sourness, softness by sharpness, clarity by quick action, unctuousness by roughness, stability by quick absorption, smoothness by depressant action, sliminess by non sliminess, and viscosity by subtleness. Thus disturbing the mind dependant on ojas, producing narcosis.

 

Heart is the seat of the channels of the rasa, vata, psyche, intellect, senses, self and primary ojas. Hence by excessive drinking and consequent damage of ojas thereby, heart as well as the dhatus located there, get affected.

 

First stage of intoxication starts when the heart is stimulated but the ojas is not affected; the second stage comes when the ojas is damaged and the third stage comes when ojas is damaged severely. Such severe damage of ojas is not affected by wine made of flour because the depressentness, roughness and non-sliminess are not so aggravated therein.

 

When the heart is overpowered by the properties of wine exhilaration, thirst, enjoyment, happiness and other peculiar rajasic and tamasic mental aberrations arise culminating in unconsciousness due to excessive drinking. This derangement caused by wine is called mada (narcosis or intoxication). (Susruta p.393).

 

Chikitsa.

 

Which ever dosha is found to be predominant should be treated first; when all the doshas are found to be equal in alcoholism; then treatment should be to the seats of kapha first, because alcoholism generally has aggravation of pitta and maruta (vata) at its terminal stages.

 

By ingestion of large quantities of wine which possesses tiksna (penetrating), usna (heat producing), amla (sour) and vidahi (causing burning sensation) properties, the moisture in the essence of food undergoes excess cooking, assumes the properties of ksara (caustic alkali) and produces intoxication, thirst, delusion, fever, burning sensation inside the abdomen and severe giddiness, maruta (vata) getting obstructed in its passage by the other doshas aggravated by wine, produces severe pain in the head, bones and joints. When these symptoms become old or not produced by wine (by drinking again) and such a desire  (for drinking) become less, they (symptoms) get relieved by the same wine itself used judiciously and in the prescribed manner. (Astanga p.287).

 

Ksara (alkali) attains sweetness soon by getting mixed with sour; among sour things wine is the chief and sufficient to liquefy and mitigate the doshas.

 

Wine by its properties such as tiksna, usna, etc. Described earlier and dipana (carminative), and by nature becoming habituated/accustomed, it will be the best material to restore the normalcy of the dhatus.

 

The treatment for alcoholism should be done for seven or eight days only; by that period the wine localised in abnormal passages (places other than the alimentary tract) gets digested. The diseases that continue even after this period should be treated with the appropriate therapies described for alcoholism.

 

In madatyaya (alcoholism) with the predominance of vata drink wine prepared from flour mixed with

 

In madatyaya with a predominance of pitta drinking a large quantity of wine prepared from sugar added with plenty of water and honey;

 

When the patient has thirst and burning sensation, the kapha and pitta that have increased should be reduced and expelled out of the body by vomiting plenty of cold water, or wine mixed with sugar cane or juice of draksha (grapes). Samsargi (regimen of diet after purificatory therapies) such as tarpana (increasing nutrition) are ideal; by these the digestive power becomes augmented which cooks the residue of the doshas and the food.

(Astanga p.291).

 

  1. Treatment. Kapha predominant treatment: vaman (vomiting) with salt water (saindhava-rock salt) or yasti madhu (liquorice) water decoction, boil down from 8 cups to one. Madhavapala, limejuice taken with warm water. Emaciated patient should not be treated with vaman therapy.
  2. Pitta is increased. Pachaka pitta has been vitiated by excess vata, therefore pachaka pitta has to be strengthened by agni deepana therapy, use trikalu with honey
  3. Correct vata. Basti therapy (medicated enema) to correct vata, also use purgatives (mild purgatives for weaker patients).
  4. Oleation treatment with sesame oil, narayana oil, panchtikta ghrita, brahmi ghrita.
  5. Rasayana to correct ojas, aswaghanda rasayana etc.
  6. Arista’s and asavas (medicated wines) can be used.
  7. Nidana parivajanam (prevention of causes). I.e. prevent loneliness etc.