Ayurvedic medicine and Indian literature on epilepsy S Jain, *PN Tandon Indian Epilepsy Centre, Delhi, *National Brain Research Centre, Manesar, India AYURVEDA

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Ayurvedic medicine and Indian literature on epilepsy
S Jain, *PN Tandon
Indian Epilepsy Centre, Delhi, *National Brain Research Centre, Manesar, India
AYURVEDA
The chief source of ancient Indian Aryan culture
and medicine are the four Vedas that are
traditionally believed to be revealed to the sages
by Brahma (the creator) some 6,000 years before
Christian era. Most western scholars believe that
the oldest of the four Vedas was compiled during
the second millennium BC. The word Ayurveda
(in Sanskrit Ayu means life, and Veda means to
know) means the knowledge of life by which the
nature of life is understood and thus life is
prolonged. Unfortunately Ayurveda is not
available in its original form, but most of its
contents are revealed to us by the Samhitas (the
encyclopedic works) of Caraka and Sushruta.
These texts originally written about 1,000 BC are
considered to be the most authentic and renowned
representatives of the original Ayurveda.1 Caraka
Samhita (around 1,000-800 BC), a treatise on the
ancient Indian system of medicine was composed
by Agnivesa, redacted by Caraka and
reconstructed by Drdhabala. The Sushruta
Samhita has been acknowledged as one of the
greatest of its kind in Sanskrit literature and is
important from the surgical point of view.1
EPILEPSY IN AYURVEDA
There are abundant references to all aspects of
epilepsy including symptomatology, etiology,
diagnosis, and treatment in the Ayurvedic
literature. The eighth chapter of Nidanasthana
(diagnosis) and tenth chapter of Chikitsasthana
(treatment) of the Carakasamhita are devoted
exclusively to epilepsy.1 Convulsions
(akshepaka), apoplectic fits (apatantraka), and
hysterical fits (daruna apatantraka) are few of
the important nervous system disorders
mentioned.
Definition
In most Ayurvedic texts, epilepsy has been
mentioned as Apasmara or Apasmrti, and has
been described as one of the earliest eight diseases
known (diagnosed) that can be controlled only
with medical therapies and can sometimes be
incurable and remain uncontrolled.2
Clinical description, classification and etiology
It is classified as prodromal symptoms and signs
(purvarupa) and clinical manifestations (rupa).
The prodrome (purvarupa) includes: contraction
of eyebrows, constant irregular movement of
eyes, hearing of such sounds as are non-existent,
excessive discharge of saliva and nasal excreta,
disinclination for food (anorexia and indigestion),
distension of abdomen, body aches, transient
blackout, giddiness, profuse sweating, increased
thirst, fainting, hallucinations, falling and
insomnia.2
In Ayurveda, clinical manifestations of
epilepsy (rupa) are divided into four types
according to the dominant dosa (humour) involved
in its pathogenesis: Vataja, Pittaja, Kaphaja and
Sannipataja. The Vataja type is characterized by
frequent fits, regaining consciousness in shortest
time interval; bulging eyes; excessive crying,
frothing at mouth; irregularly contracted fingers;
reddish rough and blackish nails, eyes, face and
skin; hallucinations and trembling. Kaphaja type
has features of prolonged fits with delayed
recovery; increased frothing at mouth; white nails,
eyes, face and skin; and visions of white, heavy,
unctuous, smooth objects (description like grand
mal seizures). Pittaja type is characterized by
regaining consciousness in shorter periods,
scratching of ground, greenish-yellow and coppery
nails, eyes, face and skin; and visions of bloody,
agitated, irritated, frightful and burning objects
(description like partial complex seizures). The
fourth type, the Sannipatika form of the disease,
is caused by the simultaneous vitiation of all the
three dosas that gives rise to a combination of
symptoms and signs and is incurable (description
like intractable epilepsy). 2
In Ayurvedic texts, three basic factors have
been implicated for the etiology of epilepsy.
Endogenous factors (genetic, congenital,
constitutional, enzymatic disturbances and
idiopathic); Exogenous factors (intake of
unwholesome and unhygienic foods, aggravation
of vata dosa due to trauma, worms and other
Address correspondence to: Prof. Satish Jain, MD; DM; Indian Epilepsy Centre, A-258, Defence Colony, New Delhi – 110 024 (India)
Neurology Asia 2004; 9 (Supplement 1) : 57 – 58
Neurology Asia 2004; 9 (Supplement 1)
58
environmental factors); and Psychological factors
(excessive worry, grief, fear, passion, anger,
anxiety and excitement). The aggravated dosa
spreads throughout the body through the nerves
(dhamanis) leading to the manifestation of the
epileptic fit in the form of shaking jerks or
convulsions (akshepaka) or episodes of brief
unconsciousness without shaking (apatantraka). 2
Clinical examination and diagnosis
A comprehensive evaluation of the patient (rogi
pariksha) preceeds the disease diagnosis (roga
pariksha). Ayurveda emphasizes on a detailed
history of the patient for a correct diagnosis.
TREATMENT OF EPILEPSY
Various treatment modalities that include strong
elimination and alleviation therapies, depending
upon specific requirements are mentioned as being
useful for epilepsy patients. When epilepsy is
associated with extrinsic factors, then mantras
(hymns) have been recommended. The physician
is advised to first take steps for the awakening of
heart channels and mind blocked by dosas
(humors) by drastic emesis (Vatika Apasmara),
enema (Paittika Apasmara) and purgatives
(Slaismika Apasmara). Drug formulations have
been recommended only after the patient has
been cleansed by all means and consoled well.1
A wide variety of ghrtas (purified butters)
have been recommended for internal use. One of
the most important among these is Maha Panca
Gavya Ghrta. Use of mixtures of ghrta and taila
(oil) cooked with drugs has also been mentioned.
Oils cooked with different herbal and animal
products have been recommended for anointing
the body of the patient. Even nasyas (nasal
applications) have been recommended. The use
of a wide variety of anjanas (collyriums) and
anjana vartikas (collyriu sticks) to bring the
patient to senses has also been mentioned. A
variety of Ayurvedic medicines for epilepsy
available in the Indian market include:
Asvagandhadyarishta, Bali Tail, Brahmi ghruta,
chandanadi tail, Chaturmukha rasa, haratala
bhasma, Kalyanaka ghruta, Kumaryasava,
Mahakalayanaka ghruta, Mahamrutyunjaya
rasa,Rajata bhasma, saarasvatarishta,
sarpagandha vati, Svarna bhasma,
Svarnamakshika bhasma, Vaatakulantaka rasa,
and Yogendra rasa.2
The modes of administration of drugs for
epilepsy recommended in Ayurveda include
external applications, internal use, application in
the eyes and nose. The only first-aid measure
recommended in epilepsy is blood-letting
(Siravedha) from the veins of the temples.
Cauterization of both the parietal bones with
needles (Soocivedha) has also been mentioned.1
THE FUTURE
Practitioners of modern medicine and ancient
medicine like Ayurveda should join hands with
researchers to understand the scientific basis of
Ayurvedic therapies using the current scientific
principles and technologies. Modern and Ancient
medicine systems should be combined to plan
effective health-care delivery systems for better
epilepsy care. Ayurvedic therapies could be
scientifically tested and then used at least as addon
therapies like the new anti-epileptic drugs
(AEDs). Ayurvedic and other ancient therapies
could form the basis of the future “New AEDs”.
REFERENCES
1. Tandon PN. Ayurveda and epilepsy. In: Tandon PN,
ed. Epilepsy in India: Report based on a multicentric
study on epidemiology of epilepsy carried out as a
PL 480 funded project of the Indian Council of
Medical Research, New Delhi, India, 1989: 176-80.
2. Bhatt HA, Gogtay NJ, Dalvi SS, Kshirsagar NA.
Epilepsy. In: Mishra LC, ed: Scientific basis for
Ayurvedic therapies. Washington DC: CRC Press,
2003: 427-37