ANVESHANA A CRITICAL REVIEW ON KAPHAJA UNMADA

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1 ANVESHANA Review Article AYURVEDA MEDICAL JOURNAL ISSN: A CRITICAL REVIEW ON KAPHAJA UNMADA Shyla M. G 1, Narayana Prakash B 2 1 PhD Scholar, 2 Prof. and HOD, Dept. of Manasaroga, S. D. M. College of Ayurveda, Hassan, Karnataka, India Corresponding Author: drshylamanasa@gmail.com ABSTRACT In Ayurveda Unmada is the common term used in every mental disorder. The term Unmada can be applied to a wide range of diseases. Like that the Kaphaja Unmada can be applied to wide range of diseases. Depressive disorder is one among them. In Ayurveda Kaphaja Unmada is explained as a separate entity with the explanation of specific Nidana panchaka and treatment. Present paper deals with the critical review on Kaphaja Unmada. Key words: Kaphaja Unmada, Depressive disorder, Nidana, poorvaroopa, roopa, upasaya, samprapthi, Chikitsa INTRODUCTION The word Kaphaja Unmada consist of two components viz Kaphaja & Unmada. Kaphaja: The word Kapha is derived from the root shlisha, Alingane and ja means produced by. Unmada Nirukthi (Etymology): Unmada-un/ud+mada Un/Ud-urdhava i.e. upward direction Mada- madyate, madyati iti Mada i.e. intoxication, excitement, uncontrolled force. Though the prefix ud means upward direction; in this context the overflow or beyond the limit would be an appropriate meaning. Hence from nirukti it can be comprehended that Unmada is a disease related to the uncontrolled or excited mental stage. Kaphaja unmada (Depressive dis orders): is one of the common psychiatric disorder with trend of rising incidence in recent years throughout the world is still a serious challenge to the medical profession. It is one of the leading cause of disability worldwide. Approximately 15% of general population reports depressive syndrome (Kaphaja Unmada). Kaphaja Unmada can be applied to wide range of diseases. Depressive disorder is one among them. Many references are available related to Kaphaja Unmada. In this article different views of different Acharyas are compiled in brief. Paribhasha Acharya Charaka defines Unmada is the disease characterized by the perversion of mind (Manas) intellect (Buddhi), consciousness (Samjnajnana), memory (Smriti), desire (Bhakti), manners (Sheela), behavior (Chesta) and conduct (Achara). Here Vibhramsha means the total disability to perform assigned function or dysfunction of particular entity. 1 Susruta defines Unmada is distraction of mind due to the upward movement of Doshas. 2 Ashtanga Samgraha and Ashatangahridaya defines Unmada is Mada (toxicity, disorder) of the mind produced by the Doshas (Vata etc), moving in the wrong paths. 3-4 Madhava nidanakara 5 has accepted Susruta s opinion. Among all above

2 definitions, definition by Charaka could be termed as complete as it gives a clear picture of disease. By examining this definition it can be said that Unmada is a very broad term comprising of various kinds of Manovikaras. Table 1: Samanya Nidanas of Kaphaja Unmada SN Nidana A.H A.S C.S S.S M.N B.P G.N Y.R 1 Bhiruta Upaklishta Satva Alpa Satva Kamacrodhadibihi Abhyahada Manaha Vyadi Vega Samudbhava Vishma Sareera Cheshta Abhikhata Abhyahatha Devagurudvija Pradharshana Poojya Vythikrama Utsanna Dosha Athyupa Ksheena Deha Samala Vikruthopahata Aharasevana Vishannatha Vishena Upavishena Visesha Nidana 1 Sampoorana Mandacheshta Nidana General Nidana for Unmada is described in Ayurvedic classics. But specific Etiology for Doshonmada like Vata, Pitta and Kapha are not described in detailed manner. Only Charaka has explained specific Nidana and samprapthi for doshik type including Kaphaja Unmada. The same matter is quoted in Gadanigraha, Bhavaprakasa, Madhavanidana and Yogaratnakara. There is no specific Poorvaroopa told for individual Unmada in classics. So Samanya Poorvaroopa told for Unmada can only be taken as the Poorvaroopa of the Kaphaja Unmada. Samprapthi of Kaphaja Unmada Samprapthi help us to understand how the disease has manifested after Nidana. Acharya Vagbata explained samanya samprapthi of Unmada as the excited doshas of the individual with alpasatwa is moving in wrong path and vitiate hridaya which is the seat of manas and buddhi and disturb manas occluding manovahasrotas. This in turn causes loss of buddhi due to which the individual loses the power of discrimination and indulges in faulty activities. And this disturbed state is referred to as Unmada. Acharya Susrutha narrated the samprapthi of Unmada as the upward movement of dosha of alpasatwa vitiate hridaya and occlude manovahasrothas. Madhavanidanakara is accepted Susrutha s opinion. There is no clear explanation of samprapti of disease kaphaja Unmada except from some of the Acharyas like Charaka. The samprapthi of Kaphaja Unmada explained by Acharya Charaka tells that kapha gets vitiated because of sampoorana (over nourishment) and mandacheshta (sedentary life style). The aggravated kapha along with pitta afflicts the vital organs (heart) adversely affects the intellect and memory and vitiate the mind leading to this specific morbidity that is Kaphaja Unmada. Here the two etiological factors described are excessive eating or over nourishment and sedentary life style. But only to these factors are not enough to precipitate a mental disorder. So a general ethiology of mental abnormalities along with these circumstances of kapha vitiation is necessary for manifestation of Kaphaja Unmada. AAMJ / Vol. 1 / Issue 5 / Sep Oct

3 Table 2: Kaphaja Unmada lakshanas in different classics SN Symptoms A.H A.S C.S S.S M.N B.P G.N Y.R 1 Arochaka Chardi Alpacheshta Alpahara Alpavak Sthri Kamada Rahapriti Lalasinghanakasruti Baibhatsyam Sauchavidwesha Nidra Svayadhuranane Balavanrahtrau Sthanamekadeshe Shuklasthimitha Malopadiudhakshata Nakhadishauklyam Agnimandya Kasa Alpamati Ushnasevi Bukthamatrebalavan Sadana Saadhyaasaadhyatha (Prognosis) The diseases with alpalakshana ekadosha (with single dosha involvement and less number of signs and symptoms) are usually saadhya). Hence Vataja, Pitaja and Kaphaja Unmada are saadhya i.e they carry good prognosis. The diseases with sarva sampoorna lakshnas are always asadhya (i.e carries bad prognosis). Chikitsa-vivechana General line of treatment for doshonmadas Snehana (Oleation) Swedana ( Formentation) Vamana (Emesis) Virechana (Purgation) Astapana and Anuvasana type of enemas Upasaimana (Alleviation Therapies) Nasya (Errhines) Dhooma (Smoking) Dhoopana (Fumigation) Anjana (Collyrium) Avapida and Pradhamana type of snuff Abyanga (Massage) Pradeha (Ointment) Parisheka (Affusion) Anulepana (Unction) Vadha (Assault) Bandha (Tying) Avarodha (Confinement) Vithrasana (Frightening) Vismapana and Vismarana (Inducing astonishment and forgetfulness) Apatarpana (Depletion) Sira Vedha (Venesection) And also suitable diets should be given according to the requirements of the patient. DISCUSSION Acharya Charaka defines Unmada is the disease characterized by the perversion of Manas, Buddhi, Samjnajnam, smriti, Bhakti, Sheela, Cheshta and Achara. Here vibramsha AAMJ / Vol. 1 / Issue 5 / Sep Oct

4 means total disability to perform assigned functions or dysfunction of particular entity. Unmada is the distraction of mind due to upward moment of Doshas. Unmada is Mada of the mind produced by the Doshas moving in wrong path. Heena Satwa is considered as predisposing factors and other factors precipitate the mental abnormality. All the etiological factors are common to all types of Doshonmada including Kaphaja Unmada. Excessive eating and sedentary lifestyle as modulated factors, which may modify the above said nidanas leading to the manifestation of Kaphaja Unmada. In the same way the normal physical and mental dispositions (Kapha Prakruthi and Tamasa prakruthi), food habits of the person etc. will also act as the modifier of the basic Pathology. So all the factors in the nidana of Doshonmada along with the specific nidanas of Kapha vitiation are necessary for the manifestation of Kaphaja Unmada. Asyasamsravana due to the vitiation of Kaphadosha there will be increase in the pramana of Syannaguna of Kapha in Kandapradesa which leads to asyasamsravana which is a Kaphaja vyadhi. Arocaka, Avipaka, Ananabhilasha due to the intake of virudha malinahara sevana and sleshmalahara sevana and sedentary lifestyle there will be mandagni which results in avipaka, arocaka, Ananabhilasha. Hridgraha Due to the Kaphaja Ahara Viharas there will be mandagni which leads to rasavahasododrishti. The moola of rasavahasrodas is hridaya. Due to the vitiation of the rasadushti which leads to avaroda of udana and vyana results in hridgraha. Swapne kalushanam ambhasam avarthe nimanjanam Due to the Prabala Doshasanjaya in manovahasrodas there will be swapna. These rationalities can be given for the poorvaroopa of Kaphaja unmada. Roopa of Kaphaja Unmada: Arocaka may be of two types Manasathapaja and Kaphadoshaja. Kaphadoshaja is due to the increase of Kaphajaharavihara and virudhaharaseela causes agnimandya which leads in rasadushti and results in rasavahasrotodushti which is a rasapradoshajavyadi. Chardi Due to atidrava atisnigda asatmyaja bhojana there will be agnimandya which leads to srodorodha and Kaphotklesa and udanavayokopa which resulting in Chardi. Alpahara Due to the virudhahara sevana there will be agnimandya resulting in arochaka and alpahara. Alpavakyatha, Alpacheshta due to the sleshmala ahara and mandacheshta there will be vitiation of kapha and tamas in manovahasrodas in heenasatwa person which results in alpacheshta and alpavak. Alpamati due to the Kaphavardaka and malinahara sevana and alpacheshta there will be mandagni which leads to rasavahasrododrishti. The moola of rasavahasrodas is hridaya. Manas and buddhi is situating in hridaya due to the Kaphavarana and tamoavarana there will be decrease in buddhi. Nari Priyada Kaphavridhikara ahara vihara results in increase of soumyabhava and soumyadhathu ie, suklavridhi which leads to nari priyada. Due to the Kaphavardaka and malinahara sevana and alpacheshta results in increase of tamoguna which results in interest in woman and it is one of the tamasa prakruthi lakshana. Viviktapriyatha due to the increase of thamoguna in manovahasrothas person prefer to be alone. Viviktapriyatha is one of the thamasaprakruthi lakshana. Athinidratha, Nidra occurs due to the adhikya of kapha and thamas. As kaphadosha thamoguna increases in a person atinidra occurs. Sadana is a rasapradoshaja vyadi. Due to malinahara sevana and kapha vridhikara ahara vihara which causes agnimandhya which in turn leads to rasadushti and sadana results as a rasapradoshaja vyadi. Lalasravam Due to AAMJ / Vol. 1 / Issue 5 / Sep Oct

5 Kaphavridhikara ahara vihara kapha increases and leading to ulklesha of kapha which results in lalasrava. Ratribrisham and Manovibramam During the early hours of night there will be vitiation of kaphadosha so symptoms aggravated at that time. Due to the prolonged avarana of kapha vitiation of vata is occurring which results in mano vibramam. Bukthebhalam: After the intake of food kapha produces first in the body. So symptom increases. Upasaya and Anupasaya of Kaphaja Unmada: Upasaya and anupasaya are the two aspects to control and increase the condition Kaphaja Unmada respectively. CONCLUSION Nidanas explained in Ayurvedic Classics were found to act as pre disposing precipitating and modulating factors in production of unmade. There was significant role of heenasathwatha in initiation of all Unmadas. Two factors told by Charaka ie, excessive eating and sedentary lifestyle act as modulating factors which may modify the samanya nidanas leading to the manifestation of Kaphaja Unmada. But also the other factors like cultural, psychosocial stress factors are responsible manifestation of this disorder. All the factors in the nidana of doshonmada along with specific nidanas of kapha vitiation are necessary for the manifestation of Kaphaja Unmada. Nidana parivarjana has a definite role in reducing the recurrence of Kaphaja Unmada. Increasing sathvabhala also nidana parivarjana. There is no specific poorvaroopa told for individual type of Unmada in classics. The actual science and symptoms of the disease will be seen in the vyakthaavastha where doshadooshya sammoorchana takes place. With the help of roopa this is can be diagnosed and confirmed. The samprapthikhatakhas can be studied with the help of roopa only. The views on samprapthi explained by different Acharyas in similar. It is helpful in diagnosing the disease during doubtful situation. When physician fails to diagnose the disease with the help of nidana poorvaroopa samprapthi, diagnosis of the case is made by upasaya and anupasaya. Before the start of treatment physician should decide should be included for treatment and decide the line of treatment as well as the prognosis of the disease. REFERENCES 1. Vaidya Jadavaji Trikamji Acarya, Charaka Samhita of Agnivesha, Ayurved Deepika Commentry Cakrapanidatta, Krishnadas Academy Varanasi. P.467, p Vaidya Jadavaji Trikamji Acarya and Narayan Ram Acarya Kavyatirtha, Susrutha Samhitha of Susrutha with Nibanda Samgraha Commentry of Sri. Dalhanacarya Chowkhambha Krishnadas Academy Varanasi. P Dr. Shivprasad Sharma, Ashtanga Samgraha of Vriddha Vagbhata, Sasilekha Sanskrit Commentry by Indu Chowkhambha Samskrita Series Varanasi - p Pt. Bhisakagacharya Hari Shastri Paradkar Vaidya Akola berar, Astangahridaya, Vagbhata Arunadhatha Sarvangasundari Vyakhyanam Ayurveda rasayana of Hemadri Chowkhambha Krishnadas Academy Varanasi. P Yadunandana Upadhyaya, Madhavanidanam, Madukosa vyakhyanam, Chowkhambha Prakasam Varanasi p Pt. Bhisakagacharya Hari Shastri Paradkar Vaidya Akola berar, Astangahridaya, Vagbhata Arunadhatha Sarvangasundari Vyakhyanam Ayurveda rasayana of Hemadri Chowkhambha Krishnadas Academy Varanasi. P Dr. Shivprasad Sharma, Ashtanga Samgraha of Vriddha Vagbhata, Sasilekha Sanskrit Commentry by Indu AAMJ / Vol. 1 / Issue 5 / Sep Oct

6 Chowkhambha Samskrita Series Varanasi - p Vaidya Jadavaji Trikamji Acarya, Charaka Samhita of Agnivesha, Ayurved Deepika Commentry Cakrapanidatta, Krishnadas Academy Varanasi. P.467, p Vaidya Jadavaji Trikamji Acarya and Narayan Ram Acarya Kavyatirtha, Susrutha Samhitha of Susrutha with Nibanda Samgraha Commentry of Sri. Dalhanacarya Chowkhambha Krishnadas Academy Varanasi. P Yadunandana Upadhyaya, Madhavanidanam, Madukosa vyakhyanam, Chowkhambha Prakasam Varanasi p Pt. Brahmashankaramurthy, Bhavaprakasa of Bhava Misra Chowkhambha Samskritha Samstahn p Ganga Sahaya Pandeya, Vaidyasodala, Gadanigraha, Vidyodini Hindi Vyakhana Part 3 by Indra Deva, Tripadi Sahya p Yogatratnakara, Vydya prabha Hindi Vyakhyana by Indra Deva Tripadi and Daya Sankar Tripadi -386, 388 Chowkhambha Publications How to cite this article: Shyla and Narayana Prakash: A Critical Review on Kaphaja Unmada. AAMJ 2015; 1: Source of Support: Nil. Conflict of Interest: None declared AAMJ / Vol. 1 / Issue 5 / Sep Oct