By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Apasmara is without doubt one of the illnesses included beneath Ayurveda psychiatry. It’s thought-about as one of many psychological problems. Grasp Charaka has defined the chapter pertaining to analysis and remedy of Apasmara instantly after the chapter pertaining to analysis and remedy of Unmada.
Unmada is a broad-spectrum psychological dysfunction which incorporates many psychological situations beneath its wing. It has typically been in comparison with psychoses, lunacy and lots of different psychological problems. Grasp Charaka has additionally specified that the remedy of unmada and apasmara are alike and shall be dealt with by comparable interventions. Apasmara is in comparison with epilepsy in Ayurveda scientific apply. However apasmara is greater than that. The time period Apasmara has embedded in it the phrase ‘smriti’ which suggests reminiscence. Apasmara undoubtedly is a situation whereby derangement of reminiscence could be evident. So, is apasmara ‘epilepsy’ or ‘reminiscence problems’? Allow us to see what the classics have to inform about it.
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That means of Apasmara, the best way to perceive
Smrteh apagamanam – ‘Destruction of reminiscence’ is taken into account as apasmara by consultants.
So lack of reminiscence is the predominant attribute function and diagnostic level for apasmara. However all instances of ‘reminiscence associated problems’ should not thought-about as apasmara. The affiliation of different signs talked about beneath makes the definition of apasmara full and complete. Apasmara is a situation predominantly marked by lack of reminiscence related to –
- tamah pravesha i.e. feeling as if enveloped by darkness (blackout) and
- bhibhatsa cheshta i.e. scary actions (scary for many who are seeing). It additionally means disgustful actions
Each tamah pravesha and bibhatsa cheshta are prompted as a result of dhee-sattva samplava.
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Tamah – darkness, Pravesha – getting into
Tamah pravesha means feeling like getting into a zone of darkness. Coming into into the darkness is a time period used to elucidate ‘lack of knowledge or intelligence (momentary)’ which the individual experiences throughout an assault of the illness. Identical to we don’t perceive something whereas enveloped by pitch darkness, we can not perceive or entry something when attacked by (surrounded) the illness.
Bhibhatsa – scary; Cheshta – actions
The individual does scary or hideous actions as a result of absence of information / destruction of intelligence and thought course of on getting into into the zone of darkness. Hideous actions embrace irregular jerky actions of the limbs and deviation of eyes, froth showing from the mouth and many others.
What causes ‘doing hideous actions’ and ‘destruction of reminiscence’ within the affected person of apasmara?
Dhee-sattva samplava is alleged to be the trigger for doing hideous actions and destruction of reminiscence within the affected person of apasmara. Hideous actions should not carried out deliberately. They seem with out the data of the affected person on getting into the darkish zone, dropping data / mind and judgment and being blacked out. Dhee means mind. Sattva means thoughts. Samplava means deviation or destruction. So destruction of mind and thoughts is the primary explanation for destruction of reminiscence and hideous actions in apasmaara.
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Chain of occasions resulting in apasmara
- Dhee Sattva Samplava (destruction / deviation of mind and thoughts)
- Smriti apagamana (lack of reminiscence)
- Tamah Pravesha (lack of consciousness)
- Bhibhatsa Chesta (hideous actions)
Be aware – these occasions might not comply with the chronology and should occur on the similar time.
Based on Madhava Nidana
Madhava Nidana treatise defines apasmara and its hallmark options together with the outline of the pathogenesis of the illness. The sequence of the illness is as defined beneath –
- Publicity to etiological elements which disturb and trigger imbalance of thoughts and attributes of the thoughts like worries, grief and many others
- The doshas get aggravated
- And transfer in direction of the hrt-srotas i.e. mind and thoughts channels and get lodged therein
- Causes smriti apadhwamsa i.e. destruction of reminiscence
- Because of destruction of reminiscence and buddhi i.e. mind by aggravated doshas
- Tamah pravesha –blackout
- Samrambha – hideous actions like deformities and obliqueness of the attention / eyes, violent and jerking actions of arms and legs (higher and decrease limbs)
- The mixed results of those occasions results in manifestation of a illness referred to as apasmara, which is of 4 sorts
The reason is sort of much like that of Grasp Charaka. Madhava Nidana has defined the causes and the occasions following to the causation of apasmara. Alternatively Madhavakara has used the time period ‘samrambha’ as a substitute of ‘bhibhatsa chesta (Charaka)’.
Is there solely reminiscence loss in apasmara?
Although the primary attribute function of apasmara is lack of reminiscence together with hideous actions and lack of consciousness, smriti is a time period stated to be consultant of a grosser harm within the illness. Smriti apagamana additionally contains lack of mind, knowledge, thought course of, increased mental capabilities and data together with reminiscence.
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Based on Grasp Sushruta
The phrase Apasmara is made up of two phrases, apa and smara. Apa is used within the that means of ‘killing, destroying or giving up’. Smara is used to elucidate smrti i.e. reminiscence. Smrti can be to recollect and recollect the previous experiences and data of issues. When mixed collectively – apa + smara = destruction of reminiscence.
Antakrt – Sushruta tells that this illness would have a tendency to finish the lifetime of the affected person if not handled correctly. Because of destruction of reminiscence, mind and knowledge, the individual would enter water or hearth and finish life since they can’t keep in mind the results through the assault. Smrti needs to be understood broadly and may embrace mind, knowledge and reminiscence. It’s because throughout apasmaara one tends to neglect the reminiscences and experiences gained not solely from the previous but in addition these of the current time.
Grasp Dalhana, commentator of Sushruta Samhita additionally opines that destruction of reminiscence is known as as apasmara. One other reference from Grasp Charaka clarifies the identical –
Because of destruction of reminiscence, mind and thoughts, the individual does many scary actions together with look of froth from the mouth, cramps and irregular actions of the limbs and physique elements, irregular actions of eyes, grinding of enamel, throwing of limbs and many others whereas enveloped by darkness and causes lack of consciousness immediately and repeatedly. This situation is known as apasmara.
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Apasmara is ‘epilepsy’ or ‘reminiscence problems’?
Apasmara has been in comparison with epilepsy. Even in epilepsy we will see that the individual could have irregular actions of the physique elements (convulsions, shaking, tremors), froth happens within the mouth, the individual faints and loses consciousness for a short while and when he comes out of the episode of epilepsy he wouldn’t keep in mind something (lack of reminiscence). When the assaults are repeated or are frequent, one’s data, knowledge and analytical expertise are additionally misplaced. Remedy of apasmara works in offering reduction, prolonging the assaults or curing apasmara. Subsequently in a method it’s appropriate to check apasmara with epilepsy.
Apasmara can be a psychological dysfunction. When the thoughts, reminiscence and mind are broken and when the signs repeatedly happen and illness turns into power, the reminiscence of the individual will probably be severely affected or destroyed. Since lack of reminiscence is the predominant function of apasmara, it may be thought-about as ‘reminiscence dysfunction’ additionally.
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