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 of as one of many psychological problems. Grasp Charaka has defined the chapter pertaining to prognosis and remedy of Apasmara instantly after the chapter pertaining to prognosis and remedy of Unmada.
Unmada is a broad-spectrum psychological dysfunction which incorporates many psychological circumstances beneath its wing. It has usually been in comparison with psychoses, lunacy and plenty of different psychological problems. Grasp Charaka has additionally specified that the remedy of unmada and apasmara are alike and shall be dealt with via 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 positively 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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Which means of Apasmara, easy methods 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 circumstances of ‘reminiscence associated problems’ will not be thought of 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 individuals who are seeing). It additionally means disgustful actions
Each tamah pravesha and bibhatsa cheshta are induced attributable to 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 clarify ‘lack of knowledge or intelligence (momentary)’ which the particular person experiences throughout an assault of the illness. Similar to we don’t perceive something whereas enveloped by pitch darkness, we can’t perceive or entry something when attacked by (surrounded) the illness.
Bhibhatsa – scary; Cheshta – actions
The particular person does scary or hideous actions attributable to absence of information / destruction of intelligence and thought course of on getting into into the zone of darkness. Hideous actions embody irregular jerky actions of the limbs and deviation of eyes, froth showing from the mouth and so forth.
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 will not be accomplished deliberately. They seem with out the information of the affected person on getting into the darkish zone, shedding information / 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 principle reason behind 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 could not comply with the chronology and will occur on the identical time.
In response to 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 so forth
- The doshas get aggravated
- And transfer in the direction of the hrt-srotas i.e. mind and thoughts channels and get lodged therein
- Causes smriti apadhwamsa i.e. destruction of reminiscence
- Attributable to 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 known as apasmara, which is of 4 sorts
The reason is nearly just like that of Grasp Charaka. Madhava Nidana has defined the causes and the occasions following to the causation of apasmara. However Madhavakara has used the time period ‘samrambha’ as a substitute of ‘bhibhatsa chesta (Charaka)’.
Is there solely reminiscence loss in apasmara?
Although the principle attribute function of apasmara is lack of reminiscence together with hideous actions and lack of consciousness, smriti is a time period mentioned to be consultant of a grosser injury within the illness. Smriti apagamana additionally contains lack of mind, knowledge, thought course of, larger mental features and information together with reminiscence.
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In response to Grasp Sushruta
The phrase Apasmara is made up of two phrases, apa and smara. Apa is used within the which means of ‘killing, destroying or giving up’. Smara is used to clarify smrti i.e. reminiscence. Smrti can also be to recollect and recollect the previous experiences and information 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. Attributable to destruction of reminiscence, mind and knowledge, the particular person would enter water or hearth and finish life since they can’t bear in mind the implications in the course of the assault. Smrti needs to be understood broadly and will embody mind, knowledge and reminiscence. It is because throughout apasmaara one tends to neglect the recollections 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 known as as apasmara. One other reference from Grasp Charaka clarifies the identical –
Attributable to destruction of reminiscence, mind and thoughts, the particular person does many scary actions together with look of froth from the mouth, cramps and irregular actions of the limbs and physique components, irregular actions of eyes, grinding of tooth, throwing of limbs and so forth whereas enveloped by darkness and causes lack of consciousness instantly and repeatedly. This situation known as apasmara.
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Apasmara is ‘epilepsy’ or ‘reminiscence problems’?
Apasmara has been in comparison with epilepsy. Even in epilepsy we are able to see that the particular person can have irregular actions of the physique components (convulsions, shaking, tremors), froth happens within the mouth, the particular person faints and loses consciousness for a short while and when he comes out of the episode of epilepsy he wouldn’t bear in mind something (lack of reminiscence). When the assaults are repeated or are frequent, one’s information, knowledge and analytical expertise are additionally misplaced. Remedy of apasmara works in offering reduction, prolonging the assaults or curing apasmara. Due to this fact in a means it’s appropriate to match apasmara with epilepsy.
Apasmara can also 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 particular person shall be severely affected or destroyed. Since lack of reminiscence is the predominant function of apasmara, it may be thought of as ‘reminiscence dysfunction’ additionally.
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