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Research status of Medhya with special reference to Anxiety disorder Smita Chandrachood* and Apoorva Sangoram** Tilak Ayurved Mahavidyalaya, Pune

Abstract: The article deals with concept of Medhya, (its components & their description), description of Mana, the process of acquiring knowledge, and assessment of Medhya Karma. This status will help practicing physicians for treating patients with Anxiety disorders.

Introduction: According to Ayurveda, the term ‘Sharira’ refers to body including five senses and mind. Mind is an inter-link between the inert body and the sentient soul. Ayurveda is the science where the approach towards disease is not only curative but also preventive mental health. This aspect is similar for mental diseases too. Since ancient era of Vedic period, there has been a lot of studies for the establishment of the theories of mental functions. First reference was seen in Samhita, as Medhajanana&Medhavardhana .

Concept of medhya- The drugs, herbs that are beneficial to Medha are said to be Medhya . These dravyas act by improving components of Medha i.e. Dhi, Dhruti and Smruti as • Improve cognition and help in improving Dhi. • Improve retention power and help in improving Dhriti • Improve recall i.e. memory and help in improving Smriti. In Ayurveda, Rasayana herbs are mentioned to increase overall health of subjects. These rasayana herbs specifically show Medhya actions Definitions of Medha: 1. The etymological derivation of word ‘Medha’ According to etymological derivation, Medha means to come together.

Medha is the subtle, continuous, uninterrupted, deep knowledge perceived by sense organs, specifically the auditory senses. Medha is an unobstructed and uninterrupted perception and retention of knowledge of all aspects of an object. Synonyms of Medha: Thus Medha is also considered as one of the synonyms of . Other synonyms are enumerated below: Manisha, Dhinshana, Pradnya, Dharana, Semushi, Mati, Dhi, Buddhi, Praatipat, Preksha, Pratipatri, Chetana, Samvit, Dnyapti, Upalabdhi, Medha, Manan, Man, Bhal, Bodha, Sanstha, Sankhya, Pratibha. Sadnya, Dnyan, Vidnyan, Medha, Drushti, Dhruti, Mati, Manisha, Shruti, Smriti, , Krutu. - Aitarey

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Concept of Medha: The etymological derivation of Medha suggests that it is a conjugation of all faculties of Buddhi i.e. Dhi. The definition of Medha is, ‘Medha is the intellect which has the ability to uninterruptedly, earnestly grasp & retain the finest knowledge acquired by the sense organs.’ Thus, when the information is being grasped, Medha conjugates , indriya & mana for this process. This information is then processed by its faculties. The conjugation of the faculties (Dhi,Dhruti & Smruti) is again facilitated by Medha. After perception as knowledge, the perceived knowledge is retained & recalled with the help of Smruti, a component of Medha. The coming together of all faculties of Buddhi along with mana,forming a chain for gaining, processing & retention of knowledge is the function of Medha. In short, Medha is a true governing power which gathers all the required tools to gain & perceive knowledge in its true sense. Components of Medha Dhi, dhruti and smruti are the components of medha. There are some references which suggest that Buddhi is a synonym to Dhi, while some other references define Buddhi in a wider sense. While describing the components of Medha it is necessary to see details of Buddhi & Pradnya. Buddhi - ‘Buddhi’ is a broad term.The term “buddhi” is derived from It means knowledge. Buddhi covers this function under its umbrella, but Buddhi means much more than merely the power of determination. Definition – Faculty that helps in taking decision is called Buddhi. This includes long-standing as well as quick decisions. The whole process of taking the perfect decision, from perception, processing & conclusion is function of Buddhi. In this function, Buddhi needs to understand the object in its true form without the doubts. Commentator Chakrapanidatta describes Dhruti, Smruti as the types of Buddhi. Pradnya- Intellect which helps to acquire deep & wholesome knowledge is Pradnya. Commentator Arundatta mentions Dhi as a synonym to Buddhi & Pradnya both. Thus it can be said that Buddhi & Pradnya are synonymous. Dhi, Dhruti, Smruti are types of Pradnya. Buddhi, Medha & Pradnya are synonyms.

Pradnya

Dhruti Smruti Dhi

Definition and Meaning of Dhi, Dhruti, Smruti and Mana: 1. Dhi- The word is a derivate from Dhi is the component of Buddhi, which always perceives the knowledge correctly (C.S.1/99). Thus understanding & knowledge of the object is the function of Dhi. It is the judgment of the soul. Intellect is an attribute of the soul and not of the mind as mind cannot make its own decisions. Dhi is defined as the power that determines the nature of the object and that gives concluding remarks about its merits & demerits for orientation of attitude. 2. Dhruti-

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Niyamatmika is the word used to describe Dhruti, which literally means ‘the regulator’. Dhruti is the regulator as well as controller of mind. It prevents the Mana from indulging into harmful things. It maintains & regulates the functions of Mana. Power of retention of knowledge is also called Dhruti. 3. Smruti- The word is derived from The various definitions of Smrurti are as follows: It is non-destruction of experienced knowledge. The synchronized union of Atma & Mana along with Sanskara is termed as Smruti. The power that helps the mind in analysing the entire percept with the help of concepts formed by past experiences is called as Smruti (recall). Smruti is re-collection of audio visual & experienced objects. The similar definitions are given in Sushruta Samhita & Asthanga Hrudaya. The 25 factors responsible for promotion of Smruti are Pranidhan (Attention), Nibandh (Association), Abhyas (Repetition), Linga (Sign), (Descriptive Sign), Sadrushya (Similarity), Parigrah (Ownership), Ashrayashrit (Relation of Correlatives), Sambadh (Close Relation), Aanntaya (Relation of Immediate Sequence), Viyog (Separation,Ek-karya (Identity of Function), Virodh (Enmity), Atishaya (Superiority), Prapti (Acquisition), Vyavdhan (Intervention), Sukh Dukkh (Pleasure & Pain),Eccha-Dwesh (Desire and Aversion), Bhaya (Fear), Arthaitwa (Need), Kriya (Action), Rag (Affection), (Merit), Adharma (Demerit). Mana (Mind) is the important mediator of this chain for process of knowledge. It conjugates the Atma & Buddhi on one side & the sensory & motor organs on the other side. Thus mind serves as a bridge between these bhavas & thus helps the process of knowledge & cognition. 4.Mana- Coordinator for genesis of knowledge i.e. the one by which thorough knowledge is perceived is Mana. The function of mana (Manovyapara) is divided into three processes- Cognitive process (Dnyana vyapara) Buddhi is important factor in the cognitive process. It mainly includes gaining of knowledge. Affective Process (Bhavana pradhan vyapara) Affective process is the middle stage between cognitive & connotive processes. Mind is unconscious but active while the self (Atma) kindles consciousness. (Ca. Sha.1/70-72) Psychic movements, shifting of sense organ’s impulsion & restraint of mind, mentally arriving at another world, desire, aversion, happiness, misery, will, consciousness, control, knowledge, memory & ego are some of the signs of self (Atma) (Cha.Sha. 1/70-72). With these signs of self, the affective process is continued. The process goes on in the form of response to exterior. Connotive process (Chesta pradhan vyapara) Chestha i.e. action is initiated after affective process. The actions are of four types- a) Voluntary Actions c) Automatic Actions b) Involuntary Actions d) Reflex Actions

Process of acquiring knowledge: In the process of acquiring knowledge, a chain is established as follows: Atma conjugates with mana, mana then conjugates with sense organs, and the specific sense organ then perceives the specific sense.

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The perceived information is brought back to Atma through the chain of sense organs & mana, is then established as knowledge. The process occurs in following stage- Desire originates in Atma: The desire to acquire knowledge i.e. Iccha originates in the Atma. With the desire to acquire a particular knowledge, comes into role & thus the actual process to acquire knowledge begins. Deciding what knowledge is to be acquired comes under the umbrella of Buddhi, the decision making ability. Atma is a site of Buddhi. Budhhi along with its 3 components viz. Dhi, Dhruti & Smruti, initiate a signal for Mana & the sense organs to perceive a specific knowledge. Mana as a mediator: Mana is the important mediator of this process, which is then stimulated. Mana stimulates the particular sense organ for gaining the knowledge related to a particular sense; eyes for example are given the signal for acquiring the sense of vision. Sense organs as receivers: The sense organs are capable of perceiving their objects only when they are supported by mind. Without mana sense organs cannot gain the signals or take wrong signals. Interpretation and decision: The sense object is recognized by the sense organ in conjugation with the mana. After perception, the object is interpreted by mana having regards to its guna (merits) & dosha (demerits).Now this perceived information about the object is brought back to Buddhi by mana for its proper understanding & acceptance as knowledge. Buddhi then processes this knowledge with the help of Dhi, Dhruti, Smruti along with mana. After interpretation of the percept, the power that determines the nature of the object and that gives concluding remarks about its merits & demerits for orientation of attitude is called as Dhi. After determination of knowledge it is stored in the form of Dhruti & recalled whenever & wherever necessary with the help of Smruti. When the percept is obtained & all the doubts are cleared, there is a genesis of a formed knowledge i.e. Dnyana(¥ÉÉlÉ). In accordance with the Dnyana, the person is inspired to work. This inspiration is generated by Buddhi. When a book/newspaper is perceived by eyes, Buddhi gives an inspiration to motor organs to read. Depending upon the inspiration an action is projected through five karmendriya (Motor organs). In this process, the power that controls the orientation of the attitude & an action to be projected is called Dhruti. While the Smruti helps to recall the experience. Process of Acquiring Knowledge

dnyana to Atma

desire Artha in Atma

indriya Mana

The constituents of Atma, Mana, Indriya & Artha

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Atma Mana Indriya Artha

• Iccha • Chintya • Shrotra • Shabda • Dwesha • Vicharya • Twak • Sparsha • Sukha • Uhya • Chakshu • Rupa • Dukha • Dhyeya • Rasana • Rasa • Prayatna • Sankalpya • Ghrana • Gandha • Chetana • Dhruti • Buddhi • Smriti • Ahamkar

I.2.9 Review of Mana: • Definitions- Mind is defined as the entity which even on contact with self, sense production or otherwise of knowledge by its attending or non-attending respectively. (Cha.Sha.1/18) Mind is understood by uninterrupted collective perception of knowledge. (.Darshan.1/1/6.) Mana is the entity whose efficacy is dependent on its objects (Artha) & at the same time it is responsible for action of sense organs. (Ca.Su. 8/4). • Synonyms of Mind: Chitta, Cheta, Hrudaya, Swanta, Hrut, Manasa. (Amarakosha) • Etymological derivation of synonyms: Satva- The Satva indicates radiance of mind. It is usually used when connection of mind to the outer world is to be denoted. Chitta- Chitta is indicative of knowledge and is used in the context of relationship of mind and buddhi. Mana- When process of thinking and doing its own functions is going on by mind, it is termed Mana. All these are customs followed in Samhitas. Attributes of Mind: Minuteness & oneness are the two qualities of mind-(Cha.Sha.1/19). Minuteness (Anupramana), one in number (ekatva), distinguished (Pruthakatva), conjunction (Samyoga), disjunction (Vibhaga), Remoteness (Paratva), Proximity (Aparatva) & Momentum (Vega) are the attributes of mind. • Mind as a faculty: Mind is the dual faculty with sensory and motor functions. Mind exists as an, thinking faculty, analytical faculty, and cognitive faculty. • Objects of mind:

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The objects are ➢ Chityai. e. thinking, which is initial thought process. ➢ Vicharya i.e. analysing, is analysis of thought. ➢ Uhya i.e. reasoning. Negative and positive aspects of thought are thought of. ➢ Dheya i.e. meditating. In this process mind sets, the goal. ➢ Sankalpa i.e. determination where mana determines to begin work. ➢ Whatever is to be perceived by mind is its object. (Cha.Sh.1/20.) The thought process also involves all above objects in same sequence. • Action or function of Mind: The function of mind consists of ➢ Indriyabhigraha i.e. Control over senses ➢ Swasayanigraha i.e. Self-restraint ➢ Uhai.e reasoning ➢ i.e. analyzing Three Constituents of Mana: The satva, raja and tama are three constituents of mana, although for its evolution sattva and Raja play a greater role. These are called as mahagunas. Charaka describes the three types of mana i.e. sattva, , tamas on the basis of dominance of one of the three gunas. • Mind: A substratum of diseases: Mental health is a state of sensorial, mental, intellectual & spiritual wellbeing. Unhealthy interaction between individual & his environment results in ill mental health. Mind & body including the faculties are considered as a substratum of diseases.

I.2.10 Interrelation of Components of Medha: Dhi, dhruti and smruti are components of Medha. In process of acquiring knowledge mana is the important link of chain. These all are interrelated. The functions of mind consist of control over senses, self-restraint, reasoning, analysing Further, it is the authority of Buddhias the perception of correct knowledge is the function of Dhi. (Cha.Sha.1/99.) Dhruti controls mind from indulging in sensual pleasures from the noxious object. (Cha.Sha.1/100). This allows Dhi to achieve its function. Perceiving the past knowledge by evaluating and correlating is the function of Smruti(Cha.Sha.1/100). Thus, the components of Medha are interrelated.

Inter-relation between Mana and Buddhi: There are many evidences in Ayurvedic texts on the basis of which it is quite evident that mana &Buddhi are not identical but interrelated. In Carakasamhita, it is clearly mentioned that functions buddhi are ahead of the functions of mana. While explaining the dnyanotpatti karma (process of genesis of knowledge), Acharya Caraka says that, the buddhivyapara follows manovyapara for attaining the determined knowledge. The sense object is received by sense organs conjugated with mind. The mind analyses it in the form of merits & demerits then forwards it to buddhi which produces significant knowledge by which one produces to act accordingly. I.2.11 Relation of Dosha, Dhatu with Buddhi& Mana: Physiologically body is defined as

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The body is made up of dosa dhatu, mala. Each function of the body is totally dependent on the organize function of dosha, dhatu & mala. Medha is influenced by attributes of doshas, dhatu & mala. The following references enumerate the relationship of doshas & Ojas with Medha are given below. Table 25: Relation of Dosha, Dhatu with Buddhi and Mana Attributes Normal Aggravation Vitiation

Vata Enthusiasm, Manoniyamana, Moha, Dainya, Cinta ,Shoka, Bhaya controller & Manoprerana Bhaya, Shoka, Dainya, Moha, stimulator of Sarvondriy-yojanam Pralapa Manovyaharsha mind Sarvendriyarth- abhivahanam Buddhikarma

Prana Supporter of Buddhidharana, Indriy-opaghata mental Indriyadharana functions Manodharana

Udana Generation Dhi, Dhriti,Smriti, Manobhransa of memory Manovibodhana, Dhi-bodhana, Dhriti - bodhana, Smruti-bodhana Vyana Smrutiksaya Pitta Activities of Medha (Grnthakarshana Indriya- Irsha brain, Samarthyam Sadhakagni daurbala Krodha, Shoka, Bhaya Generation Sadnyam), Krodha of Medhajanana intelligence Harhsa Abhilasa, Dhi

Sadhak Functions of Abhiprarthithamanorathas Indriya- a-pitta mind adhanm daurbalya Buddhi, Medha, Krodha Abhimana,, Abhipretarthasadhanam. Kapha Intelligence, , AlobhaJnanam, Kayavakamanovyapar will power Buddhi,Dhi a, Anarambha Tarpak Indriyatarpana Ojas Dehasthitinibandhanam Tushti, Pushti, Kopa, Dhyana, Shoka, Bala Shrama, Bibheti, Durbala, Vyathitendriya, Duschaya,

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Durmanaha.

• Relationship of Dhatu: While describing sarata of 7 dhatus following references regarding mana and buddhi are found: Rasa sara: knowledgible person having good intelligence Raktasara: Intelligent (Medhavi) Mamsa: superior dhruti but can forgive quickly. Majja: having good grasping ability and knowledgible. The Asthamsarata known as ‘Satvasarata’ is having indicative of outstanding qualities of mind as: gifted with memory, devotion, grateful, learned, wholesome, brave, skillful, determined, fighting in battles with expertise, free from anxiety, having well directed, serious intellect as well as activities and engaged in honourable acts. (Ch. Vi. 8/102-111)

Pharmacodynamics of Medhya Rasayana: Drugs favourable for Medha are termed as Medhya Rasayana. These are considered to endorse the mental functions along with their Rasayana effect. A group of all the Medhya drugs described in the Ayurveda classic texts reveals that though it seems a slight amplification in describing certain pharmacodynamic properties of these drugs, majority of the Medhya drugs show a mixed picture. Interpretation of the effect of all Medhya drugs on one uniform principle of their pharmacodynamics is difficult. in Rasavaiseshika has clearly mentioned that Medhya drugs act mainly by prabhava (r.vai. Su.1:27). Broadly speaking, different Medhya drugs performs their Medhya karma at different levels such as rasa, , srotasa etc. • At the level of rasa they act by improving the nutrition of the faculties of Medha e.g. Shatavari. • At the level of agni, these drugs act by stimulating and improving the functions of sadhakagni e.g. Pippali, Vacha, Jyotishmati etc. • At the level of srotasa these drugs improve the circulation of ahararasa by opening and clearing the srotasa and these ultimately improve the functions of Medha e.g. Shankhapuspi, Haritaki. The probable pharmacodynamics of Medhya rasayana drugs can be understood on the Ayurvedic concept of rasapanchaka which is as follows: Bhautika Constitution: The pharmacological properties of the drugs are the consequential of the different permutations and combinations of the five mahabhuta. Accordingly, drugs are classified into five groups viz. akashiya, vayaviya etc. These bhuta are said to have the characteristic of the three mahagunas i.e. Sattva, Raja, Tama. The Medha and all conscious manifestations are credited to the Satva-guna. Satva predominant mahabhuta are Akash (Satvabahula), Teja (Satva + Raja bahula) and Aap (Satva+Tama bahula).Hence the akasiya, tejasa and apya drugs having the Satvaguna predominance are mainly responsible for the promotion and nourishment of medha. Elements predominant in Vayu act at the level of mana by acting with rajasguna. Guna: The predominance of Sattva, Raja and Tama in the guna can be understood by knowing the pancabhautika constitution of the drugs. According to this, the laghu, Ushna, shita, snigdha,

Rasamruta, 11:4 April 2019 tikshna, sara, manda, picchila, slaksna, suksma, drava, vyavayi and vishadaguna are having a Sattva guna dominance of varying degree. As medhya drugs are dominated by Sattva guna, they may possess some of the above mentioned guna. Their mode of action can be interpreted as under: ➢ The drugs of guru, shita, snigdha, manda, sthira, mrudu, drava, picchila and slaksnaguna increase the kapha in general and tarpaka and avalambakakapha in particular which nourishes the Dhi,Dhruti,Smruti and medha. ➢ The drugs of laghu, Ushna, tikshna and saraguna increases the pitta in general and stimulate sadhakagni which in turn generates Medha. ➢ The drugs of sukshma, drava, vyavayi and vishadaguna improve the circulation of ahararasa by opening and clearing the micro channels and thus ultimately improve the functions of medha. Rasa: ➢ The herbs of madhura rasa boost the kapha in general and tarpaka and avalambakakapha in particular, which nourishes the dhruti, smruti and Medha. ➢ The herbs of amla & lavana rasa increase the pitta and stimulate sadhakagni which generates Medha especially dhi. ➢ The herbs of katu, tikta rasa stimulate the agni and make amapachana, removes mala thus removes Jadya over Medha. Especially Tikta rasa is described as Medhya. ➢ Kashaya rasa acts as srotasa shodhana due to cleansing property (Vishadaguna) and improve the functions of Medha. Vipaka: ➢ Drugs of madhuravipaka nourish Dhruti, Smruti & Medha. ➢ Katu and amlavipaki drugs also show Medhya effect, however they achieve these functions by stimulating agni and purifying srotasa. Veerya: Both Ushna and Shita Virya are responsible for the promotion and nourishment of Medha. ➢ Drugs of shitavirya increase kapha, nourish the Dhruti, Smruti and thus Medha, support intellectual function. ➢ Ushnavirya increases the pitta and stimulates the sadhakagni and aids intellectual functions especially regarding Dhi. As Acharya Caraka said in Chikitsasthana, all Rejuvenators (Rasayana) act as Medhya. They may be contributing to for the nutrition of brain by enhancing the cerebral circulation and providing micro-nutrients. Thus Medhya drugs have a definite role in the treatment of psychiatric and psychosomatic diseases, where chief aim of the treatment is to achieve sedation, tranquillity and stimulation of the activities of the mind. Besides, the above mentioned pharmacodynamics and therapeutic uses of the Medhya drugs, modern researches conducted until now on these Medhya drugs like Jatamansi, Jyotismati, and Shankhapushpi etc. specify that these drugs have different psychotropic actions. Many drugs have been screened for stimulant, antidepressant, and sedative and tranquilizing effects both experimentally and chemically, shown encouraging results. Therefore, it can be concluded that the Medhya rasayana of Ayurveda is a broad concept having direct action of psychological as well as cognitive functioning and they are beneficial for the promotion of the Medha.

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Assessment of Medhya Karma As discussed earlier, Medhya rasayana of Ayurveda is a broad concept having direct action of psychological as well as cognitive functioning. Hence, they have a definite role in the management of psychiatric and psychosomatic diseases. They can be used in the treatment of sub normality. Medhya karma of any Medhya Rasayana drug has to be assessed in: 1. Children of different age group with various learning disabilities 2. Normal children having certain learning and behavioural problems 3. Normal children for rising excellence in various academic and extracurricular activities 4. For the people who are prone to mental stress. 5. For the middle aged, early elderly people, to reduce amnesia, to prevent degenerative conditions. Assessment of Medha according to samitas Acharya Charaka has given guidelines in Vimansthana for the assessment of Medha, Smruti, dhruti and various other faculties of mind etc. (Vi 4/8) Chakrapani has commented that Medha should be assessed by evaluating the proper understanding of textual information and all sort of knowledge. Smruti should be assessed by recollection of recall of the past experiences and by understood knowledge. According to Dalhanacharya Medha should be evaluated by assessment of ➢ Sarvatah- perception of all indriya ➢ Avyahata – unrestricted, unimpeded. ➢ Pragadha- subtle Hence Medha can be understood by assessing unobstructed understanding and grasping of perception by all indriya. (Indriyabuddhi) (S. Chi. 28/1-2) Acharya Vagbhata in Ashtangahrudaya gave guidelines for assessment of Medha as: Gruhitasya - perceived / grasped Avicchedana - continuously, uninterrupted Dharana - retention This means that Medha should be assessed by uninterrupted retention of understood knowledge. Considering above aspects of assessment of Medha, comprehensive protocol incorporating assessment of grasping capacities of all the sensual perceptions & functions of mind like thinking, determination power, self-control etc. and retention power should be prepared to assess Medha in normal as well as in the individuals with subnormal intellect. Assessment of Functions & Objects of Mana: The strength of body is of three types, congenital, time affected & acquired. Among these, congenital strength is that which is natural to the body & mind. (Ca.Su.11/36) The assessment of mind state is the explained by Aacharyacaraka in Vimansthana as ‘satvapariksha’. The three types of satva has been mentioned according to their strength of tolerance viz. Pravar, Madhya and Avar. The pravarsatva individuals are similar as Satvasara while symptoms of Madhya and Avar sara are discussed earlier in disease review (C. Vi. 8/119). Also while describing Anuman Pramana Aacharya Caraka, gave examination of Mana should be according to its perceptions of the objects. (C. Vi. 4/8) The above article can be summarized as, the Medhya Rasayancan helps not only to enhance the various mind functions but also used as treatment in various mental diseases. For choosing appropriate Medhya Rasayan it is necessary to have knowledge about both the

Rasamruta, 11:4 April 2019 mode of action of the drug and properties of the drug. The above article can help in better understanding of Medhya Rasayan, Medhya concept, Mana, Buddhi and its assessment. This will finally help in deciding line of treatment.