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AYUSHDHARA ISSN: 2393-9583 (P)/ 2393-9591 (O) An International Journal of Research in AYUSH and Allied Systems

Review Article

EVALUATION OF TREATMENT METHODS OF MADATYAYA (ALCOHOLISM) IN M.H.Biradar1*, Jyoti M. Ganer2 *1Associate Professor & HOD, Dept. of Tantra, BLDEA’S AVS Ayurveda Mahavidyalaya, Vijayapur, Karnataka, India. 2Assistant Professor, Dept. of Agada Tantra, Uttaranchal Aturved College, Raipur, Dehradun, Uttarakhand, India.

KEYWORDS: Madatyaya, ABSTRACT Alcoholism, Ayurveda, Today we have forgotten the art of leading life. Thus, we have ended up Nidana, Lakshana, life miserably resulting in many lifestyle disorders pertaining to the body Management. and mind. Ayurveda deals with life in a holistic way in every aspects of life. Alcoholism is termed as Madatyaya in Ayurveda which is one among the lifestyle disorders, is also disabling addictive disorder. It has increased at an alarming rate worldwide, even in India it is a burning

issue. Alcohol consumption in India increased two folds between 2005 *Address for correspondence and 2006, according to the Global Status Report on alcohol and health Dr M.H.Biradar 2018 released by the world health organization (WHO). Alcoholism is Associate Professor & HOD, also known as alcohol use disorder (AUD), is a broad term for any Dept. of Agada Tantra, drinking of alcohol that results in mental or physical health problems. BLDEA’S AVS Ayurveda The disorder was previously divided into two types: Alcohol abuse and Mahavidyalaya, Vijayapur, Alcohol dependence. It is characterized by compulsive and uncontrolled Karnataka, India. consumption of alcohol despite its negative effects on the drunkard’s

Email: health, relationships and social standing like other drug addictions, [email protected] alcoholism is medically defined as a treatable disease. This article Phone no: 8951001964 highlights diagnosis and management of Madatyaya.

INTRODUCTION In Ayurvedic science Madhyavarga has been Madatyaya or Panatyaya explained among 12 Ahara Varga (classification of Alcohol affects the mind causing inebriation, food). It is used as Ahara Dravya (food Adjunct), as enhances Tamoguna, and affects the intellect of the Anupana (after drink) or as Aushadhi (medicine). In person. It is substance which on administration there is reference of Madhya disturbs all the functions of the body i.e. , being used for Samdnyaharana (anesthesia) in Dhatu, Mala and makes them abnormal. If taken Shastrakarma (surgeries). On the basis of use, improperly and in excess amount can degrade the Madhya is classified into two types; as medicine and health and causes death.[2] as beverage. It is further classified into 5 types Now days the alcohol consumption has depending on method and raw material used viz; become passion for the people and without Asava, Arista, Sura, Varuni, Sidhu, out of which first knowing its proper utilisation and its effects, two are used for medicine and remaining as persons are getting addicted to the alcohol which in beverages. Madhya is one which produces Madhya turn obviously may deteriorate the health and life (alcoholic beverages) is one which produces Mada span. (excitement). When consumed with proper rules But Acharya Charaka has focused about quantity, time and procedure, it gives importance separately on alcohol (Sura) its happiness, strength, reduces fear, strain and act a as utilisation and its effects on the body. Actually in Amruta (nector) for the body. But the same when the olden days the alcohol was consumed with great consumed without following these rules it results in respect, i.e. worshipped by the gods led by their Madatyaya.[1]

AYUSHDHARA | March - April 2019 | Vol 6 | Issue 2 2128 M. H. Biradar, Jyoti M. Ganer. Evaluation of Treatment Methods of Madatyaya (Alcoholism) in Ayurveda king from the early times; offered as obtain in classified drugs i.e.; drugs possessing Tamoguna Sautramani sacrifice; honoured by priest. predominantly and which causes derangement of Materials and Methods the mind are called a Madakari (intoxicants) for In the present review article, detailed example Sura and the Madhya. treatment methods related to Madatyaya are Classification of Madatyaya analysed from Charaka, Sushruta and Vagbhata, and It is also called as Panatyaya, it is Tridoshaja also relevant references are taken from other Vyadi, according to , Paramada, Panajeerna Ayurvedic and research articles. and the serious condition is called Panavibrama.[4] Literary Review Panatyaya (Madatyaya) according to Dosha is 1. Madatyaya has been described in 24th chapter of Vataja, Pittaja, Kaphaja and Sannipataja. Charaka Samhita after Visha Chikitsa, because Stages of Mada Madhya is having properties like Visha (poison). Charaka and Sushruta both have explained Charaka explains in detail the Madhya Gunas three stages of Mada, but Acharya Madavakara (qualities), stages of Madatyaya and diseases exlained in Porvardha of Madhava Nidhana of 18th caused by alcoholism, their signs, symptoms chapter mentions 4 stages of Mada. and Chikitsa has also been explained. First Stage of Alcoholic Intoxication[5] 2. In Sushruta Samhita, Uttara Tantra 47th chapter, Intake of alcohol results in 3 stages of Acharya has described about Madatyaya in intoxication, Prathama, Madhyama and Antima detail in the name of Panatyaya Pratisheda. Avasta. 3. In Astanga Sangraha, Madatyaya Chikitsa has The person comes across exhilaration, been explained in detail in 9th chapter of passion, proper manifestation of the attributes of Chikitsa Sthana. He mentions Madhya Prayoga food and drink, and the wisdom and creativity of in Madatyaya and also mentions treatment of music, song, humour and stories. It does not impair Mada and Murcha. the wisdom and memory and does not cause 4. In Astanga Hrudaya, Nidana (causes) of inability for the senses to perceive their objects. Madatyaya has been explained in 6th chapter of This results in sound sleep and post-waking feeling Nidanastana, and in 7th chapter of of freshness. Thus, this stage of intoxication is Chikitsasthana has explained treatment of conductive to happiness. Mada, Murcha, Sanyasa including Nidana and Second Stage of Alcoholic Intoxication[6] Chikitsa of Dwamsaka and Vikshaya. The person often remembers things and 5. In Kashyapa Samhita, Chikitsastana author has often forgets them, his voice becomes inarticulate explained effects of Madhya in pregnant women and confused, and he speaks sense and nonsense and infants with their treatment. simultaneously. 6. In Madhava Nidana, Madatyaya explained after His movement, posture, drinking, eating and Krumi Nidana. talking are all appropriately and inappropriately 7. In Bhava Prakash, Madatyaya explained in funny. These are the signs and symptoms of the Madyama Khanda after Murcha, Bhrama, Nidra second stage of intoxication. Tandra and Sanyas Adhikarana, followed by Third Stage of Alcohol Intoxication [7] Daha Adhikarana. After crossing second stage and in the 8. Yogaratnakar has explained a separate chapter beginning of the third stage, persons become as Madatyaya Adhikara after Murchadhikara. inactive like a broken tree with his mind afflicted Madatyaya (Alcoholism) with intoxicating morbidities and unconsciousness. Madatyaya is a combination of two words Though alive, he resembles dead person. He Mada and Atyaya. Mada means Harsha (excitement) becomes incapable of recognizing pleasing things Atyaya means Atikrama (excess), which could be and friends. He is soon deprived of all happiness for defined as Madyati Janonena, it means after which he had taken alcohol. He loses the very sense consumption it makes the person to lose his sense of distinction of rightful, happy and useful items is called as Madhya. This over excitement is caused from the wrong, miserable harmful ones by excess consumption of Madhya. Depending on respectively; therefore, no wise person will ever the involvement of the Dosha, its toxic effects are like to place himself in such a stage of intoxication. seen.[3] He is condemned and censured by all persons, and In Sharangadhara Samhita while defining disliked by them. As the natural outcome of this the term Madakari, Madhya is also included in the

AYUSHDHARA | March - April 2019 | Vol 6 | Issue 2 2129 AYUSHDHARA, 2019;6(2):2128-2133 indulgence, he suffers from miseries and diseases Aahara), who does not undertake exercise all the time (Vyayam), who sleeps during day time (Divaswapa), Nidana and Lakshana of Madatyaya and who indulges in the Sukhaseenata, excessively In Sarangadhara Samhita while describing drinks Madhya which is not an old or which is the Madakari property, the Madhya is also included prepared of Guda, and Paishtika, then he in the classified drugs, Madhya is drug possessing immediately develops Kaphaja Madatyaya. Tamoguna predominantly and cause derangement Lakshana: In Kaphaja Madatyaya symptoms are of the mind are called Madakari.[8] characterised by vomiting (Chardi), anorexia The Madhya is made of many properties and (Arochaka), nausea (Hrullasa), drowsiness actions, it is like the nectar if consumed according (Tandra), timidity (Sthaimitya) and heaviness to prescribed method in proper quantity, in proper (Gaurava). time with wholesome food, in accordance with Sannipataja Madatyaya one’s own strength and cheerful mind, alcohol In Sannipataja Madatyaya all Tridoshaja or some of works like ambrosia. three individual Dosha can be seen. All the types of Madatyaya are caused by Lakshana: Body pain (Shareera Dukham), vitiation of Tridoshas. The classification is made on unconsciousness (Balavat Sammoha), chest pain the basis of whichever Dosha is dominating in (Hrudvyatha), tastestlessness (Aruchi), excessive presenting symptoms, the condition is named by thirst (Pratata Trushna), fever (Jwara), heat cold that Dosha. feeling (Sheetoshna Lakshana), headache Types of Madatyaya[10] (Shirokamp), yawning (Jrumba), excitement Charakacharya describes Madatyaya types as (Sphuranam), chest congestion (Urovibandha), Vataja, Pittaja, Kaphaja and Sannipataja. cough (Kasa), hiccups (Hikka), difficulty in breathing (Shwasa), insomnia (Prajagara), Vataja Maadatyaya shivering (Shareera Kampa), dieases of ear, eyes, Nidana: If a person is excessively emaciated mouth (Karna Akshi Mukharoga), vomiting (Chardi), because of indulgence in women (Vyavaya), grief loose motion (Atisara), nausea (Hrullasa), giddiness (Shoka), fear (Bhaya), carrying heavy load (Bhrama), Pralapa. (Bharavahana), walking long distance Sushrutacharya describes the adverse (Chankramana), other strenuous activities (Sahasa), effects of chronic usage of Madhya, when taken while eating ununctuous food (Ruksha Aahara), less against the rules and regulations prescribed for quantity of food (Alpa Aahara) drinks alcohol at Madhya intake are classified as Panatyaya, night and which is excessively fermented then this Paramada, Panajeern and Panavibhram.[11] leads to the impairment of his sleep (Nidra) and causes Vataja Madatyaya. 1. Panatyaya-Sushrutacharya explained Panatyaya in the place of Madatyaya. Four types of Lakshana: Vataja Madatyaya is characterised by Panatyaya described as Vatakrita, Pittakrita, signs and symptoms like hiccup (Hikka), asthma Kaphakrita and Sarvakrita. (Shwasa), tremors in the head (Shirakampa), pain in the sides of the chest (Parshva Shoola), insomnia a. Vataja Panatyaya: It is characterised by and delirium in excess (Bahupralapa). numbness (Stambha), bodyache (Angamarda), palpitation, a catching and pricking pain in the Pittajja Madatyaya region of the heart (Hridayagraha), pricking Nidana: If a person, indulging in food that is Tiksna, sensation (Toda), and headache (Shiroruja). Ushna, Amla in excess and having liking for b. Pittajanita Panatyaya: It is characterised by excessive exposure to the fire and sun, drinks perspiration (Sweda), delirium (Pralapa), excess quantity of Madhya that is Tikshna, Ushna dryness of mouth (Mukhashosha), burning and sour, then he suffers from Pittaja type of sensation (Daha), loss of consciousness Madatyaya. (Murcha), yellowness of face and eyes Lakshana: Symptoms are like thirst (Trushna), (Vadanalochan Peetata). burning sensation (Daha), fever (Jwara), sweating c. Kaphajanita Panatyaya: It is characterised (Sweda), giddiness (Moorcha), diarrhea (Atisar), by vomiting (Vamathu), shivering (Sheetata), Vibhram, green colouration of the body water brash (Kapha Praseka). (Haritavarna). d. Sannipataja Panatyaya: All Tridoshaja Kaphaja Madatyaya Lakhsanas seen in this type of Panatyaya. Nidan: If a person who is habituated to sweet (Madhura), unctuous (Snigdha), heavy food (Guru AYUSHDHARA | March - April 2019 | Vol 6 | Issue 2 2130 M. H. Biradar, Jyoti M. Ganer. Evaluation of Treatment Methods of Madatyaya (Alcoholism) in Ayurveda 2. Paramada: It is characterised by heat All the types of alcoholism are Tridoshaja, hence the (Ushmanam), heaviness in the body physician should first treat the Dosha which is (Angagurutam), excessive accumulation of predominant there in. Sleshma (Sleshmadhikatwam), an aversion of Otherwise in alcoholism the treatment should be food (Aruchi), suppression of stool and urine started from Kapha because it is predominantly (Malamutra Sangam), thirst (Trushna), headache situated flanked by Pitta and Vata.[13] and joint pain (Shiro and Sandhiruja). 2. Administration of Madhya (Madhya 3. Panajeerna: Distension of abdomen Prayoga)[13] (Aadhmana), sour taste in the mouth (Udgiran The diseases which arise from inadequate, Amlarasa), Vidaha and indigestion (Ajeerna) and improper and excess drinking of liquor get cured by features of aggravated deranged Pitta should be the same if administered properly. regarded by a physician as the exciting factor of Charaka explains more about the usage of this wine the disease. that Vayu obstructed in channels due to Dosha 4. Panavibhrama: It is characterised by piercing excited by wine produce intense pain in head, bones pain in the heart and body (Hridgata Toda), and joints. In such cases for liquefying the Dosha vomiting (Vomathu), fever (Jwara), sensation of particularly wine should be given because of its the rising of fumes into the throat properties like quick absorption, sharpness and (Kanthadhuma), giddiness (Murcha), salivation hotness unlike of other remedial measures. (Kaphasravan), headache (Shiroruja), burning Wine removes the obstruction of channels, sensation in the throat (Vidaha). carminates vata, improves relish, stimulates Vagbhata - Aacharya Vagbhata explains four types digestive fire and becomes suitable by practice. On of Madatyaya viz., Vataja, Pittaja, Kaphaja and removal of obstruction in channels and carmination Sannipataja. Apart from this Dhvamsaka and of vata, pain subsides, disorders are also pacified. Vikshaya is also explained.[12] 3. Administration of Milk (Dugda Prayoga)[14] Etiology: A person, if suddenly stopped drinking If by these tested measures the alcoholism does not Madhya, takes recourse to drinking Madhya in subside one should advise the intake of milk leaving excessive amount again, then he suffers from the above measures relating to wine. After Dhvamsaka and Vikshaya. discontinuing wine, when Kapha is diminished, Signs and Symptoms debility and lightness arises due to lightening Dhvamsaka: Sleshma Praseka, Kanthasya Shosha, (Langana, Pachana, procedures and Shabdasahishnuta, Atitandra and Nidra. Shamana measures and Vata and Pitta becomes Vikshaya: Sammoha, Chhardi, Angaruja, Jwara, predominate in the patient inflicted by wine, so Trishna, Kasa, Shiroshoola. milk administration acts as a boon like rains for the A person suffering from Dhvansaka or Vikshaya are tree which is extremely dried in summer. After difficult to cure, as the person is already become some days milk also should be withdrawn slowly weak and emaciated because of his earlier alcohol with substitutes of Pathya Dravyas. drinking habit. 4. Psychological measures (Harshanakriya)[15] Upadrava of Madatyaya: Hikka with Jwara, Alcohol does not cause alcoholism without causing Vamathu, Vepathu, Parshwashoola, Kasa and agitation of the mind and causing morbidity in the Bhrama. body hence exhilarating measures necessary. Asadya Lakshana (Incurable): Irresponsive to Beautiful parks, ponds, with lotus flower, good food questions (Heenottaraushtiham), extreme cold and drinks, pleasing companions, garlands, (Atisheetam), heaviness of tongue (Jivha perfumes, clean clothes, melodious music, Gauravata), cold teeth (Sheeta Danta), bluish entertaining parties, ample arrangement of talks, discolouration of teeth (Neela Danta), yellowish jokes and songs and beloved and submissive discolouration of eyes (Peeta Nayana), reddish women etc. alleviate alcoholism. discolouration of eyes (Rakta Nayana). 5. Administration of drugs to cure alcoholic Management of Madatyaya intoxication should be done after the lapse of 1. Samanya Chikitsa - (general management) seven or eight days; by this time the wine that is 2. Visisthta Chikitsa - (specific treatment) residing in unusual (wrong) channels becomes digested, such of the diseases which continues Samanya Chikitsa after period should be treated appropriately 1. Doshanusara Chikitsa with drugs suitable for alcoholic intoxication.[16]

AYUSHDHARA | March - April 2019 | Vol 6 | Issue 2 2131 AYUSHDHARA, 2019;6(2):2128-2133 Visistha Chikitsa Further in the evening the patient of 1. Vataja Madatyaya - Chukra, Maricha, Ardraka, Panajirna should drink wine again, (to restore the Dipya and Kusta with a little of Sauvarchala , i.e. the digestive power.)[21] should be taken with Madya, Prtvika, Dipyaka, Mahaushada and Hingu along with Sauvarchala Panavibrama Chikitsa salt should be dispensed as beneficial recipe. 1. Syrup prepared from Draksa, Kapitha, citreous Pana prepared with Amra Phala, Amrataka, fruits and Dadima with lot of Madhu and Sita Dadima and Matulunga should be given. Or the cures Panavibrama. patient should use meat soup (Mamsa Rasa) etc. 2. In the same way, Amrataka and Kola should be mixed with Matulunga Swarasa and Mamsa of used as syrup. marshy animals added with Sugandi Dravyas 3. Syrup prepared from Kharjura, Vetraka, Karira, (flavouring agents).[17] Draksa, Trivrit and Sriparni with Sita should be 2. Pittaja Madatyaya - Madhya should be mixed used in the cold state. with Kashaya prepared with Madura Rasa 4. Tender leaves of latex tress, Bisa, Jiraka, Dravyas along with Madhu and Sita and the good Nagapuspa, Patra, Ilvalu, Sitasariva, Padamaka, flavours are beneficial. After drinking this Amkarata, Bhavya, Karamarda, Kapitha, Kola, Madhya, one should take Ikshu Rasa, it should be Vrksamla, Vetraphala, Jiraka and Dadima should brought out completely by vomiting. be taken after adding Yasti and Utphala as a cold Lava Mamsa Rasa, Aina and Tittira, or Mudga drink.[22] Rasa with Sita and Ghruta should then to be One who after discontinuing the intake of wine given to drink for benefit. starts taking it in excessive quantity suffers from 3. Kaphaja Madatyaya - Induce Vamana by the the diseases named Dhvamasaka and Viksaya. help of Madhya with Bimbi and Vidula Swarasa. Dhvamsaka: Sleshma Praseka (excessive Mamsa Rasa of wild fatty animals with bitters salivation), Kantasya Shosha (dryness of throat and and pungent should be given; further soups mouth), Shabdasya Asahisnuta (intolerance to prepared with pulses is beneficial.[18] sound), Tandra (excessive drowsiness as well as 4. Sannipataja Madatyaya - Due to all three Dosas Nidra (sleep), these are the symptoms of measures to counteract all of them should be Dhwamsaka.[23] undertaken, however, in case with dual Dosas Vikshaya: Hrudaya, Kantha Roga (abnormality in involvement, having assessed both of them the heart and throat), Sammoha (mental confusion), main one should be treated first. In addition, all Chardi (vomiting), Angaruja (pain in the body), other beneficial measures, as also those which Jwara (fever), Thursna (thirst), Kasa (cough) and please the mind are described should be carried Shirashoola (head ache) these are symptoms of out.[19] Viksaya. Paramada Chikitsa[20] Chikitsa: The management is same as that of the Kasmarya, Daru, Vida, Dadima and Pippali, Vatika type of Madatyaya. Basti, Sarpi for Pana, and along with Draksha, should be added to water and Ksheera and Sarpi is used for Abyanga (massage), drink should be made, to which Bijapuraka juice Udwartana (unction) and Pana.[24] should be added and if this is quickly taken as drink According to Kashyapa: Madatyaya is Amaja, that the condition of Paramada gets totally received in is why while treating Madatyaya, are of Tridoshaja. no time. Therefore, in the beginning, treatment should be Draksha, Sita, Manduka, Jiraka, Dhanya, done for the most predominant Dosha. If all Doshas Trivrit should be similarly prepared and taken as a are equally aggravated, then the treatment should drink. In the same way Mamsa Rasa of wild animals be done first for the location of Kapha, followed by with Sauvarchala and citrus fruit juices should be that of Pitta and lastly that of Vata.[25] taken. A bath water processed with Bharangi is also CONCLUSION beneficial. It is concluded that Madatyaya is explained Panajirna Chikitsa in detail in all Ayurvedic classics. It helps in Iksvaku, Dhamargava, Vrksaka and diagnosis and management depending on the Kakahvayo, Damambarika should be cooked with involvement of the Dosha in Madatyaya, Thus milk and given in an Anjali Pramana to induce Ayurveda have ultimate and effective solution in the vomiting. management and rehabilitation of drug addiction. REFERENCES AYUSHDHARA | March - April 2019 | Vol 6 | Issue 2 2132 M. H. Biradar, Jyoti M. Ganer. Evaluation of Treatment Methods of Madatyaya (Alcoholism) in Ayurveda 1. Dnyaneshwar kantaram Jadhav, Global journal of 14. R.K.Sharma, Bhagawan Dash Vol.4 Charaka Addition &Rehabilitation Medicine, An Ayurvedic Samhita, Choukhamba Publication, 2015, Review on Madatyaya w.s.r Alcoholism, March Chikitsa stana 24 Chapter, Shloka195-196, page 22 2017 Juniper Publisher, Volume 1- Issue 3- 428. page no-001-004. 15. R.K.Sharma, Bhagawan Dash Vol.4 Charaka 2. Kulakarni Ravidra P Deo Sunil H, Upadhyay Samhita, Choukhamba Publication, 2015, Rajesh S, Ayurlog; National Journal of Research Chikitsa stana 24 Chapter, shloka117-120, page in Ayurved Science, Concept of Madhya an 412. ayurvedic perspective, volume 3, issue 3, July 16. R.K.Sharma, Bhagawan Dash Vol.4 Charaka September 2015, page no 99-106. Samhita, Choukhamba Publication, 2015, 3. Mannalal Abimanyu, Amarakosh of Amarasimha, Chikitsa stana 24 Chapter, Shloka 195-196, Choukambha Publication 1999, Trutiya khanda3, page428. Page 204. 17. R.K.Sharma, Bhagawan Dash Vol.4 Charaka 4. 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M. H. Biradar, Jyoti M. Ganer. Evaluation of Treatment Methods of Madatyaya (Alcoholism) in Ayurveda. AYUSHDHARA, 2019;6(2): 2128-2133. Source of support: Nil, Conflict of interest: None Declared

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