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Seizure Disorders - Views of the Indian Medical Systems

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Seizure Disorders - Views of the Indian Medical Systems Indian Journal of Psychiatry, 2001, 43(1), 12-15 SEIZURE DISORDERS - VIEWS OF THE INDIAN MEDICAL SYSTEMS O. SOMASUNDARAM ABSTRACT The deschptions, etio-pathology and some aspects of treatment of the seizure disorders in the three Indian Systems of Medicine, namely The Siddha, The Ayurveda and The Unani are briefly mentioned. If more or less, three humors cause disease, The learned count the wind is the first of these.' Medicine, Thirukkural Key words : Seizure disorder, ayurveda, siddha, unani Views of the Indian Medical Systems and the Siddha system of Medicine was The Indian Medical systems have attributed to him. He was one of the 18 Siddhars considered the various mental disorders in their who bequeathed their experiences in Medicine respective ancient texts and some of the aspects and yoga to posterity. A number of medical books have been elaborated by Deb Shikdar (1961), are imputed to the sage, who probably lived in Varma (1965) and Somasundaram (1984) and the 6th or 7th century B.C., evidence of which is (1998) In this paper it is proposed to deal with provided in the Rig Veda, Ramayana, another important disorder viz., namely seizure Mahabharata etc. disorder Historical aspects of this disorder in the Atreaties on mental diseases were called western culture has been elaborately, detailed Agasthiyar Kirigai Nool' is ascribed to him. by Temkin (1971) and the subsequent period's Herein were described 18 psychiatric disorders have been covered by GeBerrios (1995) and with their appropriate treatments, which has been Porter (1995). described in an earlier paper (Somasundaram Siddha System et al.,1985). The Siddha system of medicine was The relationship between mental illness indigenous to the old culture of the Tamils, which (i.e. Kirigai) and epilepsy is well recognized in is of great antiquity. It is still practiced in Tamil this treatise were in one of the disorders is called Nadu and other neighbouring countries where Epileptic Insanity (Vallipu Kirigai). people of Tamil origin live. The term "Siddhi" The features of Vallipu Kirigai is described means achievement and siddhars were men who as follows :"The subject wails out a loud cry achieved certain results in medicine as well as followed by convulsions spread throughout the in yoga or tapas According to tradition it was body, all the time moaning and writhing in pain Lord Shiva who unfolded the knowledge of the associated with drooling of saliva, violent Siddha system of Medicine to his consort uncontrollable head shaking. The eyes are ruddy Parvathi who handed it down to Nandideva and and turgid." from him to the siddhars. The origin of Tamil It should be noted that the intimate relation language was attributed to the sage Agasthya between seizures and epileptic deterioration is 12 SEIZURE DISORDERS : INDIAN MEDICAL SYSTEMS recognized here. The Siddha Classification of It should be remembered that the crow is the Epilepsy describes 5 major types : conveyance (vahana) of the Saturn (Sam 1. Kumarakandam - an affliction named after Bahavan). hornless animals. Muyal vali : This form of epilepsy is 2. Amarakandam-disorder with ghastly features precipitated by the proximity to or the sight of like hell. fire or water It seizes the body and throws into 3. Bhramakandam - characterised by prolonged convulsions with twitching of the facial muscles stupor. too. The saliva froths and dribbles. The entire 4. Kakkai vali - named after the crow. body is heavy and writhes in pain. Muyalagan is 5. Muyal vali - named after the demon, on which the demon on which Lord Shiva performs his Lord Shiva performs his dance. dance. A brief description of the symptoms Most of the features of Grandmal seizure associated with each of the following : are to be found in the above 5 types of The sickness of the three pains/ description with considerable mixing up of Kumarakandam : This affliction comprises of details. We can deduce from the above unending stomach ache followed by diminution description the epigastric coma, uterine of vision with protrusion of tongue and distortion sensations, flaccidity much rarer to the rigidity of lower jaw. There is stiffening of the neck due and reflux epilepsy produced by fire and water. to severe pain around the shoulders. The Further 16 types are enumerated. Most of them features are attributed to three humors, namely are symptomatic and associated with the Vata, Pitham, Kavam. pathological features or various types of pains Amarakandam : In this disorder there is and emotions. restlessness due to a nagging pain and itching 1. Thimir Vali (? Stubbornness) associated with increased perspiration and 2. Konnu Vali (? Dyskinetic fits) respiration. Sometimes the illness is so severe 3. Chandala Vali (? Lethal fits) in form that the patient almost lays like a corpse, 4. Marana Vali (? Terminal fits) numb in pain. This experience is compared with 5. Mano Vali (fits as. With tension, prob. Hysteria) a hellish experience. 6. Nanju Vali (fits caused by external toxins) Bhramakandam (Kurangu vali): The limbs 7. Mukkutra Vali (ass. With lust) are flaccid and gelid. The patient strains in pain 8. lyya Vali (ass. With suspicion) and clenches his/her teeth associated with 9. Vil Vali (the body contorts like a bow) photophobia. The eyes are set staring lifelessly. 10. Soora Vali (? Febrile fits) The doctor invariably pronounces poor 11. Vikkal Vali (ass with hiccoughs) prognosis after examining the pulse in this 12. Thalai Vali (ass with headache) condition This condition is attributed to the foul 13. Kozhai Vali (ass. With phlegm) interplay of the three humors. 14. Odu Vali (fits produced by fever and Kakkai vali: This disease seizes the victim exhaustion) faster than the wind and extinguishes his life like 15. Marbu Vali (ass. With chest pain) Yama. the God of death. The features, which 16. Thamaraga Vali (ass. With secretions of resp. help to identify the victim of this illness, are : the tract.) eyes will be widely open with a constant upward Many of these confirm to symptomatic fits gaze The patient will have double incontinence either physical or mental along with the with excessive chillness spread throughout the associated features body. There is stiffness of limbs, collection of Ayurveda System phlegm in the throat along wim slurring of speech Apasmara which roughly corresponds to almost fitting the condition to a state of delirium. epilepsy was defined in Ayurveda as a disorder 13 O. SOMASUNDARAM due to the derangements of the intellect and the epilepsy mainly by vamana (the emesis). As mind characterized by loss of memory, loss of preventive measures mortality and mental consciousness and convulsive movements of the tranquillity are advised. Existing psychic causes body. In those persons in whom the doshaa had like worry anxiety, greed, grief, passion should become excessive, deranged by addiction to be avoided. unwholesome and unclean food and the Sathuva Various drugs and massage therapy with quality of mind had become obscured by passion the aid of oils like mustard oil, katabhyadi oil, and ignorance, the brain had become occluded triphatadya oil were recommended. Drugs like with morbid humors and the mind oppressed with ghrtas (classified butter) Maha Panchgamya worry, passion, fright, anger, grief and anxiety etc. Ghrta, Brahma Ghrta were recommended. There are four kinds which are described in the Apatantraka - is a disease caused by ancient medical literature on the basis of doshas psychic causes with physical manifestations. the following are the kinds of apasmara. When it occurs in women it is called 1. Vataja Apasmara yosapannana and resembles hysterical disorder. 2 Pittaja Apasmara One of the manifestations, closely resembles 3. Kaphaja Apasmara pseudoseizures. 4 Sannipataja Apasmara The apatantraka shows the following SYMPTOMS OF ENDODENOUS OR HUMORAL symptoms - APASMARAS 1. Fainting 2. The body bends like a bow and causes Vataia Pittaja Kaphaja convulsions of limbs Nails face, skin and They are ginger like They are found 3. Eyes are fixed in wide stare or remain closed eyes are red & dusky green or Coppery in white or Pale 4. Unconsciousness. in colour Dribbling of frothy Stertorous Drooling of 5. Cooing like a pigeon. saliva from mouth breathing saliva from 6. Making a mourning noise. angle of mouth 7. After relaxation of vata from heart the Head drawn to one Tossing on the Falling en the side, clenching of ground ground No consciousness is regained. fingers & feet strong convulsive 8. Dreadful condition. movts are seen 9. Difficulty in breathing. Frequent attacks of Frequent attacks Slowly becoming Hence Madhavani danakara included transient unconscio­ like vataja unconscious anc usness & immediate regaining apantantraka in apasmara but Susruta Samhita regaining of consciousness described it as apantanatraka (Gupta, 1977). consciousness Unani System Visual aura of jerky, Visual aura of blood Visual aura of This system became popular during the fickle harsh &dry red, fierce terrifying white hairy and objects blazing & angry glossy shapes & Muslim rule of the country and continues to be looking forms & homologation of practiced even today in India. Najabuddm non-homologation antagonistic of Unhammad (1222 AD) made a special study of to pitta causing kapha humor mental diseases and described 7 varieties of factors illness The treatment usually was purging and The Sanni Pataja apasmara is called bleeding supplemented with nutritious diet. incurable due to combination of three humors According to the Unani system of medicine, The symptoms are usually atypical and this epilepsy is mainly due to the vicious humor apasmara has usually bad prognosis The vata accumulating in the blood. type of epilepsy is treated by means of basic Based on this theory there are 4 humors : (the enemata), pittava epilepsy is treated mainly (i) Dum (sanguine blood) by virecana (the purgation) and kapha type of (ii) Balgham (phlegm) 14 SEIZURE DISORDERS: INDIAN MEDICAL SYSTEMS (iii)Safra (yellow bile) REFERENCES (iv) Sauda (black bile) Humoral theory plays a vital role in the Ge Berrios,E.
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