The commentary says that after the chapter on non-human afflictions, apasmāra is begun because of the sameness of mental impairment and because the graha treatment is praised here too. 'Apa' means going away, smāra is memory; apasmāra is the disease in which memory goes away.
Key terms
apasmāra
A classical disorder of loss of memory and awareness with seizure-like episodes.
Smṛti is the knowledge of things as they are; 'apa' is in the sense of removal (parivarjana); therefore this disease is called apasmāra, which brings an end.
The commentary gives the derivation: because of loss of memory and awareness of things as they are, the disease is apasmāra. 'Bringing an end' (antakṛt) means destroying, since, from the loss of memory, one falls into water, fire and the like. Others take antakṛt as referring to the final stage described in the passage beginning 'the one who repeatedly loses memory, wasted'.
मिथ्यातियोगेन्द्रियार्थकर्मणामभिसेवनात् |
विरुद्धमलिनाहारविहारकुपितैर्मलैः ||४||
वेगनिग्रहशीलानामहिताशुचिभोजिनाम् |
रजस्तमोभिभूतानां गच्छतां च रजस्वलाम् ||५||
तथा कामभयोद्वेगक्रोधशोकादिभिर्भृशम् |
चेतस्यभिहते पुंसामपस्मारोऽभिजायते ||६||
Meaning of the śloka
From wrong use of the sense-objects and actions, from foods and conduct that are incompatible and unclean, from aggravated doṣas, in those who hold back natural urges, eat unwholesome and unclean food, are overcome by rajas and tamas, or have intercourse with a menstruating woman; and from great desire, fear, agitation, anger and grief, in a man whose mind is struck: apasmāra arises.
The commentary gives the causes of mental injury. Wrong use (mithyā), non-use (ayoga) and excess (atiyoga) of sense-objects and of bodily, verbal and mental action are meant; for example, hearing harsh or inauspicious speech is wrong use, hearing excessive loud drums is excess, hearing nothing is non-use; likewise for touch, sight, taste, smell; for bodily action (exercise at forbidden times, too much, or none), verbal action (harsh or false speech, too much talk, or complete silence), and mental action (thinking of grief, too much thought, or none). Incompatible food is as taught in the hitāhitīya chapter; unclean food is putrid, hated, impure or stale. The doṣas are vāta, pitta, kapha and rajas and tamas, which soil the body. Holding back urges refers to stool, urine and so on. The repetition of unwholesome and unclean food is for emphasis. Menstruating women are those whose period is seen. When the mind is injured by these causes, apasmāra arises.
Trembling of the heart, emptiness, sweating, deep brooding, fainting, deep confusion and loss of sleep will occur in this (apasmāra) as premonitory signs.
When the channels that carry consciousness are pervaded by the doṣas and overcome by rajas and tamas, the person, confused, with a bewildered mind, flings his hands and feet, with crooked brows and eyes, grinds his teeth, vomits froth, and falls to the ground with open eyes; after a short time he regains consciousness. That is called apasmāra...
The commentary explains the episode. An objection: the channels of consciousness are two only ('one wakes by two'), so why plural? Answer: the fine ramifications of both are many. 'Pervaded by doṣas' means overcome by vāta and other doṣas, and by rajas and tamas. The person is bewildered from a confused mind, flings limbs about, has crooked brows and eyes, grinds his teeth, and falls with open eyes. In this disease, with such movements, the patient falls to the ground; that disease is apasmāra.
Key terms
saṃjñāvaha srotas (saṃjñāvaheṣu srotaḥsu)
Channels carrying consciousness.
phena
Froth at the mouth.
vivṛtākṣa
With eyes wide open.
Adhikarana ೬ (೧೦) · Śloka ೧೧
... ಸ ಚ ದೃಷ್ಟಶ್ಚತುರ್ವಿಧಃ ||೧೦||
ವಾತಪಿತ್ತಕಫೈರ್ನೄಣಾಂ ಚತುರ್ಥಃ ಸನ್ನಿಪಾತತಃ |೧೧|
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... स च दृष्टश्चतुर्विधः ||१०||
वातपित्तकफैर्नॄणां चतुर्थः सन्निपाततः |११|
Meaning of the śloka
... and it is seen to be of four kinds: by vāta, pitta and kapha in people; the fourth by sannipāta.
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ಅಪಸ್ಮಾರಸ್ಯ ಸಙ್ಖ್ಯಾಮಾಹ- ಸ ಚ ದೃಷ್ಟ ಇತ್ಯಾದಿ| ಚತುರ್ವಿಧ ಇತಿ ಸಙ್ಖ್ಯಾಕರಣಂ ದ್ವನ್ದ್ವಜಾಪಸ್ಮಾರನಿಷೇಧಾರ್ಥಮ್| ದ್ವನ್ದ್ವಜಾಸಮ್ಭವಸ್ತು ವ್ಯಾಧಿಸ್ವಭಾವಾತ್| ಚಾತುರ್ವಿಧ್ಯಂ ವಿವೃಣ್ವನ್ನಾಹ- ವಾತಪಿತ್ತಕಫೈರಿತ್ಯಾದಿ| ವಾತಾದಿಭಿಃ ತ್ರಯಃ||೧೦||-
Meaning of the commentary
The commentary states the number. 'Fourfold' is stated to exclude two-doṣa types; two-doṣa types do not occur, from the nature of the disease. Three are by the doṣas singly.
वेपमानो दशन् दन्तान् श्वसन् फेनं वमन्नपि ||११||
यो ब्रूयाद्विकृतं सत्त्वं कृष्णं मामनुधावति |
ततो मे चित्तनाशः स्यात् सोऽपस्मारोऽनिलात्मकः ||१२||
Meaning of the śloka
Trembling, biting the teeth, breathing hard, vomiting froth, and saying 'a deformed, black being is chasing me; then I shall lose my mind': that is apasmāra of vāta nature.
The commentary describes the vāta type. The seeing of a black being is a false appearance caused by the influence of vāta in the channels of consciousness, not a real pishāca or other being, as another tantra also says: 'from vāta he sees harsh, reddish-brown and black forms'. The same applies to the pitta and kapha types.
Key terms
vātaja apasmāra (anilātmaka apasmāra)
Apasmāra from vāta.
vikṛta sattva (vikṛtaṃ sattvam)
A deformed figure seen in the episode.
Adhikarana ೮ (೧೩) · Śloka ೧೪
ತೃಟ್ತಾಪಸ್ವೇದಮೂರ್ಚ್ಛಾರ್ತೋ ಧುನ್ವನ್ನಙ್ಗಾನಿ ವಿಹ್ವಲಃ |
ಯೋ ಬ್ರೂಯಾದ್ವಿಕೃತಂ ಸತ್ತ್ವಂ ಪೀತಂ ಮಾಮನುಧಾವತಿ ||೧೩||
ತತೋ ಮೇ ಚಿತ್ತನಾಶಃ ಸ್ಯಾತ್ ಸ ಪಿತ್ತಭವ ಉಚ್ಯತೇ |೧೪|
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तृट्तापस्वेदमूर्च्छार्तो धुन्वन्नङ्गानि विह्वलः |
यो ब्रूयाद्विकृतं सत्त्वं पीतं मामनुधावति ||१३||
ततो मे चित्तनाशः स्यात् स पित्तभव उच्यते |१४|
Meaning of the śloka
One afflicted by thirst, heat, sweating and fainting, tossing his limbs, helpless, who says 'a deformed yellow being is chasing me; then I shall lose my mind': that is said to arise from pitta.
शीतहृल्लासनिद्रार्तः पतन् भूमौ वमन् कफम् ||१४||
यो ब्रूयाद्विकृतं सत्त्वं शुक्लं मामनुधावति |
ततो मे चित्तनाशः स्यात् सोऽपस्मारः कफात्मकः ||१५||
Meaning of the śloka
One afflicted with cold, nausea and sleep, falling to the ground, vomiting kapha, who says 'a deformed white being is chasing me; then I shall lose my mind': that is apasmāra of kapha nature.
The commentary says heart pain (toda) belongs to the vātika type, thirst to the paittika, and nausea/spitting (utkleśa) to the kaphaja; these signs are known in that order in the three types.
Key terms
hṛttoda (hṛdi toda)
Pricking pain in the heart region.
utkleśa
Retching or nausea.
Adhikarana ೧೧ (೧೬) · Śloka ೧೬
ಪ್ರಲಾಪಃ ಕೂಜನಂ ಕ್ಲೇಶಃ ಪ್ರತ್ಯೇಕಂ ತು ಭವೇದಿಹ ||೧೬||
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प्रलापः कूजनं क्लेशः प्रत्येकं तु भवेदिह ||१६||
Meaning of the śloka
Raving, murmuring and distress occur here in each (type).
The commentary gives the signs of sannipātaja apasmāra: the signs of vāta and the other types come together. Since the verse says arising from the aggravation of all doṣas, it means arising from the three doṣas each aggravated by its own cause, not from one aggravated doṣa aggravating all.
Key terms
sannipātaja apasmāra (sarvadoṣaprakopaja)
Apasmāra from all three doṣas, with combined signs.
sarvaliṅgasamavāya
Combination of all signs.
Adhikarana ೧೩ (೧೭) · Śloka ೧೮
ಅನಿಮಿತ್ತಾಗಮಾದ್ವ್ಯಾಧೇರ್ಗಮನಾದಕೃತೇಽಪಿ ಚ ||೧೭||
ಆಗಮಾಚ್ಚಾಪ್ಯಪಸ್ಮಾರಂ ವದನ್ತ್ಯನ್ಯೇ ನ ದೋಷಜಮ್ |೧೮|
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अनिमित्तागमाद्व्याधेर्गमनादकृतेऽपि च ||१७||
आगमाच्चाप्यपस्मारं वदन्त्यन्ये न दोषजम् |१८|
Meaning of the śloka
Because it comes without cause, goes away even without treatment, and comes again (from itself), others say apasmāra is not from the doṣas.
The commentary states the view of others, that apasmāra is of external origin (āgantuka). 'Without cause' means arising accidentally; 'goes away even without treatment' means subsides without being treated (some read 'from untreated medicine'); 'comes again' means of itself, not from another cause, since the doṣa-born nature has been shown. Others read 'they say it arises from mutual (doṣa)', meaning from rajas and tamas; still others read 'from mutual affliction', meaning mutual spoiling of body and mind.
By the sequence of use (of causes) of the doṣas, by their momentary nature, by its (arising from) both its own and other (sources), and by its manifold forms, the learned describe it as doṣa-born. As, even when the rain falls, some seeds sprout in the ground only in autumn, so the origin of a disease occurs. Some (doṣas) that remain, quickly increased in a short time, show manifold disorders by their nature. Apasmāra is a great disease; therefore it is surely doṣa-born.
The commentary refutes the other view and states its own. The four reasons: the doṣas cause disease in the sequence of accumulation and the rest, which answers 'arising without cause'; the doṣas are momentary, so the disease may go away even without treatment as the doṣa's surge subsides, which answers 'goes away without treatment' (the commentary notes that Āyurveda, as a universal assembly, uses even the Buddhist doctrine of momentariness here); 'from its own and from others' means from independent and dependent sources, and the four types (vāta, pitta, kapha, sannipāta) are described in both; and 'manifold forms' because it has all signs of all the doṣas and of rajas and tamas. An objection: if the doṣas are always present in the body, apasmāra would be continuous. The answer is the rain simile: even when rain falls on ploughed soil, some seeds sprout only in autumn; so, though the seed of every disease, the doṣas, is present, apasmāra arises only when causes and the tissues meet. Others explain it differently: when no rain falls, in autumn some seeds still sprout in damp soil; so doṣas in the body, slightly increased in a short time, produce a disease. The doṣas are stable and, by their spoiling nature, show manifold disorders. So apasmāra is doṣa-born and not caused by possession by a being.
For it, the whole regimen stated in the (chapter on) unmāda should be done. Drinking old ghṛta, and anointing, are praised, and especially the use of the formulas stated for the grahas; from these all succeed, but one may also treat by other formulas. Oil cooked with the bark-juice of śigru, kaṭvaṅga, kiṇva, āhi and nimba, in four times cow's urine, is beneficial in anointing.
The commentary gives treatment. An objection: the regimen of unmāda is yet to be stated, so why not cross-refer there? Answer: because unmāda measures are especially beneficial in apasmāra. Anointing is with old ghṛta, for it counters all three doṣas. Śigru is śobhāñjana; kaṭvaṅga is araluka or śyonāka; kiṇihī is white syandana; the bark with juice is used, meaning paste and juice both. 'Cow's urine' is specified because elephant, goat and sheep urines are mentioned in mind-disorder treatment and are here excluded. The oil is sesame oil.
Key terms
purāṇa sarpis (purāṇasarpis)
Old (aged) ghṛta.
abhyaṅga
Anointing.
gomūtra (gavāṃ mūtra)
Cow's urine.
Adhikarana ೧೬ (೨೪) · Śloka ೨೫
ಗೋಧಾನಕುಲನಾಗಾನಾಂ ಪೃಷತರ್ಕ್ಷಗವಾಮಪಿ ||೨೪||
ಪಿತ್ತೇಷು ಸಿದ್ಧಂ ತೈಲಂ ಚ ಪಾನಾಭ್ಯಙ್ಗೇಷು ಪೂಜಿತಮ್ |೨೫|
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गोधानकुलनागानां पृषतर्क्षगवामपि ||२४||
पित्तेषु सिद्धं तैलं च पानाभ्यङ्गेषु पूजितम् |२५|
Meaning of the śloka
Oil cooked with the bile of monitor lizard, mongoose, snake (nāga), spotted deer, bear and cow is praised for drinking and anointing.
The commentary explains a second oil. Nāga is the elephant; pṛṣata is the spotted deer; ṛkṣa is the bear. The oil is cooked with the bile of each of these, equal in measure to the oil.
Key terms
pitta
Bile.
pānābhyaṅga
For drinking and anointing.
Adhikarana ೧೭ (೨೫) · Śloka ೨೫
ತೀಕ್ಷ್ಣೈರುಭಯತೋಭಾಗೈಃ ಶಿರಶ್ಚಾಪಿ ವಿಶೋಧಯೇತ್ ||೨೫||
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तीक्ष्णैरुभयतोभागैः शिरश्चापि विशोधयेत् ||२५||
Meaning of the śloka
One should also cleanse the head by sharp (measures) from both sides.
The commentary says that after the oil, head-purging is given. 'Sharp ones from both sides' means viṣāṇikā, brāhmī, kāravellaka and the like. Others read 'by sharp emetics and purgatives, and by head-purgings', taking 'sharp' as joined with both: emetics and purgatives (both ways) and head-purging are done with sharp agents.
Key terms
śirovirecana
Head-cleansing (nasya).
ubhayatobhāga
Both directions (up and down).
Adhikarana ೧೮ (೨೬) · Śloka ೨೬
ಪೂಜಾಂ ರುದ್ರಸ್ಯ ಕುರ್ವೀತ ತದ್ಗಣಾನಾಂ ಚ ನಿತ್ಯಶಃ |೨೬|
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पूजां रुद्रस्य कुर्वीत तद्गणानां च नित्यशः |२६|
Meaning of the śloka
One should worship Rudra and his hosts constantly.
Kulattha, barley, kola, śaṇa seed, palaṅkaṣā, jaṭilā, the two pañcamūlas and pathyā, decocted with care; ghṛta cooked with goat's urine is beneficial in the vātika type.
The commentary says kola is badara; palaṅkaṣā is guggulu; jaṭilā is māṃsī; the two pañcamūlas are the śāliparṇī group and the bilva group (or eraṇḍa-bilva groups per others); pathyā is harītakī. Some read 'yogataḥ' for 'yatnataḥ', explaining that one of decoction and urine is taken fourfold and the other equal.
Ghṛta with a paste of kākolī and the rest, cooked in the first group (vidārigandhādi), mixed with milk, honey and sugar, is beneficial in the paittika type.
The commentary says the paste is of pippalī, vacā, mustā and the like; the decoction is of āragvadhādi; the eightfold urine group is used. Others take the urine group as goat, sheep and elephant urine, since these are mind-disorder relieving.
Siddhārthaka ghṛta: cooked with suradru (devadāru), vacā, kuṣṭha, mustard, vyoṣa, hiṅgu, mañjiṣṭhā, the two haridrās, samaṅgā, triphalā, mustā, karañja seeds, śirīṣa seeds, girikarṇī and citraka, in four times urine. It destroys worms, kuṣṭha, artificial poison, breathlessness, kapha, irregular fevers, all bhūta-graha and insanity, and apasmāra.
The commentary explains the ingredients: suradruma is devadāru; siddhārtha is mustard; vyoṣa is dry ginger, pepper and pippalī; rajanī-yugma is the two haridrās; samaṅgā is lajjālu; ambuda is mustā; śairīṣa is śirīṣa seeds; girikarṇī is white syandanā; hutāśana is citraka. The ghṛta is cooked with the paste in four times urine and is called siddhārthaka. Gara is artificial poison; balāsa is kapha.
Pañcagavya ghṛta: a long list of decoctions (daśamūla, indravṛkṣa bark, mūrvā, bhārgī, triphalā, śampāka, śreyasī, saptaparṇa, apāmārga, phalgu) and pastes (bhūnimba, pūtīka, vyoṣa, citraka, trivṛt, pāṭhā, the two haridrās, the two sārivās, puṣkara, kaṭukā, yāsa, dantī, ugrā, nīlinī, kṛmiśatru), with ghṛta, cow's milk, curd, urine and dung juice, cooked as pañcagavya; it destroys all apasmāra and bhūta, and checks quartan fever, wasting, breathlessness and insanity.
The commentary explains the pañcagavya ghṛta. Indravṛkṣa is kuṭaja; mūrvā is corasnāyu; phalgu is kāṣṭhodumbarikā; bhūnimba is kirāta; pūtīka is cirabilva; vyoṣa is trikaṭu; nīlinī is rajanikā; kṛmiśatru is viḍaṅga. Decoctions of daśamūla through kāṣṭhodumbarikā, pastes of bhūnimba through viḍaṅga, each of cow's milk, curd, urine and dung juice in measure equal to the ghṛta, are cooked to make the ghṛta called pañcagavya, which stops all apasmāra and the rest.
Key terms
pañcagavya
The five cow products: ghṛta, milk, curd, urine and dung juice.
Cook a pāyasa of śāli rice in milk boiled with bhārgī; prepare it for a boar that has fasted for three days to eat. Knowing it has become 'sweet', one should kill it and take out the (poisoned) food; three parts of its powder are mixed with one part of kiṇva; the bhārgī decoction is added, well cooled, for the maṇḍa-water; the mixture is placed in a clean jar, and then a surā (liquor) with scent and taste formed is given by the physician to the patient.
The commentary explains the preparation. The pāyasa is cooked with a quarter paste of bhārgī and four times water in the milk. The boar, fasted three days, is fed it. 'Made sweet' means unmixed with phlegm and not yet at the stage of burning digestion; others explain 'sweetened' as poisoned, since 'sweet' is used for poison; the poisoning of the pāyasa is by the container's influence, recognised by the boar's drooling, fainting and other poison signs. The boar is killed and the poisoned food is taken out, dried, powdered, and three parts of the powder are mixed with one part of the yeast (kiṇva). The bhārgī decoction is added until it turns properly to surā; those who know the method must be consulted. The time for the liquor to mature is 'when scent and taste have formed'.
Key terms
varāha
Boar.
kiṇva
Fermentation starter.
surā
Fermented liquor.
Adhikarana ೨೬ (೪೧) · Śloka ೪೧
ಸಿರಾಂ ವಿಧ್ಯೇದಥ ಪ್ರಾಪ್ತಾಂ ಮಙ್ಗಲ್ಯಾನಿ ಚ ಧಾರಯೇತ್ ||೪೧||
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सिरां विध्येदथ प्राप्तां मङ्गल्यानि च धारयेत् ||४१||
Meaning of the śloka
... then one should open the vein that has been reached (the stated one), and he should wear auspicious things.
The commentary says 'reached' means the vein on the chest, forehead or limbs stated; others read 'prāptām' as the vein at the middle of the jaw joint. Auspicious things are those stated in the chapter on care of the wounded, such as umbrella and atichatra; some read 'have auspicious rites done', and explain auspicious rites as those laid down in the Atharva Veda.
Thus ends the sixty-first chapter, named Apasmārapratiṣedha, in the Uttaratantra, in the Suśruta commentary called Nibandhasaṅgraha composed by Śrī Ḍalhaṇa.