Dravyabhuta chikitsa of unmad in Kaya chikitsa
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Dravyabhuta chikitsa unmada Kaya chikitsa Ayurveda drug treatment psychiatric
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Dravyabhuta Chikitsa of Unmada in Kaya Chikitsa
Overview
Unmada (insanity/psychosis) is described in Kaya Chikitsa as a syndrome in which the mana (mind), buddhi (intellect), smriti (memory), bhakti (orientation), sheela (conduct), cheshta (behavior), and achara (social norms) become perverted due to vitiated doshas, particularly affecting the manovaha srotas (channels of the mind). It broadly corresponds to modern psychotic disorders (schizophrenia, mania, psychotic depression, etc.).
Ayurvedic management of Unmada employs three major principles:
- Daivavyapashraya chikitsa - spiritual/divine therapies
- Yuktivyapashraya chikitsa - rational/drug-based treatment (= Dravyabhuta chikitsa)
- Satvavajaya chikitsa - psychotherapy/mind-control
Dravyabhuta chikitsa is the pharmacological/drug-based arm of treatment. It constitutes the bulk of Kaya Chikitsa management and is described extensively in Charaka Samhita (Chikitsa Sthana, Chapter 9).
Sequential Phases of Dravyabhuta Chikitsa
The drug-based treatment follows a systematic phase-wise protocol:
Phase 1: Deepana and Pachana (Digestive Fire Correction)
Before any major procedure, digestive and carminative drugs are given to correct agni (digestive fire) and digest ama (unprocessed metabolites). This prepares the body for further purification.
Phase 2: Snehapana (Internal Oleation)
Medicated ghee (sneha) is administered orally before purification. This loosens and mobilizes the vitiated doshas. Key sneha preparations include:
- Kalyanaka Ghrita - considered the best; indicated in all types of unmada, apasmara, and mental disorders
- Tikta Ghrita - used especially in Pittaja unmada
- Jivanthyadi Ghrita (also called Mishrak Sneha) - used in Vataja unmada
- Panchagavya Ghrita and Mahapanchagavya Ghrita - classical CNS-active preparations
- Lashunadya Ghrita - garlic-based ghee, alleviates all types of unmada
Phase 3: Mridu Shodhana (Mild Purification)
Mild emesis (vamana) or purgation (virechana) is employed to expel vitiated doshas. For kapha-dominant presentations, vamana is preferred; for pitta-dominant, virechana is used.
Phase 4: Samsarjana Krama
Post-purification dietary regimen to rebuild digestive strength gradually.
Type-wise Dravyabhuta Chikitsa
1. Vataja Unmada
- Characterized by laughter, dancing, singing, crying, excessive talking, wandering
- Snehana (oleation) is primary - Jivanthyadi Ghrita, Mishrak Sneha
- Vamana (therapeutic emesis) with appropriate drugs
- Warm, unctuous, nourishing medications
- Single drugs: Ashwagandha (Withania somnifera), Bala, Shatavari, Rasona (garlic)
2. Pittaja Unmada
- Characterized by anger, aggression, abuse, red eyes, seeking shade and water
- Tikta Ghrita and Jivanthyadi Ghrita as sneha
- Virechana (purgation) - predominant purification
- Cold, sweet, bitter medicines; cow milk, ghee
- Single drugs: Brahmi (Bacopa monnieri), Shatavari, Chandana
3. Kaphaja Unmada
- Characterized by lethargy, excessive sleep, mucus discharge, eating only once daily
- Vamana (emesis) - the key intervention
- Pungent, sharp, dry drugs; Vacha (Acorus calamus) is key
- Brahmyadi Yoga - important polyherbal formula
4. Sannipataja Unmada (Tridosha)
- Mixed features from all doshas
- Difficult to treat (kashtasadhya)
- Treatment targets the predominant dosha first
- Unmada Gajakesari Rasa (herbo-mineral compound)
5. Agantuja (Manasika) Unmada - External/Psychological cause
- Caused by grief, shock, fear, or supernatural factors
- Reassurance, spiritual therapies alongside drugs
- Siddharthakadi Agada formulation
Key Single Drugs (Ekakala Dravya) Indicated in Unmada
| Drug (Sanskrit) | Botanical Name | Action |
|---|---|---|
| Shankhapushpi | Convolvulus pluricaulis | Medhya (nootropic), anxiolytic |
| Brahmi | Bacopa monnieri | Medhya, antipsychotic |
| Vacha | Acorus calamus | Unmada-nashana, antipsychotic |
| Sarpagandha | Rauwolfia serpentina | Antipsychotic (contains reserpine) |
| Jatamansi | Nardostachys jatamansi | Sedative, anxiolytic |
| Kushtha | Saussurea lappa | Anti-psychotic, anti-inflammatory |
| Tagara | Valeriana wallichii | Sedative, nervine tonic |
| Devadaru | Cedrus deodara | Vata-kapha shamana |
| Jyotishmati | Celastrus paniculatus | Medhya, memory enhancer |
| Ashwagandha | Withania somnifera | Adaptogenic, antipsychotic |
| Hingu | Asafoetida | Vata-nashana, improves digestion |
| Amalaki | Emblica officinalis | Rasayana, antioxidant |
| Rasona (Garlic) | Allium sativum | Anti-vata, antimicrobial |
| Mandukaparni | Centella asiatica | Medhya |
| Kushmanda | Benincasa hispida | Used in unmada as rasayana |
| Hema (Gold) | - | Nervine tonic, anti-aging |
Important Compound Formulations
Ghrita (Medicated Ghee) Preparations
- Kalyanaka Ghrita - Contains 28 drugs including Vishala, Triphala, Harenuka, Devadaru, Tagara, Haridra, Sariva, Brahmi, Manjishtha, etc. - considered the foremost treatment for Unmada
- Tikta Ghrita - Bitter-drug based; Pittaja Unmada
- Jivanthyadi Ghrita / Mishrak Sneha - Vataja Unmada
- Lashunadya Ghrita - Garlic ghee; "alleviates quickly all types of unmada, both endogenous and exogenous"
- Panchagavya Ghrita - Uses five cow-products; improves cognition
- Mahapanchagavya Ghrita - Stronger version with additional herbs
Polyherbal / Classical Oral Formulations
- Brahmyadi Yoga - Contains Brahmi, Vacha, Sarpagandha, Kushtha, Tagara, Jatamansi - shown to be effective in schizophrenia clinical trials as an adjuvant
- Saraswatarishta - Neuroprotective, antidepressant effects
- Ashwagandharishta - Antioxidant, antipsychotic
Herbo-mineral Compounds (Rasa Aushadhi)
- Unmada Gajakesari Rasa - Shown to reduce psychopathology in residual schizophrenia
- Saptasagara (S. Sagara) Rasa - Contains purified mercury, sulphur, arsenic compounds, copper bhasma; effective in paranoid and catatonic schizophrenia
Agada (Antitoxic Formulations)
- Siddharthakadi Agada - White mustard, Vacha, Hingu, Karanja, Devadaru, Manjishtha, Triphala, Trikatu, Priyangu, Shirisha, Haridra - used as intake, collyrium, snuff, paste; "alleviates epilepsy, poisoning, unmada"
External Dravyabhuta Interventions (Bahya Prayoga)
Though not strictly internal drugs, these are still "dravyabhuta" (drug-based) external applications described in Unmada chikitsa:
- Anjana (Collyrium) - Shirisha, Madhuka, Hingu, Lashuna, Tagara, Vacha, Kushtha - triturated with goat's urine
- Nasya (Nasal instillation / Pradhamana Nasya) - Sharp, pungent drugs blown into the nose - important for Kaphaja and Vataja unmada; Vacha powder is commonly used
- Dhuma (Medicated smoking/fumigation) - Shveta and other drugs with Hingu used as fumigation/inhalation
- Lepa (Paste application) - Applied externally over the head
- Seka (Pouring) - Over the head with medicated liquids
- Utsadana (Anointing) - Medicated oils/pastes rubbed on the body
Special Drug-Based Panchakarma in Unmada
| Procedure | Indication | Key Drug Used |
|---|---|---|
| Vamana | Kaphaja, Vataja unmada | Madanaphala, Vacha |
| Virechana | Pittaja unmada | Trivrit, Tikta Ghrita |
| Nasya | All types, esp. Vataja and Kaphaja | Vacha, Shirisha |
| Shirodhara | Calming, residual symptoms | Brahmi taila, medicated oils |
| Raktamokshana | If pittaja with blood vitiation | Jalauka (leech) |
Pathya (Dietary indications during treatment)
- Easily digestible, relishing food
- Cow's milk, ghee
- Fresh fruits (particularly Amalaki)
- Light meat soups (Jangala mamsa rasa)
Apathya (Contraindications)
- Spicy, heavy, incompatible foods
- Alcohol (except medicated wine in specific cases)
- Mental stress, suppression of natural urges
- Irregular sleep
Summary
Dravyabhuta chikitsa of Unmada in Kaya Chikitsa is a comprehensive, phased pharmacological system. The cornerstone drugs are Kalyanaka Ghrita (internal oleation), Vacha and Sarpagandha (antipsychotic singles), and Brahmyadi Yoga (polyherbal formula). Treatment proceeds from Deepana-Pachana → Snehapana → Shodhana (Vamana/Virechana) → Samsarjana Krama → Shamana (pacifying drugs) → Rasayana (rejuvenation). The approach individualizes treatment based on the dominant dosha (Vata, Pitta, or Kapha) and the phase of illness (acute vs. residual/chronic).
Modern pharmacological research supports many of these drugs: Sarpagandha contains reserpine (antipsychotic), Ashwagandha has dopamine-modulating and neuroprotective effects, Brahmi improves cognitive function, and Jatamansi has sedative-anxiolytic properties - validating the classical Ayurvedic framework through contemporary science.
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