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Introduction

Today madatyaya is the main social problem, leading to mortality and morbidity in turn leads to burden on nation’s economy, to deal such social problem this study has been carried out. The fashion of alcohol drinking leading to a chronic alcohol consumption which is being recognised as a disease alcoholism. Alcoholism is a broad term used for problems with alcohol and is generally used to mean compulsive and uncontrolled used of alcoholic beverages, usually to the detriment of drinkers health, personal relationship and social standing1. It is medically considered a disease, specifically an addictive illness. In psychiatry several other terms have been used, specifically “alcohol abuse”, “alcohol dependence” which have slightly different definition.WHO define health i.e.’’ Health is defined as a state of physical, mental and social well-being not merely absence of diseases2.

         Alcohol misuse has the potential to damage almost every organ in the body, including the brain. It seems that the worldly temptations to quench the thirst of senses and sensory motor organs people indulge into various activities which might give momentary delight but are harmful in long run, one of such activity is to consume intoxicating substances which are harmful to human body and mind. These activities are called as Pragyaparadh3. With the progress of time the concentration and the intoxicating effect of these beverages went on increasing and causing various ill effects within shorter period of the consumption.

Madatyaya is behavioural disorder characterised by repetitive and excessive consumption of alcohol affecting general health and socio-economic status of a person. Oksatmya according to ayurveda, particular thing is made wholesome or completely agreeable4. Intake of alcohol in more concentration causes  vitiation of tridosha, the ruksha guna of Alcohol increases vata dosha giving rise to symptoms like insomnia (Anidra) and pralapa (Irrelevant talk), sharia kampa, the pitta dosa causes bhrama,daha, trushna and the kapha dosha causes vaman, arochaka etc5.There is similarity of this condition described in Ayurveda  with that of alcohol withdrawal syndrome The cumulative toxic effect of chronic alcohol abuse can cause both medical and psychiatric problem, one who has alcoholism is called an alcoholic. To help those people who wants to withdraw the alcohol and maintain their health and socio-economic status is main goal of this study. Considering this disease not only personal  but also social problem.  Acharya Charak, sushrut, vagbhata, Yogratnakar and  other samhita had described   “Madatyaya chikitsa”. Mathit  yog is one of the remedies for madatyaya.7 Contents in this drug are Til tail, godadhi and karpoor are easily available and cost effective   and easy to prepare.

OBJECTIVES :

1. To study the efficacy of Mathit yog  in Madatyaya.
2. To study the aetiology and samprapti ((pathogenesis)of madatyaya according to ayurvedic text in the context for alcoholism.

In the above distribution 42.9% patients were of 25-35 age group and 40% patients belong to 35-45 age group. It is seen that in 35 patient  there were 25 patients (71.42%) belongs to lower socioeconomic group, and 10 patients (28.57%) were belongs to middle class group.  Thus the occupation and economic status play a major role in Madatyaya.In this study, 21 patient (60%) out of 35 patients had  pittavaataj prakruti, pitta and vaata get easily aggravated in these patients by Alcohol consumptions. 12 patient (34.3%) had pittakaphaj prakruti. kapha pradhan prakruti was less involved(kaphaja –pittaja 0nly 1 patient (2.9%) patients were seen).The line graph clearly shows that there is decrease in Aruchi score for each patient after the treatment. Before treatment all 35 patients had some grade of Aruchi. 1 patient had aruchi 1 grade (i.e., occasionally present), 5 patients had frequently present Aruchi (i.e.2 grade), 29 patient had 3 grade Aruchi (i.e. continuously present), but after treatment 18 patient were not having Aruchi at all whereas 17 had only 1 grade Aruchi.The line graph clearly shows that there is decrease in Chhardi score for each patient after the treatment. Before treatment 18 patients were not having chardi and 17 were having 1 grade of chardi.The line graph clearly shows that there is decrease in Prajagaran score for each patient after the treatment. Before treatment 1 patient was sleeping less than 3 hrs a day, 30 patients were having grade 2 prajagaran (sleeping 4-6 hrs a day), 3 patients having grade 1 prajagaran and only 1 was not suffering through it. After treatment 26 patient had 1 grade prajagaran and 9 got complete relief.The line graph clearly shows that there is decrease in Bhram score for each patient after the treatment. Before treatment 4 patients had 3 grade bhram, 24 patients had 2 grade bhram (i.e. positional vertigo with vomiting, able to sit), 6 had 1 grade vertigo and only 1 had no vertigo.After treatment amongst 35 patients, 14 patients did not suffer from vertigo and 21 patients suffered 1 grade vertigo only. The line graph clearly shows that there is decrease in Hrullas score for each patient after the treatment. Before treatment amongst 35 patients, 31 patients had 3 grade hrullas, and 4 had 2 grade hrullas. After treatment 9 patients had 1 grade hrullas and 26 got complete relief i.e. no hrullas at all.The line graph clearly shows that there is decrease in Pralap score for each patient after the treatment. Before treatment 22 patients had 2 grade pralap, 12 had 1 grade pralap and 1 had no pralap at all. After treatment 10  had 1 grade pralap and 25 did not have pralap anymore.The line graph clearly shows that there is decrease in Sharirkamp score for each patient after the treatment. Before treatment amongst 35 patients 5 had 3 grade sharirkamp, 21 had 2 grade sharirkamp and 9 had 1 grade sharirkamp.After treatment 22 patients did not suffer from sharirkamp anymore whereas 13 patients had 1 grade sharirkamp.The line graph clearly shows that there is decrease in Roopanam asatymachaivdarshanam  score for each patient after the treatment. Before treatment 3 patients had 0 grade  Roopanam asatymachaivd arshanam, 13 patients had 1 grade and 19 patients had 2 grade Roopanam asatymachaivd arshanam.After treatment 32 got complete relief while 3 patients had 1 grade of symptom to still persist.To test whether there is significant difference in before treatment & after treatment readings on an average if factors Aruchi, Chhardi, Prajagaran, Bhram, Hrullas, Pralap, Sharirkamp, Roopanam asatmyachaivdarshanam are considered.

Since P value < 0.05, the level of significance for Aruchi, Chhardi, Prajagaran, Bhram, Hrullas, Pralap, Sharirkamp, Roopanamas atmyachaivdarshanam; there is strong evidence to reject the null hypothesis for each factor stated above.

Factors: Hb%, Wbc, Platelet, ESR, blood Creatinine, BSL, T.Bilirubin, D.Bil., I.Bil, SGOT, SGPT, Akl Po4, T.Protein, Alb, Glb, Body Wt

Test2: To test whether there is significant difference in before treatment & after treatment readings on an average if factors HB%, WBC, Platelet, ESR, BUL, Creat, BSL, T.BILIRUBIN, D.BIL., I.BIL, SGOT, SGPT, AKL PO4, T.PROTEIN, Alb, Glb, Body Wt are considered.

Since P value < 0.05, the level of significance for HB%, WBC, ESR, BUL, Creat, T.Bilirubin, D.Bil., I.Bil, SGOT, SGPT, Akl Po4, T.Protein, Alb, Glb, Body Wt; there is strong evidence to reject the null hypothesis for each factor stated above.

Discussion

In this study, 35 patients of Madatyaya were included data. All the patients were clinically examined on the basis of Ayurvedic aspects.  The assessment was carried out before and after treatment to evaluate the total effect of treatment. Result was analyzed by using  Wilcoxon rank  test for subjective parameters and paired ‘t’ test for objective parameters.

1. Aruchi :

The percentage relief in the Aruchi was 82 %, this was further put to statistical analysis   by Wilcoxon Signed rank test, extremely significant result were obtained.

 2) Chhardi (vomiting):-

Total 25 patient had got 3 grade relief; 10 patient had got 2 grade relief. The percentage relief was 100%, this was further put to statistically analysis by Wilcoxon Signed rank test, extremely significant result was obtained, thus the drug is very effective in vomiting.

3) Prajagara (insomnia)- 

Total 8 patient had got 2 grade relief; 24 patient had got 1 grade relief and 3 patient have no relief. The percentage relief in the Prajagara (Insomnia)was 60.60% ,this was further put to statistical analysis by Wilcoxon Signed rank test, extremely significant result was obtained. Thus, the drug is more effective on Prajagara.

4) Bhrama (giddiness):-

               In this study, 11 patients had got 2 grade relief, 23 patient had got 1 grade relief and 1 patient have no relief. The percentage relief in the bhrama was 68.18%, this was further put to statistical analysis  by Wilcoxon Signed rank test, extremely significant result was obtained. Thus, the drug is more effective on bhrama.

5) Hrullas (nausea):-

In this study, 22 patients had got 3 grade relief, 13 patient had got 2 grade relief. The percentage relief in the Hrullas was 90.09% , this was further put to statistical analysis by Wilcoxon Signed rank test,extremely significant result were obtained. Thus the drug is more effective on Hrullas.

6) Pralap (Irrelevant talk):-

In this study, 12 patients had got 2 grade relief, 22 patient had got 1 grade relief, 1 patient have no relief. The percentage relif in the Pralap (Irrelevant talk) was 82.14%, this was further put to statistical analysis by Wilcoxon Signed rank test, extremely significant results were obtained. Thus, the drug is more effective on pralapa.

7) Kampa (Tremors):-

In this study, 1 patient had got 3 grade relief, 17 patient had got 2 grade relief, 16 patient had got 1 grade relief, 1 patient have no relief. The percentage relif in the Kampa (Tremors) was 80.30%, this was further put to statistical analysis by Wilcoxon Signed rank test, extremely significant results were obtained. Thus the drug is more effective on  kampa (tremors).

8) Roopanam asatmyachaivdarshanam-(visual hallucination):-

In this study, 16 patients had got 2 grade relief, 16 patient had got 1 grade relief, 3 patient have no rerlief. The percentage relif in the RACP was 94.11%, this was further put to statistical analysis by Wilcoxon Signed rank test, extremely significant results were obtained. Thus, the drug is more effective on Roopanam asatmyachaivdarshanam.

Effects on Biochemical markers:

Effect on Total Serum Bilirubin Level:-

Among 35 patients selected averages S.billirubin Score before treatment was 6.7971 which was decreased up to 2.3257 after a treatment. So 65.78% releif seen in total bilirubin level, suggesting that Mathit yog  is extremely significant in decreasing in S billirubin.

Effect On SGOT:-

Among 35 patients selected average SGOT Score before treatment was 115.4571 which was decreased up to 53.4000. So 53.74% relief seen in SGOT level after the treatment, suggesting that Mathit yog is extremely significant in decreasing in SGOT level.

Effect On SGPT LEVEL:-

Among 35 patients selected average SGPT Score before treatment was 130.7229 which was decreased up to 49.9714. So 61.77% relief seen in SGPT level after a treatment, suggesting that Mathit yog is extremely significant in decreasing SGPT level.

Effect on alkaline phosphatase:-

Among selected 35 patients  average alkaline phosphatase score before treatment was 203.3543 which was decreased to 127.0286. So 37.53% relief seen in alkaline phosphatase level after a treatment, suggests that Mathit yog is extremely significant in decreasing alkaline phosphatase level.

Effect on Hb:-

In the selected patient average Hb% score before treatment  was 11.6114 which increased to 11.78 After treatment. So 1.45% gain in Hb% suggests that Mathit yog  is  very significant in increasing Hb% level.

Effect on WBC:-

In the selected patients average score before treatment was 11857.14 which decreased to 8931.4286 After treatment, so 24.67% decrease in total WBC count suggests that Mathit yog  is significant in decreasing WBC count.

Effect On other Haematological Values:-

Other investigations were done before treatment and after completion of treatments, It is observed that  Mathit Yog has  Not very significant role over other investigations, like sr.protein. sr albumin sr.globulin, platelet, BSL. No increase in Renal function test shows that the drug has no any renal toxic effect.

Action of Mathit Yog in Madatyaya -

The action of Mathit Yog in Madatyaya is seen due to its rasa, guna, veerya and prabhava.9 Til tail acts as rasayan and relieves agnimandya. Karpoor has shit property, it acts as dah, trushna, aruchi nashak. Dadhi has rochan, deepan, sar properties, with these properties Mathit yog purifies the channels & tissue pores functions are achieved and ultimately improving the status of agni10  The ingredients Til tail, godadhi, karpoor are having madhur, snigdha properties which are advised in the treatment of these symptoms Aruchi, Hrullas, Cchardi, Prajagar, Bhram, Kamp11. Mathit yog helps to maintain the status of gastrointestinal disorders, agni i.e. Jatharagni and dhatvagni.  It is seen that none of the patient was found to have complete remission. Mathit yog has provided better relief in most of the symptoms except prajagar and bhram. Then it clearly indicates that Mathit yog has significant role in Alcohol withdrawal (Madatyaya).

Conclusion

Mathit yog has provided better relief in most of the symptoms except Prajagar and bhram. There was significant difference in before treatment & after treatment readings on an average if factors HB%, WBC, ESR, BUL, Creat, T.bilirubin, D.bil., I.bil, SGOT, SGPT, AKL PO4, T.Protein, ALB, GLB, Body wt. are considered. here was no significant difference in before treatment & after treatment readings on an average if factor Platelet, BSL is considered. No unwanted effects of the drug were noticed after administration of drug for a period of 6 weeks. All ingredients are easily available, safe, cost effective and it is well tolerated by the patients. Study shows that Mathit Yog is beneficial for the Madatyaya patients.