HTML Full Text

Introduction

Diseases caused by Visha (poison), Shastra (weapons), Agni (fire), and other factors fall into the Agantuja group. The term Visha is derived from the root 'Vis' (Vyaptau), which has the proportion 'Kt' and signifies to envelop, pervade, or occupy. As a result, Visha is the one that penetrates the entire body soon after consumption. Visha is the name for a chemical that brings misery to the planet. As a result, Visha dravya can be characterised as a drug that is life-threatening or causes several other issues as well as grief.[1] Ayurvedic scriptures address the treatment of a variety of diseases that are either Nija (endogenous) or Agantuja (induced/exogenous). Many Visha dravyas are employed as Aushadha dravya in Ayurvedic texts after appropriate processing because, although dosage distinguishes a medication from a poison, a remedy at one dose might function as Visha at another.[2] As a result, a chemical that is lethal at a little dose might be classified as Visha.

Based on its origin, Visha is divided into two categories: Jangamavisha (animal poison) and Sthavaravisha (plant and mineral poisons). It is also separated into two types: Akritrimavisha (natural poison) and Garavisha (chemically created poison), with Akritrimavisha being further divided into two types: Sthavara and Sthavara.[3]  The Vedas record the history of Visha, or poison, and poisoning. The Atharvaveda describes two sorts of visha, sthavara and jangama, and how to regulate them via mantrachikitsa. Vaidya Sushena, with the help of Sanjeevani vidyaa from Himalaya, healed Lakshmana for poisoning in the Ramayana. Many references to Visha are found in Kautiliya Arthashastra, a text unrelated to toxicology, including descriptions of Kalakuta, Vatsanabha, Halahala, musta, kushtha, mahavisha, vellitaka, kolasaraka, and others.[4,5]

Aim

To study the efficacy of Panchakarma Therapy in management of Visha Chikitsa.

Panchakarma in Visha Chikitsa

Ayurveda has developed bio-purification treatments such as Panchakarma to detoxify the human body and neutralise toxins produced in our bodies as a result of modern society's high levels of stress. Panchakarma treatment is a preventative health care method that can assist any adult, regardless of his or her current health status. Ayurveda, on the other hand, is a preventative medical discipline with the goal of keeping the human body in perfect condition. Standard pathological tests may now be used to track the elimination of toxins from the body. Panchakarma should be done on a regular basis, preferably once a year, to keep the body in great form.[8] Standard pathological tests may now be used to track the elimination of toxins from the body. Panchakarma should be done on a regular basis, preferably once a year, to keep the body in top shape. Standard blood tests should be performed before and after the Panchakarma to determine the efficiency of the detoxification. For those who follow a good diet and live a healthy lifestyle, these should improve with each cycle of detoxification. Panchakarma methods are used to define cleansing therapy in terms of Sanshodhana. Panchakarma's five treatments have been used to treat practically all ailments.[6]

Toxins are eliminated using panchakarma treatment, which is also known as detoxification therapy, in order to restore physiological balance. As a result, Panchakarma serves a full therapeutic role as a preventative, curative, and rehabilitative technique. As seen in Figure 1, Panchakarma serves three key purposes in Visha chikitsa.

The Panchakarma procedure is divided into 3 steps [7]

1. Purvakarma - It is a process that must be completed prior to detoxification. Snehana and Swedana have been included.

• Snehana (Internal oleation) – It is completed by ingesting a little amount of medicinal oil or ghee. A physician determines it based on the patient's state and the illness. Oleation, liquefaction, enhanced fluidity, and softening are all effects of Snehana karma. These procedures are used to soften the channels and toxins so that they may be readily separated and expelled during the primary detoxification process. It reduces stiffness, heaviness, and coldness in the body while also causing perspiration.

Snehana karma is of two types –

1.Abhayanga – After internal oleation, massage with medicinal oils is performed, followed by external oleation. A medicinal oil is rubbed over the entire body or a specific body area.

2.Shamana - Internal oleation is accomplished by ingesting modest amounts of medicinal oil or ghee. After analysing the patient's bodily constitution, the physician determines the period of internal oleation, as well as the quantity and type of medicinal oil or ghee to be used. The day before internal oleation, the patient must eat only fluids or light meals.

Swedana – Swedan is performed after Snehana by steaming the body. As a result of the relief of stiffness in bodily pathways, toxins and waste products are delivered into Kostha (abdomen). These waste products are readily removed from Kostha using Panchakarma's major strategies. Both of these karmas are beneficial in relaxing bodily channels, releasing toxins and waste products from channels, and bringing them into Kostha, where Panchakarma treatments may remove them. In cases of acute poisoning, these Purvakarmas are not required because the situation is urgent and the poison is not absorbed by the body.[8]

Pradhankarma – - This is the primary detoxification procedure. Pradhana karmas are the five Panchakarma procedures: Vamana, Virechana, Basti, Raktamokshana, and Nasya.[9,10]

• Vamana

When poison is consumed, it enters the stomach and begins to be absorbed. Emesis assists in toxin removal by moving upward. Pipali, Ikshu rasa, Madhu, Sharkara, Yashtimadhu kwath, and salt water are some of the main Dravya utilised for Vamana karma.

Indication of Vamana karma [11-13]

1. In Aamasayagata visha – immediate Vamana with madanphala, katutumbi, koshataki phal, or dadhi jala, takra or tandulodaka.
2. In Sarpavisha chikitsa, Taila, Kulattha yush, Madya, and Kanji are contraindicated in Sarpa damsha visha for Vamana.as
3. In Dooshivisha chikitsa
4. In Gaurava, Utklesh, Hrullash due to Kapha vaman with milk.
5. In Garavisha chikitsa.
6. In Kaphasthangata visha chikitsa.
7. In Loota (spider) visha – Tikshna vamana.
8. In Mooshak damsha (rat bite) – Vaman with Katu tumbi, Mainphala, Ankoth kashaya,

Contraindication

It is not recommended for caustic poisoning, convulsant medications such as strychnine, petroleum distillates, coma, severe cardiac and respiratory distress, advanced pregnancy, and other conditions.

Vamana Chikitsa mentioned by Vagbhata[14]

Sarpadamsha Chikitsa - In case of bite by Darvikara, in the 2nd stage. In case of bite by Mandali, in the 3rd stage.

Akhu Damsa (Rat poisoning) - The patient should be made to vomit.

Sthaavara Visha Chikitsa - In the 1st, 2nd, 3rd stage of poisoning.

Gara Visha Chikitsa - The patient of Gara visha should be made to vomit.

Dushi Visha Chikitsa - Emesis and purgation

Musika Visha Chikitsa - Emesis.

Haritala Visha - First the person should be purified by emesis.

• Virechana [15-18]

It is the procedure of expelling the poison, toxin and vitiated Dosha out from stomach through anal route. According to Acharya Charaka, it is done in the second stage of poisoning.

Indication of Virechana karma

1. Sthavar visha
2. Dushivisha
3. Pittasthanasthit visha chikitsa - In person of Pittaj constitution, bitten by snake of predominant Pitta, bite site below umbilicus, poison present at seat of Pitta22.
4. Aggravated Vata
5. Luta poisoning – in exaggerated stage of Dosha
6. Mushak poisoning – Virechana by Trivrutta, Nilini and Triphala
7. Insect poisoning
8. Alarka visha (dog bite) – Virechana by Arka juice.

Contraindication

It is contraindicated in intestinal obstruction, perforation, severe dehydration, Shock etc.

Virechana Chikitsa mentioned by Vagbhata[19]

Sthaavara Visha Chikitsa - In the 2nd and 3rd stage

Haritala Visha - Purgation indicated

Dushi Visha Chikitsa – Purgation

Luta Damsha Chikitsa - Purgation should be done

Alarka Visha Chikitsa – Administer a purgative drug along with milky sap of Arka quickly.

• Raktamokshana

It is the process of removing toxin, poison, or vitiated Dosha from the bloodstream via the skin. Blood is an excellent vehicle for poison to move throughout the body. Because of this, poison is quickly absorbed and distributed throughout the body, potentially leading to death. When we remove blood from the body using the Raktamokshana method, we also remove poison or toxin. As a result, Raktamokshana is the best therapy for poisoning.[20]

It can be done by Pracchana (muitiple incision), Shrunga (horn like shape), Jalouka (leech therapy), Alabu or Siravedha (venesection). Siravedha is currently widely practised. Toxins can be removed from blood by bloodletting of veins in the extremities and forehead. Vrudhipatra (sharp instrument), Shrunga, Jalouka, Alabu, Kutharika (Blunt instrument), medicines to block blood flow, and Scalp vein for venesection are all needed for this treatment.

Indications [21]

1. When poisoned area becomes discoloured, swollen, rigid and painful.
2. In unconsciousness state, it should be done at extremeties and forehed.
3. Raktagat visha (poison in blood).
4. Poison at seat of Kapha Dosha
5. In Rajiman Sarpadamsha Raktamokshana is done with Alabu.
6. In Dushivisha Panchsiravedhan
7. In Luta poisoning
8. In Mushak (rat) poisoning.
9. In Alarka Visha (dog bite)

Contraindications

It is contraindicated in pregnancy, children, and old persons.

• Nasya (Nasal medication)

It is a method of removing poison, toxin, and vitiated Dosha by administering medicine through the nose. If the poisoned patient is experiencing headaches, heaviness in the head, lethargy, neck stiffness, or Galgraha, Nasya should be performed immediately. Bandhujiva moola, Bharangi moola, and Krishna tulsi moola juice are used individually for nasya if Visha is present in the brain and head area. Pippali, Hingu, Vrishchikali, and Shirish beeja should be utilised for Chetnanirmiti (to gain consciousness) if there is a condition of unconsciousness. Kantakari, Beejpur, Jyotishmati, Mrutasanjeevani Agad, Shirishpushpa Yog, Paramagad, Ksharagad, Powder of Pippali, Hingu, Vrishikali, Manashila, Shirishbeej, Apamarga, Lavana, and others are among the drugs necessary.[22,23]

Indication

1. In treatment of 3rd, 6th, 7th vishavega
2. Darvikara sarpa visha vega 3rd and 7th, Rajiman sarpa visha vega
3. In Loota, Mooshak, Sarpa and other Keeta visha – Nasya with Vanshatvagadi agad
4. In Mooshak visha chikitsa – Nasya with Sara bhaga of Shirish and Shirish phala.
5. In unconscious patient, Vivrutaksha and Bhagnagriva – Tikshna pradhamana Nasya should be performed.

Nasya Chikitsa mentioned by Vagbhata

Sarpadamsha Chikitsa - Darvikara Visha Vyantara Visha Chikitsa. Vega Chikitsa, in the 3rd and 7th stage. Rajimanta Visha Vega Chikitsa 6th stage.

Luta Damsa Visha Chikitsa - Feeling of heaviness of the head, swelling, salivation, lock jaw etc.

Musika Visha Chikitsa - For Shirovirechana, siris sara and fruit is used.

Sthavar Visha Chikitsa - In the 3rd Visha vega.

Vrischika Damsa Chikitsa - In all cases of scorpion poisoning

• Basti and Anuvasana Basti

These two processes are not directly stated in Vishachikitsa, although the role of Basti is described in several Samhitas.[24,25]

Indication

1. Basti and Pitta jwarnashak sneha are used after Visha is removed for the treatment of Kupita pitta dosha.

2. In Krisha vyakti due to Visha's Prabhav, Srava Basti is beneficial in the condition of Ati rakta.

3. Siravedha and Panchakarma treatments are recommended for Dooshivisha.

1. Paschatkarma

The Panchakarma lifestyle, which includes a rigorous diet and activities, must be continued following the operations. The patient's digestive power is restored back to normal at this stage. There is no need to follow Paschat karma if there is acute poisoning.

Discussion

As previously said, the research of Visha gunas is required for its therapy. Because Samanya vishesha siddhanta is the foundation of treatment, a substance or food with attributes opposite to those of the ailment should be employed to treat it. Any illness is categorised into three forms of treatment: Daivavyapashraya, Yuktivyapashraya, and Satvavajaya. All of the above criteria are present in Vishachikitsa, and it is successful when all three are present.[26]  The role of Panchakarma in Visha Chikitsa is critical to the therapeutic strategy. Different varieties of Panchakarma were used in ancient times to cure various Sthavara, Jangama, Dooshivisha, and Garavisha toxicities. Panchakarma is now utilised to treat numerous ailments caused by Dooshivisha, Garavisha, and its consequences. Modern medicine has adopted several methods that are comparable to panchakarma in the treatment of poisoning. Panchakarma is effective in eliminating poisons from deep cellular storage. In Chikitsasthana, Acharya Charaka describes Chaturvimshati vishopakramas (twenty-four poison modality) as a general line of poison therapy. Except for Basti, all panchakarma procedures, such as Vamana,Virechana, Raktamokshana, and Nasya, are included in the above-mentioned detoxification therapy, according to the Ayurvedic texts. The Vata Dosha is mostly regulated by Basti. It is a sort of Sanshaman treatment. The application of Sanshodhan treatment is only important in situations of poisoning. [27] Induction of vomiting within 4-6 hours and stomach lavage are used to remove unabsorbed toxin, comparable to Vamana in Panchakarma. In the case of poison injections and snake bites, incision and suction are recommended, similar to Raktamokshana in Panchakarma. Purgation and forced dieresis are used to eliminate absorbed poison, comparable to Virechana in Panchakarma. Excessive sweating, similar to Swedana, is recommended for the removal of certain absorbed toxins. Purgation and enema are used to treat opium and barbiturates toxicity. In Panchakarma, Enema is equivalent to Basti. In the contemporary context, Panchakarma and related methods are highly effective in Visha chikitsa. [28]

Conclusion

Panchakarma treatment is a preventative health care method that can assist any adult, regardless of his or her current health status. Ayurveda, on the other hand, is a preventative medical discipline whose purpose is to keep the human body in perfect condition. Standard pathological tests may now be used to track the elimination of toxins from the body. The primary goal of poisoning therapy is to eliminate these poisons or toxins from the body as quickly as possible, because once absorbed into the body through the bloodstream, they disrupt the Dosha, Dhatu, and Mala balance, resulting in a variety of ailments and deaths. As a result of these therapy concepts, removing unabsorbed toxin is critical. Panchakarma can be used to treat both acute and chronic toxicity. In Chikitsasthana, Acharya Charak defined Chaturvimshati Vishopakramas, which include Panchkarma treatments, as a broad line of poisoning therapy.