MANAGEMENT ON SCORPION AND THEIR BITES

1. A CONCEPTUAL STUDY ON SCORPION
STINGS AS PER AYURVEDIC & MODERN
PERSPECTIVE
PRESENTED BY –
DR. ANURAG MISHRA
( M.D , B.A.M.S)
ASSISTANT PROFESSOR
DEPT. OF ATVA
KHALSA AYURVEDIC MEDICAL
COLLEGE,MANSA,PUNJAB

2. IN AYURVEDA
 Vrischika (scorpion) is said to be oldest poisonous creature on the earth. Among 800-1000
species, 30 species are lethal to humans. Due to scorpion bite casualty of life is very less, but it
causes local pain, inflammation, oedema and redness of skin.
 Vrischika is categorized under the kita visha. Kita (insects) are born from the decomposed mass
of excreta, urine, semen, egg or carcass of snakes only. They are four kinds, each one
possessing the qualities of individual doshas separately and one with qualities of all the doshas
together. There are three types of Vrischika according to poison they contain;
- Mandha visha (mild poison)
- Madhyama visha (moderate poison)
- Teekshna visha (virulent poison)
 The Vrischika which are originated from
 - Goshakrith (purified cow dung) have Mandha visha (mild poison)
 - Kashthe (wood) and eshtika (brick) have Madhyama visha (moderate poison)
 - Sarpa (sloughed snakes or from other poisonous substance) are Teekshna visha (virulent
poison)

3. SL.NO VISHESHA MANDA
VISHA
MADHYAMA
VISHA
1 ADHISTHAN VISARDHITA VISARDHITA
2 SANKHYA 12 03
3 UTPATTI FROM
DECOMPOSED
COW DUNG
FROM
DECOMPOSITI
OF SARPAAND
KEETA BODY,
&EGGS OR
FAECAL
MATTER OF 3
TYPES OF
SARPA
4 VARNA SWETAPITTA
OR BLACK
DHUMA
5 PARVA >3 3
TIVRA VISHA
VISARDHITA
15
FROM DEAD
SARPA
AGNI
1-2
VRUSCHIKA SANKHYA:
These Mild, Moderate and Virulent Vrishchika are of twelve, three and fifteen in number.
Total being thirty.

5. UPADRAVA OF VRUSCHIKA DAMSA
 Prayoga Samuchchaya and Kriya Kaumudi has mentioned the Upadravas
(complications) of Vrishchika Damsha, which may appear in case of
Ugravish’a Vrishchika.
 Those complications are – Asahyavedana (severe pain), Shotha (oedema),
Shwaasa (breathlessness), Trish’n’a (thirst) and Moha and Pralapa
(Delirium).

7. Morphology of Vrischika
 According to Ayurveda, the scorpions having Mandha visha
(mild poison) possess many joints in the tail compared to the
other types.
 The scorpions which are having madhayama visha are yellow and
brown with smoky abdomen with three joints in the tail.
 The scorpions which are having teekshna visha (virulent poison)
are having two joints in their tail, having different shapes,
different size and colours. They are terrifying and these kinds if
scorpions are to be known as pranacaurah (thieves of life or
killers).

8. MANAGEMENT
According to Ayurveda management of Vrishchika damsha can be divided in
to two parts as
1. Yukti vyapaashraya Chikitsa: - Aushadhi Prayoga.
2. Daiva vyapaashraya Chikitsa: - Mantra Prayoga.
Yukti vyapaashraya chikitsa can again be divided in two major parts as
follows :
 1. Shodhana Chikitsa – In Bahula Dosh’a condition – which may include
Vamana, Virechana, Nasya and Raktamokshana according to the
predominance of the Dosh’a.
 2. Shamana chikitsa – In Alpa Dosh’a condition – which may include
internal medicine, external application, dhoopana, Anjana etc.

9. Common treatment for Scorpion poisoning :
 First, bloodletting has to be done with Sringa (Cow's horn), jalooka (Leech), etc. followed by oral
intake (paana) and nasal administration (nasya) of Aswagandha (Withania somnifera) and
Karanja (Pongamia glabra) to be done immediately.
 Dhara (continuous pouring of liquids in a stream) to be done over the site of bite under bearable
warmth with boiled buttermilk ground with Tamarind (Tamarindus indicus), leaves of Nimba
(Azadirachta indica) and Mulaku (Capsicunm annulare).
 Saindhava (Rock salt) mixed with the swarasa of Karanja (Pongamia glabra), Tintrini
(Tamarindus indicus) and leaves of Karaskara (Strychnus nuxvomica) to be applied over each
eyelid as Pindi.
 The immediate application of the swarasa of Karanja (Pongamia glabra) squeezed by hands,
instilled into eyes, nose, mouth and site of bite will relieve all types of Scorpion poisoning.
Tamboola (Piper betel) along with Hingu (Ferula asafoetida) also can be used in a similar
fashion.
 Dhoopas (fumes) which relieves Scorpion poisoning Fumes with the feathers of chicks,
Saindhava (Rock salt) and paste of Tila (Sesamum indicum); Leaves of Nimba (Azadirachta
indica), Nisa (Curcuma longa), Nara kesa (human scalp hair), umi (husk), leaves of Snuhi
(Euphorbia nerifolia), leaves of Palm (Borassus glabellifer), Uzhinja (Cardiospermum
halicacabum) Darvi (Coccinium fenestratum) and Ramatha (Ferula asafoetida) relieve the effect
of scorpion sting.

10. COMMON DRUGS USED:
 Hingu (Ferula narthex): Hingu has Tikta (bitter), Katu Rasa (pungent); Tiksna (sharp), Laghu
(light) Guna; Ushna (hot potency) Veerya; Katu Vipaka; Pacana, Rucikara (appetiser), Krimighna
Karma (anti- microbial). It is known to have anti-inflammatory, anti-viral, antimutagenic,
antifungal actions. It is used in the treatment of asthma, gastro-intestinal disorders, and intestinal
parasites.
 Tambula (Piper betle): It has Tikta (bitter), Kashaya (astringent) Rasa; Laghu (light) Tikshna
Guna (sharp); Ushna Virya (hot potency); Katu Vipaka; Alleviates Kapha, improves taste, wards
off bad smell of the mouth, provide good complexion and appearance, removes the waste/dirt of
the lower jaw and teeth, cleanses the tongue mitigates excess of salivation and cures diseases of
the throat.[4] It has anti-fertility, anti-microbial, gasto protective, immunomodulatory, hepato-
protective, cholinomimetic, anti-oxidant, anti-diabetic, radio protective activity.
 Tintrini (Tamarind): It has Amla Rasa (sour); Guru, Ruksha Guna (heavy and dry); Ushna Virya
(hot potency); Amla Vipaka.[6] It is known to have antidiabetic activity, antimicrobial activity,
anti-venom activity, antioxidant activity, antimalarial activity, hepato-protective activity, anti-
asthmatic activity, laxative activity, and anti-hyperlipidemic activity
 Saindhava lavana: It has Lavana Rasa (salty); Laghu (light), Snigdha (unctous), Tikshna Guna
(sharp); Sheeta Virya (cold potency); Tridoshashamaka (alleviates all dosha), Agnideepana
(increases agni), Pachana (digestive), Ruchya (appetiser), Netriya (beneficial for eyes), Hridya
(cardiac toni ), Vrishya (aphrodisiac) properties

11.  Takra (Buttermilk): Tridoshaghna (alleviates all dosha), Vata-Kapha Pradhana conditions,
Grahani (Sprue), Arsha (Piles), Udara (Ascites), Sthaulya (Obesity), Prameha (Diabetes), Shotha
(Swelling), Complication of Ghrita (Ghee), Tail (Oil) & Garavisha (Low Potency Poison).
 Nimba (Azadirachta indica): It hasTikta kashaya rasa (bitter and astringent), laghu ruksha guna
(light and dry in nature), katu vipaka, sheeta veerya (cold potency). Used in krimi (microbial
infection), vrana (wound), kushta (skin ailments), etc.
 Ashwagandha (Withania somnifera): It has Katu (pungent) tikta (bitter) rasa, snigdha laghu
guna (unctous and light), katu vipaka, ushna veerya (hot potency), vatakaphahara (alleviates vata
and kapha).
 Karanja (Pongamia pinnata): It has Tikta katu rasa (bitter and pungent), laghu teekshna guna
(light and sharp in nature), katu vipaka, ushna veerya (hot in potency), kapha vatahara (alleviates
kapha and vata). Indicated in arsha (piles), krimi (worm infestation), gulmahara (abdominal
tumour), kushtaghna (skin diseases).
 Haridra (Curcuma longa): It has Katu, Tikta Rasa; Ruksha, Laghu Guna; Ushna Veerya; Katu
Vipaka; Kusthaghna (relieving skin disease) and Vishaghna (antipoisonous) karma. It contains
phyto-constituents like curcumin, curcuminoids etc. Haridra has pharmacological actions like anti-
inflammatory, antioxidant, anti-bacterial, hepato-protective, expectorant, anti-cancerous, anti-
mutagenic, free-radical scavenging property.

12. IN MODERN,
 Globally, 1988 species of scorpions are known to occur
of which, 113 valid species of 25 genera under 6 families
exist in India.Among the 86 species of scorpion in India,
Mesobuthus tamulus and Palamneus swammer- dami are
of medical importance.There are different opinions
regarding the treatment of scorpion sting. In the past
years, various regimens have been tried including lytic
cocktail, insulin, atropine, nifedipine, beta blockers and
captopril, but all these have failed to reduce mortality and
morbidity substantially.

13. Scropion Bite
Mainly 2 Types of Scorpion are present ,i.e
1) Black Scorpion – 99% -- Pain is severe
,but not fatal .To releive pain – Inj.Xylocaine
2 % - around wound.
• Another way – Keep KMno4 crystals on
the wound & sqeeze lemon on it

14. Red & Black Scorpion

15. 2) Red Scorpion – found in Guhagar,Chiplun
,Kokan area of Maharashtra state of
India,Pondechari
• This bite can be Fatal
• Tab Prazosin ( Minipress) – Drug invented by
Dr.Bavaskar ( Actually this drug was
previously used only as Anti Hypertensive )
• Dose of Prazosin –1mg stat followed by 0.25 to
0.5mg
every 4 to 6 hours

16. TYPES OF VENOM IN SCORPION BITE
• Scorpion Venom – Neurotoxic &
Haematotoxic
• Somewhat Cardiotoxic – Red Scorpion
• Since only a small quantity of the venom is
injected – mortality is very less

17. SYMPTOMS OF SCORPION BITE
• Local – more severe than snake bite –
pain,oedema & reddening
• Systemic –
Nausea,vomiting,restlessness,fever,convul
sions,coma,cyanosis
• The site of the bite is adentified as –
Pinpoint puncture spot ,local sweating &
oedema

18. TREATMENT OF SCORPION BITE
• 1) A tight ligature should be placed
proximal to the bite.
• 2) Ice should be applied around
• 3) Severe pain often responds to local
injection of emetine hydrochloride 30
mgm. given through the puncture made by
the sting, if this is visible.

19. TREATMENT FOR SCORPION BITE
• If severe pain & sweating –
• Inj Fortwin or Inj Pethidine 10 mg IM or IV
stat
• Inj Local Xylocaine 2 % -- Infiltrate around
the site of bite
• Tab Prazopress 1 mg stat or Tab Ciplar 40
mg stat ( Inchildren Tab Prazopress 1 mg
one forth to one half tab)

20. TREATMENT FOR SCORPION BITE
• Systemic Involvement –
• Profuse sweating
• Ice cold extrmities
• Priapism
• Hypersalivation
• Vomiting
• Hypertension
• Tachycardia
• Pulmonary oedema

21. TREATMENT FOR SCORPION BITE AS
PER SIGNS & SYMPTOMS:
• Note – BP ,RR –every 10 min
• Tab Prazopress 1 mg stat .Then ½ tab
after 4 hrs .Then ½ tab ,every 6 hours – till
systemic symptoms & signs disappear
• If pain is severe -- Inj Fortwin 1cc IM or IV
• If profuse sweating & dehydration – Inj
Ringer lactate IV

22. TREATMENT FOR SCORPION BITE AS
PER SIGNS & SYMPTOMS:
• If BP > 150 / 100 – Cap Depin 5 mg
sublingual .Can be repeated sos ,after ½
to 1 hour
• In Tachycardia .PR >110 /min
• Inj.Calmpose 2 cc IM or slow IV

23. TREATMENT FOR SCORPION BITE AS PER
SIGNS & SYMPTOMS:
• In Pulmonary oedema ( Breathlessness,Fine
Basal Crepitions )
• Propped up position
• Oxygen
• Inj Lasix 2 to 4 amp IV stat
• Inj Efcorlin 100 mg IV stat
• Inj Aminophylline 10 ml + 25 % glucose 10 ml
slow IV

24. TREATMENT FOR SCORPION BITE AS PER
SIGNS & SYMPTOMS:
• Life Threatening condition – severe
Dyspnoea ,frothing through mouth
• Sodium Nitroprusside drip – till pulmonary
oedema is controlled
• Inj Pruside 50 mg in 5 ml – added to 500 ml 5 %
dextrose – 15 drops/min – can be increased
upto 40 drops / min

25. TREATMENT OF SCORPION BITE AS
PER SIGNS & SYMPTOMS:
• 4) Alternatively, local injection of
Novocaine and adrenaline around the
puncture can be tried.
• 5) Application of tamarind juice locally may
also relieve the pain.

26. ANTIDOTE FOR SCORPION BITE
• There is no specific Antidote for scorpion
poison
• Invention – by Dr.Bavaskar ,Mahad,Raigad,MS
• Prazocin – Total protection against cardiac
toxicity of Scorpion bite

27. TREATMENT OF SCORPION BITE
• Wash wound with KMno4 water
• Immobilization
• Local infiltration of Anaesthetic
• Inj. Calcium Gluconate IV – to control
swelling
• Inj Atropine to avoid pulmonary oedema
• Inj Glucose, Saline & hydrocortisone

28. SCROPION BITE ANTI SERUM
• Scropion Venom Antiserum – Haffkine Bio
pharmaceuticals cop Ltd,Mumbai .Dose is 1 vial
reconstituted in 10 ml of Inj for water .If symptoms
persist administer another vial after 1 hour
• Dose ---
• 5–25 mL of antivenom diluted in two to three volumes of
isotonic saline to be given intravenously over an hour. If
there is no significant improvement, further doses of
antivenom can be given (total dose of antivenom
required is 30–100 mL in severe envenomation).

29. OTHER SUPPORTIVE :
Inj. Tetanus Toxoid – 0.5cc/IM stat
Antibiotics to prevent secondary Infections.
If Allergic reaction is seen – Antihistamines &
Corticosteroids.
Inform to nearest Police Department.

30. POSTMORTEM APPEARANCE:
External At the site of stings erythema, redness, and inflammation
may be found sometime.
Internal • Widespread Haemorrhage will be found in internal organs.
• Pulmonary Oedema & Myocardial damage will be found in
red scorpion.
• Other signs will be found as per complication.

31. MEDICO-LEGAL ASPECT-
1. ACCIDENTAL Scorpion stings are often accidental.
2. SUICIDAL Till not recorded.
3. HOMICIDAL It was found in ancient times.Now a day, it is
found very rarely.

32. THANK YOU