alcoholism in ayurveda

1. MADATYAYA
PRESENTED BY-
DR. GOPENDRA CHANDRA KAMAL
PG-2ND YEAR
GUIDED BY-
DR. ASHWINI KUMAR S. BHARATI
PROFESSOR
DEPARTMENT OFAGADA TANTRA, SDM COLLEGE OFAYURVEDA AND HOSPITAL, HASSAN
1

2. CONTENTS-
1. INTRODUCTION
2. ACUTE ALCOHOLISM/ STAGES OF MADA
3. CHRONIC ALCOHOLISM/ MADATAYAYA
4. WITHDRAWL SYMPTOMS
5. DRUNKENNESS
6. DRUNK DRIVING
7. TREATMENT
8. CASE STUDY
9. ARTICLE
10.DISCUSSION
11.CONCLUSION
2

3. INTRODUCTION
• MADYA- The Dravya which vitiates the buddhi and
causes Mada, such dravyas are tamo guna pradhana and
hence called as madya or madakari which is available in
the form of Asava, Arishta, Sura, Varuni, Sithu.- (Sha. Sa.
P.kh-6)
• ALCOHOL- The term alcohol originally refers to
ethanol , the predominant alcohol in alcoholic beverages. It
is classed as a CNS Depressant.
3

4. GUNAS OF MADA VS OJAS-
• Laghu -------------------------- Guru
• Ushna -------------------------- Sheeta
• Amla -------------------------- Madhura
• Teekshna -----------------------Mridu
• Aashuga-------------------------- Prasanna
• Rooksha-------------------------Snigdha
• Vyavayi --------------------------Sthira
• Vikasi -------------------------- shlakshna
• Visada -------------------------- Picchila
• Sukshma-------------------------bahala Ch. Chi- 24/30-31 4

5. ALCOHOL CONTENT IN
BEVERAGES
1. Spirits (whisky, brandy, rum, gin, vodka)- 35-50%
2. Wine- 10-15%
3. Champagne- 10-13%
4. Beers 4-8%
5

6. ALCOHOLISM IN INDIA
• About 30% of indian
consumes alcohol regularly.
• An individual consumption
of alcohol per year in India
is -4.3 litres.
• 1 death every 96 minutes
occur in India due to alcohol.
• Supreme court has banned
the sale of alcohol within 500
meters of national highway.
6

7. STAGES OF MADA/ ACUTE
ALCOHOLISM
STAGES LAKSHANAS
(Su.Ut. 47/11-12))
BEHAVIOURAL
CO-RELATES
OJAS AWASTHA
(Ch. Chi. 24/37)
BAC
FIRST पूर्वे
र्वीर्यरतिप्रीतिहर्यभाष्र्ादिर्वर्यन
म् |
STATE OF
EXCITEMENT
ओजस्र्वर्वहिे
पूर्वो हृदि च
प्रतिबोधर्िे|
50-150 mg%
SECOND प्रलापो मध्र्मे मोहो
र्ुक्िार्ुक्िक्रिर्ास्िथा |
STATE OF IN-
COORDINATION
मध्र्मो
वर्वहिेऽल्पे
150-250 mg%
THIRD वर्वसञ्ज्ञः पश्चचमे शेिे
नष्टकमयक्रिर्ागुणः |
STATE OF COMA वर्वहिे िूत्तमो
मिः|
>250 mg%
7

8. 1. STAGE OF EXCITEMENT- person is euphoric, action, speech
and emotions are less restrained, increased confidence , low self-
control, poor concentration, impaired judgement and memory.
2. STAGE OF INCOORDINATION- person my become cheerful/
irritable / ill-tempered. Incoordination of fine and skilled
movements, alteration in speech, nausea, vomiting, flushed face,
rapid pulse, hypothermia, breath smells of alcohol, pupil dilated.
3. STAGE OF COMA- thick, slurred speech, becomes giddy,
stagger and fall, rapid pulse, hypothermia, pupils contracted,
McEwan’s sign positive.
8

9. 9

10. 10

11. • RECOVERY is the rule unless large quantity of alcohol is
consumed within a short time. About 35% drinkers may
experience a blackout.
• With recovery, coma gradually lightens up into deep sleep
followed by alcohol hangover (depression of mood, nausea,
headache).
• If victim does not return from coma within 5 hour,
prognosis is bad and may result in death from shock,
respiratory centre depression or aspiration.
11

12. • FATAL DOSE- 150- 250 ML consumed within 1
hour.
• Death is typical if the BAC is between 300- 400
mg/dl
• FATAL PERIOD- 12- 24 HOUR
12

13. TREATMENT FOR ACUTE ALCOHOLISM
• Patient must be kept warm to treat hypothermia.
• Patient made to lie on side to prevent aspiration.
• Gastric lavage with alkaline solution within 2 hours of
ingestion.
• One litre of normal saline or 10% glucose with 15 unit insulin
to check hypoglycaemia.
• Thiamine 100 mg to prevent neuropathy.
• Respiratory support.
• Dialysis may be required.
13

14. CHRONIC ALCOHOLISM/
MADATYAYA
• मिेनात्र्र्ो मिात्र्र्ः - A.SA.NI.6
• Excess intake of madya may cause excess
excitement which is madatyaya.
• One should consider the anna, pana, vaya, vyadhi,
bala, kala, three dosas(vata, pitta , kapha) and three
types of manas - satwa, rajas and tamas before
taking madya. (Ch.Chi. 24/68 )
14

15. Ch. Chi.24/101-106
15

16. TYPES OF MADATYAYA- ACC TO CHARAKA-
Ch. Chi.-24/89-97
DOSHAS NIDANAS LAKSHANAS
VATA Indulges in stree, shoka, bhaya
shrama, disturbed sleep and
ruksha madya.
Hikka, shwasa, kampa,
parsva shula, prajagara,
pralapa
PITTA tikshna and ushna food
tiksna and amla madya
Trushna, daha, jwara,
sweda, murcha, atisara,
bhrama.
KAPHA Intake of madhura, sneha,
guda, day sleep and not
properly fermented alcohol.
Chardhi, arochaka,
hrillasa, tandra, gaurava
and sheeta.
SANNIPATA Mixed nidana of tridoshas,
effect will be as of visha, but
not as powerful as visha.
Mixed signs and
symptoms, may cause
death or leads to disease.16

17. Ch. Chi. 24/201-202
17

18. ACC TO SUSHRUTA- Su. Ut. 47/17-21
TYPES LAKSHANAS
PANAATYAYA • VATA- Sthambha, angamarda, hrudaya graha,
toda, kampa, shiroruja
• PITTA- Sweda, pralapa, mukhashosha, daha,
murcha
• KAPHA-Vamathu, sheeta, kapha praseka
• SANNIPATA- Presence of all symptoms
PARA MADA Ushma, guruta, Loss of taste sensation, Aruchi,
Malamutra sanga, Trishna, Shiroruja and
sandhibheda.
PANAAJIRNA Adhmana, vomiting, sour taste sensation in
mouth, daha- during digestion, pitta prakopa
lakshana .
PANAVIBHRAMA Hrudgatra toda, chardi, jwara, murcha, shiroruja,
daha, Dvesha- towards sura and food. 18

19. SYSTEMIC EFFECT OF CHRONIC ALCOHOLISM-
1. PHYSICAL- lack of personal hygiene, gastroenteritits,
wasting, loss of appetite, neuropathy, sterility, impotency,
cirrhosis, fatty changes in heart and liver, tremors, insomnia,
intermittent infections.
2. MENTAL- loss of memory and impaired power of judgement.
3. MORAL- it manifests as crime, domestic violence, suicides.
19

20. 1. DELIRIUM TREMENS-
 Clouding of consciousness with disorientation in time and
space.
 Coarse muscular tremors of face, tongue and hands.
 Insomnia, loss of memory, agitation, ataxia.
 Tendency to commit suicide, homicide.
 Fever, sweating, hypertension and pupillary dilatation.20

21. 2. ALCOHOLIC HALLUCINOSIS
3. WERNICKE’S ENCEPHALOPATHY
4. KORSAKOFF’S PSYCHOSIS
5. ALCOHOL PERIPHERAL NEUROPATHY
6. ALCOHOLIC PARANOIA
7. ALCOHOL
SEIZURE
21

22. TREATMENT FOR CHRONIC ALCOHOLISM AND WITHDRAWL
SYMPTOMS
• Withdrawal of alcoholic drinks.
• Ant abuse- Disulfiram
Dose- 250-500 mg/day for 1-2 weeks followed by
maintenance dose of 250 mg/day at bed time.
• Metronidazole
• Nutrients and vitamins. Thiamine 50-100 mg daily
for a week.
• Diazepam 40-80 mg/ day in divided dose
22

23. DRUNKENNESS
• DRUNKENNESS – it is a condition which
results from excessive intake of alcohol.
Loss of self-control
Inability to perform the duty
Dangerous to himself and others.
23

24. Diagnosing a case of drunkenness-
NYSTAGMUS TEST
24

25. • Walk and turn test
• Nystagmus test
• One leg stand test
• Romberg test
• Finger nose test
25

26. BREATHALYZER TEST
26

27. DRUNK DRIVING
• Permissible BAC in India- 30 mg/dl
• According to Motor vehicles act 1988, punishment for up to BAC
60 mg/dl-
 First offence- 6 months imprisonment or fine Rs. 2000 or both
 Second offence within 3 years- imprisonment for 2 years and Rs
3000 fine.
• For BAC 60-150 mg/dl-
 imprisonment for 1 year and/or RS 4000 fine.
 If repeated within 3 years- imprisonment for 3 years and Rs. 8000
fine
• For BAC more than 150 mg/dl-
 imprisonment for 2 years and /or fine Rs.5000
 If repeated , imprisonment for 4 years, fine of Rs. 10, 000 and
cancellation of license.
• Age of possession of and consumption of beverages- 18-25 years.27

28. GENERAL LINE OF TREATMENT
• सर्वं मिात्र्र्ं वर्वद्र्ाि् त्रििोर्मधर्कं िु र्म्
िोर्ं मिात्र्र्े पचर्ेि् िस्र्ािौ प्रतिकारर्ेि्
कफस्थानानुपूर्वर्ाय च क्रिर्ा कार्ाय मिात्र्र्े
वपत्त मारुि पर्यन्िः प्रार्ेण दह मिात्र्र्ः
(च.चच.२४/१०७-
१०८)
• All types of madatyaya are tridosaja. Treatment should be based on
the dominant dosa. However, most of the time treatment is started
for kapha dosa as pitta and vayu are manifested towards the end in
most of the cases of madatyaya.
28

29. Justification for Giving Alcohol in
Alcoholism
• The excessive intake of usna, tiksna madya causes vidagdha avastha
of anna rasa. This turns to kshara rasa/ alkaline in stomach. To
neutralize this, one needs amla rasa/ acid. And alcohol is best among
those having amla rasa by virtue of the 14 properties (10 guna and
madhura, kasaya, katu, tikta anurasa). Ch. Chi 24/112-113
• Also the dosas which have been aggravated by intake of madya,
obstructs the vayu in srotas causing headache, bone pain and joint
pain. This may be relieved on clearing the srotas. This requires amla
rasa. Madya is suitable for this purpose. Ch. Chi 24/118
29

30. • Ethanol is considered as antidote for methanol.
• It is given in case of alcohol poisoning ( methnol poisoning
) as it acts as competitive antagonist with methanol.
• Ethanol has higher affinity for alcohol dehydrogenase
enzyme than methanol and hence prevent the formation of
formaldehyde and formic acid.
30

31. PRACTICAL APPROACH
• SCREENING – ASSESMENT-
TREATMENT
• SCREENING- CAGE QUESTIONAIRE
1. Have you ever felt you needed to Cut down on your
drinking?
2. Have people Annoyed you by criticizing your
drinking?
3. Have you ever felt Guilty about drinking?
4. Have you ever felt you needed a drink first thing in
the morning (Eye-opener) to steady your nerves or
to get rid of a hangover? 31

32. ASSESSMENT
• INTOXICATION
• WITHDRAWL
• DEPENDENCE
32

33. TREATMENT FOR INTOXICATION
• If fit for Vamana - SADYO VAMANA with Yastimadhu
Phanta and Saindhava Jala.
• If unfit for Shodhana – symptomatic treatment.
• Shamana Aushadhi – siro-pichu, panchakola phanta
 Kharjuraadi mantha
 Sreekhandasava,
 Draksharista.
33

34. TREATMENT FOR WITHDRAWL
• SANTARPANAJANYA CHIKITSA- Deepana, Pachana,
Abhayanga, Takradhara
• Uses of anticraving agents.
• Use of medhya and sedative ayurvedic drugs.
• Shodhana therapy
• Satvavajaya chikitsa
34

35. TREATMENT FOR DEPENDENCE
• USE SEDATIVE DRUGS
• USES OF ANTI CRAVING
• SODHANA THERAPY- Deepana, Pachana , Takradhara,
Abhayanga, Panchakarma
• Psychotherapy
• Motivational Counselling
• Group Counselling
• Bhayadarshana about the disease
35

36. SINGLE DRUGS USED
• BRAHMI
• ASWAGANDHA
• BHRINGARAJA
• KUSMANDA
• JATAMANSI
• SANKHPUSHPI
• MANDUKPARNI
• GUDUCHI
36

37. FORMULATIONS USED
37

38. 38

39. CASE STUDY
• Pt.name: XYZ Age-35 yrs. Sex: male. OP-001724
Presenting complaints:
• Pt. was brought by his friends with c/o generalized body
ache, pain in the sides of chest, tremors, severe thirst,
sweating with burning sensation, irrelevant talk.
History of present illness:-
• k/c/o of alcoholic since 1 year. patient had consumed
around 300-400ml of alcohol with out taking food since last
4 days.
39

40. Systemic examination:
• CNS: Conscious., partially oriented
• Vitals: BP: 118/70mmhg, PR: 88/min.
• A- reduced B- irregular M- mild burning sensation
• S- disturbed
Diagnosis: PANATYAYA (Vatapitta pradhana)
Treatment given:
• Ashwasana
• Shirodhara with Brahmi taila
• Kharjuradi mantha 100ml bd 2days.
• Mrudvikadi kashaya 20ml tid
• Ksheera pathya
Result :
• Body ache, pain in the sides of chest, tremors- reduced
• Thirst, sweating ,burning sensation, irrelevant talk- relived
40

41. 40 diagnosed patients of madatyaya, aged between 16 – 70 years attending OPD of N.I.A Jaipur,
were randomly selected and assigned into two groups. Vamana with Madana Phala yoga &
Draksha kashaya followed by Astanga Lavana with dose 6 gram b.i.d & in control group vamana
followed by placebo capsule b.i.d for duration of 1 month was given. Follow up was done for 2
months. Assessment done on the basis of self scoring symptoms based on subjective and
objective parameters of Madatyaya.
The study clearly showed that there is marked improvement in both group with added effect in
group 1. Patients of Madatyaya is better treated with Vamana followed by Astangalavana as
Shamana Oushadhi
41

42. Clinical researches done on Ashwagandhadyarishta shows its very good
effect on Anxiety neurosis and its symptom like nervousness,
palpitation, tremors, headache, anorexia, fatigue, irritability, lack of
concentration, etc. As we know that all above symptoms are also seen in
alcohol withdrawal. By this study we can conclude that
Ashwagandhadyarishta is a good drug for treating Vataja Madatyaya
patients and it also strengthens the chikitsa sutra or line of treatment
42

43. DISCUSSION
• In charaka samhita, we find madatyaya being discussed elaborately
after visha chikitsa and before dvivraniya chikitsa. As properties of
madya are same as those of visha and after taking madya , intoxicated
person has high chance to get trauma and get wounds.
• Acharya Sushruta has used the word panatyaya instead of madatyaya.
And he has described it after description of murcha and before trisna.
Mostly because madya is one of the reason for both murchha and
trisna.
• In most of the text (Vagbhatta, yogratnakara, madhava nidana,
kashyap samhita) description of madatyaya comes along with
description of bhrama, murcha, trisna , daha, krimi roga and visha.
43

44. • Gunas of madya are similar to those of visha , however
less potent. Acharya Charaka and Acharya Vagbhatta has
considered “amla” as one of the property of madya.
• Panatyaya is acute alcoholism. Paramada is immediate
effect after the paka of mada leading to slesmaadhikya.
Paanajirna occurs if madya is not digested.
Panavibhranma is chronic alcoholism.
44

45. CONCLUSION
• Madatyaya is a disease affecting annavaha, rasavaha and
manovaha srotas predominantly.
• When used appropriately, madya acts as fortune drink
giving pleasure to all the sense organs. However,
excessive and improper intake of madya affects the ojas by
virtue of opposite gunas and hence cause disease like
madatyaya which has physical, mental and social effects.
45

46. REFERENCE
1. Gautam Biswas. Review of forensic medicine and
Toxicology. 3rd edition, New Delhi:jaypee Brothers
Medical Publishers (p)Ltd.;2015
2. K.S. Reddy. The Essentials of Forensic Medicine
and Toxicology.26th edition, hyderabad;2007
3. Charak samhita
4. Sushruta samhita
5. Astanga hridaya
6. Rajmane NM, Wali DS, Kadam AA. International
Journal of Applied Ayurveda Research ISSN: 2347-
6362 MADATYAYA (ALCOHOL
INTOXICATION) A REVIEW.
7. www.googlescholar.com
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