Madhava Nidana Chapter 18 Panatyaya Paramada Panajirna Panavibhrama Nidanam

This article explains Madava nidana 18th chapter “Panatyaya Paramada Panajirna Panavibhrama Nidanam”. Causes, pathology and symptoms of Panatyaya, Paramada, Panajirna and Panavibhrama are explained in this chapter.
Read – Acharya Madhavakara: His Work ‘Madhava Nidana’, Legacy, Amazing Facts

Alcoholic Intoxication

Relationship between madya and visha (alcohol and poison)
All the qualities and properties present in poisons are also found in madya (alcoholic beverages). Hence, indiscriminate use of madya – alcohol causes madatyaya (alcoholic intoxication). (1)
Read – Alcohol Intoxication – Symptoms, Treatment As Per Ayurveda

Properties of Madya: Alcoholic drinks

By nature, alcoholic drinks are considered to be similar to food. When it is used improperly it causes many diseases. On the other hand, when it is used properly it acts like nectar. Food sustains life. But if the same food is taken improperly (violating the basic rules and regulations of food consumption, in terms of quality, quantity and time of eating) it takes away life. Similarly, the basic nature of the poison is to take away the life but when used judiciously it acts like a rejuvenator. (2-3)

Alcohol is considered to be similar to (acts like) nectar when it is taken in accordance with proper procedure (of consumption), dose & time (of intake), with right combinations of food and in accordance to one’s physical strength. This type of consumption of alcohol gives happiness (joy) to the person.

Alcohol taken with unctuous foods (fatty foods), meats or other nurturing foods brings about an increase of lifespan, strength and development of the body.
The alcohol taken judiciously bestows beauty (good looking body), happiness of (pleasantness) of mind, physical strength and valour. (4-6)
Read – Charaka Madatyaya Chikitsa 24th Chapter – Alcoholism

Symptoms

Effects of first stage of alcoholism

Symptoms of prathama mada
In the first stage of the alcoholic effect, there is an increase of intelligence, memory, pleasantness / desire and happiness (pleasure). It enhances desire towards drinks, foods and sleep. It enhances the capacity and interest in reading, singing and the quality of voice (speech). Thus, the first stage is said to provide a very pleasant experience. (7)

Second stage of alcoholism

Symptoms of Madhya / Dvitiya mada
Effects of second (intermediary) stage of alcoholism- intellect, memory and speech of the person becomes heavily disturbed (opposite, abnormal). His activities and appearance appear like those of an insane person. He becomes uncontrollable, becomes lazy and sleeps frequently. (8)

Third stage of alcoholism

Symptoms of Trtiya Mada
In the third stage of alcoholic effect – the person indulges in forbidden acts and things, does not care for (disrespect) elders, eats things which are not to be eaten, having lost control speaks out secrets hidden in his mind.(9)
Read – Alcoholism: Ayurvedic Treatment, Medicines, Remedies

Fourth stage of alcoholism

Symptoms of Chaturtha Mada
In the fourth stage of alcoholic effect – the person falls to the ground and stays inactive (unconsciousness) just like a cut tree or dry log of wood. The person will not know the difference between activity and inactivity (confused so as to what to do and what not to, becomes incapable of doing any activity) and his condition becomes worse than a dead body.

Which intelligent person would wish to be in such a worst intoxicated condition which almost makes the man insane? Which person would develop a strange desire to enter and stroll in a dense forest which is inhabited (by the fear of) by many cruel animals like lion etc.

Note – Here the fearful forest inhabited animals are compared to the 4^th stage of alcoholic intoxication. Just like a person entering into the jungle becomes a prey for these animals and would not come back, the person entering into the 4^th stage of alcoholic intoxication too becomes a victim of this condition and would not return back. (10-11)
Read – Health Benefits, Effects Of Alcohol Consumption – Ayurveda Viewpoint

Effects of taking alcohol in an unmethodical way
Only such a person who drinks (alcoholic beverages) on empty stomach and in solitude daily becomes a victim of very difficult diseases. This can also cause loss of life (death). (12)

Other causative factors which are responsible for Madhya vikaras (diseases caused due to alcoholic intoxication)
Alcoholic drinks produce many diseases in persons afflicted with anger, fear, thirst, grief and hunger. Similarly, it produces many diseases in those debilitated by physical exercises, lifting heavy weights, too much of walking (travelling), and those who suppress natural urges of the body, those drinking large quantities of water, eating too much quantity of food or eating foods while having indigestion (before the previously taken food is digested), those who are very weak and those who are very much exposed to the heat. (13-14)

Diseases caused due to unmethodical consumption of alcohol
Pānātyaya, paramada, pānājīrna and pānavibhrama are diseases caused due to excessive consumption of alcohol in an unmethodical way. The symptoms of these conditions will be described further. (15)
Read – How To Get Over A Hangover – An Ayurveda Hangover Remedy

Symptoms of dosha predominant alcoholic intoxication

Vataja Madatyaya

Hiccough, dyspnoea (increased respiration), shaking of the head, pain in the flanks, excessive awakening (loss of sleep) and excessive talking (delirium) are symptoms of pānātyaya in which vata is the predominant dosha.

Pittaja Madatyaya

Thirst, burning sensation, fever, excessive sweating, delusion, diarrhoea, giddiness and greenish discoloration of the body are symptoms of paanaatyaya in which pitta is dominant.

Kaphaja Madatyaya

Vomiting, anorexia, nausea, stupor, feeling as if the body has been wrapped with wet cloth (laziness), feeling of heaviness and cold are symptoms of paanaatyaya in which kapha is predominant.

Tridoshaja Madatyaya

Presence of all the symptoms together (symptoms of all the three doshas) is found in tridoshaja pānātyaya. (16-18)
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Symptoms of Paramada

According to experts paramada is a type of madatyaya in which the below mentioned symptoms are seen –

• increase of kapha (seen as excess salivation, running in the nose, etc.)
• feeling of heaviness of the body,
• bad taste in the mouth (manifestation of abnormal tastes in the mouth),
• non-elimination of faeces and urine;
• stupor,
• anorexia,
• thirst,
• pain in the head and joints. (19)

Panajirna Symptoms

Panajirna means indigestion of alcoholic drink. In this condition the symptoms including profound distension of the abdomen, vomiting, burning sensation and the drink not undergoing digestion at all – are seen.
Read – 21 Lifestyle And Prevention Tips To Stop Vomiting And Nausea

Pana-vibhrama

Pana Vibhrama – Pricking (throbbing) pain in the region of the heart and of the whole body, excess salivation and running in the nose, feeling as though hot fumes are coming out of the throat, fainting, vomiting, fever, headache, severe burning sensation in the body, hatred even towards different kinds of alcoholic drinks and food are the symptoms of pānavibhrama as described by experts. (20)

Symptoms of incurability

Hanging down of upper lip, feeling of excessive cold externally (outside of the body) and excessive heat or burning sensation internally (inside the body) i.e., the body is cold to touch but is very hot inside (burns from within), face of the person appears as if smeared with oil, blackish or bluish discolouration of the tongue, lips and teeth, and eyes very red, seen in a patient intoxicated by alcohol should be refused treatment. (21)
Read – Jaundice With Alcoholic Liver Disease – A Clinical Case Presentation

Upadrava – complications of madatyaya

The complications of alcoholic intoxication are – hiccough, fever, vomiting, rigors, pain in the flanks, cough and giddiness. (22)

Thus ends the chapter on Panatyaya Paramada Panajirna Panavibhrama Nidanam in Madhava Nidana text written by Acharya Madhavakara.