A critical review on vrischika visha W.S.R. to keraliya visha chikitsa

Scorpion stings are major public health problem especially in rural parts of India. Envenomation from Scorpions if estimating on yearly basis it is about 12 lakh people per year and is responsible for nearly about 3250 deaths. There are about 1400 species of scorpions identi(cid:976)ied worldwide out of this only 53 are reported to be dangerous to humans, In India we have identi(cid:976)ied around 86 species. Poison due to insect bite is common and can be accompanied with a variety of symptoms ranging from simple itching to life threatening situations. Many may go through minor problems like swelling, tingling or numbness due to the sting. Scorpion sting usually results in severe symptoms, as its venom is more potent. Young children and older adults may require immediate treatment. Vrischikadamsha is such a speci(cid:976)ic envenomation that requires medical attention. There are ample references treatment modalities and medicines in Keraleeyavisha chikitsa granthas and ayurvedic classics which are described for managing vrischikavisha. Many of the keraliyavishagrantha are written in Malayalam hence there is a need to explore and bring out the remedies. So in this article a humble effort is made to bring out the different vrischika and treatment modalities described in keraleeyagrandhas along with the speci(cid:976)ic symptoms.


Literary Review Vrischika Visha, Keraliya Visha Grantha, Scorpion
A Scorpion stings are major public health problem especially in rural parts of India. Envenomation from Scorpions if estimating on yearly basis it is about 12 lakh people per year and is responsible for nearly about 3250 deaths. There are about 1400 species of scorpions identi ied worldwide out of this only 53 are reported to be dangerous to humans, In India we have identi ied around 86 species. Poison due to insect bite is common and can be accompanied with a variety of symptoms ranging from simple itching to life threatening situations. Many may go through minor problems like swelling, tingling or numbness due to the sting. Scorpion sting usually results in severe symptoms, as its venom is more potent. Young children and older adults may require immediate treatment. Vrischikadamsha is such a speci ic envenomation that requires medical attention. There are ample references treatment modalities and medicines in Keraleeyavisha chikitsa granthas and ayurvedic classics which are described for managing vrischikavisha. Many of the keraliyavishagrantha are written in Malayalam hence there is a need to explore and bring out the remedies. So in this article a humble effort is made to bring out the different vrischika and treatment modalities described in keraleeyagrandhas along with the speci ic symptoms.

INTRODUCTION
Agadatantra is a single subject in which maximum number of books is written in keraliyavisha chikitsa grantha and samhitas. Keraliyavishavaidyas has an ancient and renowned background. In this system, both vedic and non-Vedic schools of thoughts were present. The renowned keraliyagranthas which have description on vrischikavisha are VishaVaidya-Jyotsnika: Classi ication, symptoms and treatment of vrischikadamsha, vegalakshanas are described in the 12 th adhikara named 'vrischikavisavijnaniyapratishedam'.
Written by SreelekhaK.G, PrayogaSamuchaya in saptamapariccheda we get reference of origin, classi ication, signs and symptoms and treatments of vrischikadamsha. Written by KochunniTamburaan. Narayaniyam which is also well known as Tantra Sara Sangraha gives Different Yogas used in vrischikadamsha are explained 10 th patala written by Narayanan. KriyaKoumudi by Sri V M KuttiKrishnaMenon detailed description about vrischika, vegalakshnas, vrana and upadrava due to vrischikadamsha.

Origin of Vrischika
According to acharyavagbatta those born from the cadaver of snakes are Mahavisha, Born from cadaver of animals killed by poisoned arrow are Madhyav- Colours such as black, blue, brown, white and colour like cows urine, coarse (dull), blueblack, yellow or smoky, having hair on their belly resembling algae, red or white, having more number of joints in the tail than others.
Yellow, white-blue, many colours of black, dry, hairy has many joints, abdomen red and pale Yellow, white, blue, dry, rough, brown or dark brown in colour, hairs on the body, many joints belly being reddish or white.
isha, and Born from the putre ied dung of cow and other animals are Mandavisha (Vaghbata, 2011a).
According to sushrutaacharya those born from decomposed dead body of snakes and such other poisonous animals are termed as TeekshnaVisha. Those born from decomposed materials wood and brick are termed as Madhya Visha. Those born from decomposed cow dung are termed as Man-daVisha (Samhita, 2010). According to Prayogasammuchaya the four types of vrischika-vata, pitta, kapha and sannipathika -are born from the decayed faeces, urine, semen, egg, and dead bodies of snakes (Tamburan, 1999g). According to kriyakoumudivrischikas are born from the cadaver of snakes, decomposed materials or from dead body of animals killed by poisoned arrow, Born from decomposed cow dung (Menon, 1986b).
Black color blood comes out from all the ori ices + 29.
Dryness of the mouth + 31.

Maha visha
Manifestation of symptoms of all stages at once, development of vesicles, dizziness, burning sensation, fever, black blood lows out from ori ices and with these dreadful symptoms the person dies quickly.

Madhya visha
Produces aggravation of doshas similar to the three kinds of snakes, Give rise to swelling of the tongue, obstruction to swallowing of food, severe fainting.

Manda visha
Pain, shivering, stiffness of the body, low of black colored blood from site of sting. When bitten in the extremities pain travels upwards, giving rise to burning sensation, sweating, oedema at the area and fever. Pain in the region of heart, stoppage of movement of vata in upward direction, engorgement dilatation or formation of network of vein, pain in joints and bones, rolling on the ground, twisting pain in the calves and blue discoloration of the body Loss of consciousness, warm expiration, burning sensation in the heart, bitter taste in the mouth, tearing of muscles, swelling which is reddish yellow in color.
Bhavamishra also gives similar explanation in Bhavaprakasa.
He says that the pain in vrischikadamsha will be like a ire or burning sensation, radiating upward which afterwards will get settled at the site of the sting (Srikantamurthy, 2009). Asadhyavrischikadamshalakshanas are mentioned it can be considered as sannipatikavrischikavishalakshana, which includes severe pain at hridaya, nasika, Jihwa: patient feels as these organs have stopped functioning .skin at the site of the sting starts is necrosed and sheds. Prayogasamuchaya explains the symptoms similar to vaghbatta with some differences. The symptoms of vata pradhana pain in region of heart, regurgitation, stretching pain in the nerves, rigidity of body, pain in joints and bones, dizziness and pain at the site of bite. The symptoms of pittapradanavrischikadamsha are loss of consciousness, dyspnea, fainting, fuming sensation with burning pain mainly in chest region, breakdown and fall of musculature, in lammation with redness.
In Table 2 Lakshanas of vrischikavisha have been explained and in Table 3 -Symptoms Produced By Different Types Of Vrischika have been enumerated.
The kaphapradhana vrischikadamsha lakshanas are vomiting Alpavishaveerya, anorexia, salivation, watery discharge from nose, chest congestion, dominance of sweet taste I moth and chills (Tamburan, 1999b). KriyaKoumudi also gives explanations for the dosha predominant symptoms of vrischika. The symptoms of vata predominant vrischika include sirastoda, astitida, hridvyada, urdwavayu, darkness and pain in the veins. The symptoms of paittikavrischikadamshalakshana include swasavriddhi, raktapitta, moha, burning sensation and heartburn. The symptoms of kaphajavrischikadamsha are hrillasa, chardi, saitya,mukhamadhurya and excessive salivation (Menon, 1986a). Two types of vrischika -and ugravishaveerya. Alpavishaveeryavrischika produces severe pain, numbness, swelling and burning sensation. Ugravisha has vegas similar to that of snake and effects nerves. The power of visha depends upon the size of vrischika (Menon, 1986d). PrayogaSamuchaya and KriyaKaumudi explained signs and symptoms of vrischikadamsha in step by step as it enters deeper and deeper in subsequent dhatus. It is referred as vega of vrischikadamsha. In Table 4 -Damsha Lakshana According To Dosha Predominance have been told. And in Table 5 -Dathugata Vrschika Damsha Lakshana have been enumerated.
The Table 6 -Shows The Dosha Predominance Of Vrischika Visha According To Different Acharyas.

CONCLUSION
From all these references it can be concluded that vrichikas are numerous in nature so the vishalakshanas associated with each of them are unique in nature and the treatment protocols that should be adopted to each vrichikavishadamshas must be speci ic according to the nature of vrichika, also it can be noted that majority of acharyas have described vrischikavisha as vatolbana in nature and some as vatapittolpana in nature. Prayogasamuchaya explains the symptoms similar to vaghbatta with some differences. The symptoms of vata pradhana pain in region of heart, regurgitation, stretching pain in the nerves, rigidity of body, pain in joints and bones, dizziness and pain at the site of bite. The symptoms of pittapradanavrischikadamsha are loss of consciousness, dyspnea, fainting, fuming sensation with burning pain mainly in chest region, breakdown and fall of musculature, in lammation with redness. The symptoms of kaphajavrischikadamsha are hrillasa, chardi, saitya, mukhamadhurya and excessive salivation. Two types of vrischikaugravishaveerya. Alpavishaveeryavrischika produces severe pain, numbness, swelling and burning sensation. ugravisha has vegas similar to that of snake and effects nerves. The power of visha depends upon the size of vrischika.