VATSANABHA visha signs & symptoms all in one

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1. VATSANABHA By: Shashwath K Tripathy

2. INTRODUCTION Rasatarangini : Sthavara visha Mahavisha (9) Among 9 mahavishas only Vatsanabha is identified Charaka : Sthavara visha ( Cha. Chi. 23) Sushruta : “ Vatsanabhi”Classified it under 13 varieties of Kanda vishas .( Su.Ka . 2/5) Vagbhata : “Visa” used in the treatment of kushta , timira,gandamala , nadivrana (A.H.U.30/23) 12/18/2022 PRESENTATION TITLE 2

3. PROPERTIES Botanical name : Aconitum ferrox Family: Rananculaceae Synonyms : visa,amrut,ksveda , garalam , nagam , mahaushada etc Vernacular names : English-Monks wood; Hindi : Meetha zahar ; kannada-vasnabhi Toxic part : All parts are poisonous.. Mainly Root TYPE OF POISON : CARDIAC POISON 12/18/2022 PRESENTATION TITLE 3

4. MORPHOLOGY Distribution: Alpine Himalayas, Kashmir at an altitude of 3600m; Alpine Himalayas of Nepal Erect herb of 2m height. 12/18/2022 PRESENTATION TITLE 4

5. ROOT It is tuberous and filiform. Dark brown ; turns pink when exposed to air. More or less conical with tapering ends Contains alkaloids aconitine , pseudoaconitine , picraconitine . 12/18/2022 PRESENTATION TITLE 5

6. VARIETIES 12/18/2022 PRESENTATION TITLE 6 Aconitum chasmanthum Aconitum napellus

7. RASA PANCHAKA Rasa : Madhura Guna : ruksha , laghu , teekshna Veerya : ushna Vipaka : katu 12/18/2022 PRESENTATION TITLE 7

8. MECHANISM OF ACTION - ACONITE Toxicity is due to their actions on the voltage sensitive sodium channels of the cell membranes of the excitable tissues. Aconite first stimulates and then paralyses the peripheral terminations of sensory and secretory nerves, CNS and nerves of the myocardium, skeletal and smooth muscles. It doesn’t affect the higher centres of the brain as the consciousness remains intact till the end. It is eliminated by all routes but mainly in the urine. 12/19/2022 PRESENTATION TITLE 8

9. SIGNS AND SYMPTOMS GIT : Bitter sweet taste in mouth, burning and tingling in lips,mouth and pharynx,salivation , dysphagia, nausea, vomiting and diarrhoea. CVS : Hypotension, cardiac arrhythmia with AV block occurs. At first there is tachycardia but later bradycardia occurs due to AV block. Pulse is slow, feeble and irregular. CNS : Vertigo, restlessness, headache, giddiness. Mind may be clear although there may be hallucinations. 12/19/2022 PRESENTATION TITLE 9

10. Contd … Musculo skeletal : weakness of the muscles of the limbs with twitching pain and spasms, cramps and convulsions. Respiratory system : Respiration is slow, laboured and shallow. Ocular : The pupils alternatively contract and dilate( hippus ). Diplopia and impaired vision occurs Other : Temperature is subnormal and skin is cold. Leaves or root if held for a long time produces tingling or numbness. 12/19/2022 PRESENTATION TITLE 10

11. Toxic effects- CLASSICAL REFERENCE Rasa Vagbhata enumerated 8 stages of aconite poisoning and described the symptoms. They are: 1 st stage - Twak vikara 5 th stage – Phenodgama 2 nd stage- Vepathu 6 th stage – Skanda Bhanga 3 rd stage – Daha 7 th stage – Jadata (coma) 4 th stage – Vikritavastha 8 th stage - Marana 12/19/2022 PRESENTATION TITLE 11

12. Fatal dose : 1-2 gm of root; 2-5 mg of pure aconite; 250mg extract; 2-30ml tincture. Fatal period : 2-6 hours Therapeutic dose : 1/16- 1/8 ratti 12/19/2022 PRESENTATION TITLE 12

13. TREATMENT Classical antidote : Tankana + Ghee or Arjuna bark + honey Gastric lavage with warm water or potassium permanganate or with a solution of iodine in potassium iodide to precipitate the alkaloid Multiple doses of activated charcoal Atropine : 0.5-1 mg is useful Symptomatic treatment 12/19/2022 PRESENTATION TITLE 13

14. PURIFICATION(SHODHANA) Root is cut into small pieces and soaked in gomutra for 3 days. Each day the gomutra is changed. Later the pieces are dried Swedana in dola yantra for 1 yama using gomutra / ajadugdha / triphala kwatha . Aconite tubers may be kept in buffalo excreta and boiled for 3 hours 12/19/2022 PRESENTATION TITLE 14

15. INDICATIONS Lepa of root is applied at the site of Vrischika visha (A.H.U.37) As Pradhamana nasya in cases of shirashoola Powder used along with dasanga lepa and dhattura swarasa in cases of Sotha It is also used in the treatment of Snayuka , shukrameha Lepa is spread upon skin in the cases of neuralgia and muscular rheumatism, nasal catarrh, tonsilitis and acute gout. 12/19/2022 PRESENTATION TITLE 15

16. YOGAS Anandabhairava rasa Mrutyunjaya rasa Tribhuvana keerti rasa Hinguleshwara rasa Amrita rasayana Visa rasayana and visa taila 12/19/2022 PRESENTATION TITLE 16

17. POST-MORTEM APPEARANCE Usually unidentified. But characteristics of Asphyxia The mucosa of stomach and duodenum show congestion and occasionally ecchymosis. Frothy mucus in trachio -bronchial tree Odour of chloroform in stomach Necrosis of myocardium The lungs, kidney and brain are congested 12/19/2022 PRESENTATION TITLE 17

18. MEDICO-LEGAL IMPORTANCE It is an ideal homicidal poison – as it is cheap, easily available, lethal dose is small, sweet (given with betel leaf), is extremely unstable and destroyed by putrefaction; hence cannot be detected by chemical analysis. Accidental poisoning is due to eating the roots mistaken as horseradish. Taken with liquor to increase intoxication Root is used as an abortificient . Used as cattle poison and arrow poison. 12/19/2022 PRESENTATION TITLE 18

19. References Text book of Agadatantra by Dr Shobha Bhat Text book of Dravyaguna vijnana by Dr JLN Shastry The Esssentials of Forensic Medicine and Toxicology by Dr KS Narayana Reddy. 12/19/2022 PRESENTATION TITLE 19

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21. THANK YOU Guided by : Dr Adarsh Sir Dr Shivanand Sir