Chapter 6.9: Insanity and Psychosis Treatment (Unmada Chikitsa / उन्मादचिकित्सा)
Management of psychotic disorders through an integrated four-fold approach combining rational pharmacology, spiritual therapy, psychotherapy, and supportive care. Covers endogenous (dosha-based) and exogenous (supernatural) unmada types.
Source: Astanga Hridaya Sutrasthan by Vagbhata
Chapter 9 presents a remarkably sophisticated approach to mental illness, integrating pharmacological, spiritual, psychological, and supportive therapies. Endogenous unmada is classified by dosha (vata produces excitability, pitta produces irritability, kapha produces lethargy). Exogenous types are attributed to supernatural causes requiring spiritual intervention. The four-fold therapeutic approach (yuktivyapashraya, daivavyapashraya, sattvavajaya, upayabhipluta) represents perhaps the earliest integrated mental health treatment framework. Medicated ghee preparations (Kalyanaka, Mahapaishachika, Lashunadya, Hingvadi) are the primary pharmacological agents. The psychotherapy section describes techniques including consolation, behavioral diversion, controlled shock, and reward-based approaches. Mental strength (sattva) is identified as the key preventive factor.