SlideShare verwendet Cookies, um die Funktionalität und Leistungsfähigkeit der Webseite zu verbessern und Ihnen relevante Werbung bereitzustellen. Wenn Sie diese Webseite weiter besuchen, erklären Sie sich mit der Verwendung von Cookies auf dieser Seite einverstanden. Lesen Sie bitte unsere Nutzervereinbarung und die Datenschutzrichtlinie.
SlideShare verwendet Cookies, um die Funktionalität und Leistungsfähigkeit der Webseite zu verbessern und Ihnen relevante Werbung bereitzustellen. Wenn Sie diese Webseite weiter besuchen, erklären Sie sich mit der Verwendung von Cookies auf dieser Seite einverstanden. Lesen Sie bitte unsere unsere Datenschutzrichtlinie und die Nutzervereinbarung.
Diese Präsentation wurde erfolgreich gemeldet.
Die SlideShare-Präsentation wird heruntergeladen.×
Aktiviere deine kostenlose 30-tägige Testversion, um unbegrenzt zu lesen.
PREVALENCE OF SNAKE BITE
CLASSIFICATION OF SARPA IN AYURVEDA
DARVEEKARA SARPA-IN DETAIL
TREATMENTS FOR DARVEEKARA SARPA DAMSHA.
The problem of poisons and their treatment has been coming since prehistoric
Information pertaining to the poison is available in Vedic literature. The word
AGADA has referred several times in vedas.
Later AGADATANTRA was developed as one of the eight branches of Ayurveda
that deals with diagnosis and treatment of poisons.
Mrityu is categorized into two in classics
1. KALA Mrityu : Natural
2. AKALA Mrityu : Unnatural
The second category is also said to be AGANTUJA and may occur because of
Water - that is infected / polluted / contaminated
Agni - like fire accidents
Stree / Visha Kanya - who is contaminated with STDs
VISHA – POISONING
(Dalhana on Sushruta Sutra 34/6)
Among all these factors responsible for unnatural death
VISHA is an important one.
VISHA may be any substance that interferes normal physiology resulting in
Under different categories of Visha SARPA VISHA is an important factor that
causes unnatural death.
As per the estimates of WHO;
India has highest number of
deaths due to snake bites in
Majority of the deaths are due to
Delay / Lack in treatment,
Unable to reach hospitals in time
It has been reported that, there are ONLY 52 VENOMOUS SNAKES
out of 216 species in India.
Yet, every year 50,000 Indians, mostly poor villagers, die in 250,000 incidents of
High incidences are noticed in the states of
Uttar Pradesh, and
Having marks of wheel
Swastika (Auspicious cross)
Goad (अन्कु श)on the body.
These snakes are …
More poisonous during day time
Darvikara are fatal in young stage of life.
कोरयन््यननलःजन्िोः फणणनः सवप वविु
All hooded (Darvekara) snakes aggravate Vata.
दर्वीकरवर्वषेण त्र्वङ्नयननखदशनर्वदनमूत्रर्पुरीषदंशकृ ष्णत्र्वं रौक्ष्यं भशरसो गौरर्वं
सष्धधर्वेदना किीर्पृष्ठग्रीर्वादौबपल्यं जृम्र्णं र्वेर्पथुःस्र्वरार्वसादो
घुघुपरको जडता शुष्कोद्गारः कासश्र्वासौ हहक्का र्वायोरूर्धर्वपगमनं शूलोद्र्वेष्िनं
तृष्णा लालास्रार्वः फे नागमनं स्रोतोऽर्वरोधस्ताश्च र्वातर्वेदना र्र्वष्धत;
Poisons of Darvikara causes
Blackness in skin Eyes,Nails,Teeth,Face,Urine and place of bite,
roughness, heaviness of head, pain in joints, dullness, dry eructation,
cough, dyspnoea, hiccough, upward movement of Vayu, cramp due to
pain, thirst, salivation, emitting froth, obstruction in channels and
different types of vatika pain.
Charaka emphasized NOT TO FOLLOW all these
24 UPAKRAMAS in all cases of poisonings.
A wise physician has to examine and decide justifiable
procedures for specific condition.
Different Upakramas may be helpful in different ways.
Are to be applied / used appropriately.
THESE MAY BE HELPFUL ..
Example from 24 Upakramas
.. in restricting the entry of the poison into the systemic
Arista Bandhana, Utkartana, Chushana etc
.. to eliminate the poison form body Rakta Mokshana, Vamana, Virechana etc
.. to counteract the poisons
Leha, Aushadha, Prativisha etc
.. as supportive / symptomatic measures Samjnasthapana, Mrita sanjivana etc
.. as topical applications Anjana, Pratisarana etc
मसन्दुवारक िूलानन रसेन स्वेन् रेषयिे !
िधुयुक्ि िोयिगद रानं दवीकृ िां र्वषे
मसन्दुवारक िूलानन स्वेिा च गगररकणणपका !!
रानं दर्वपकरे दष्टे नस्यं िधु सारकलि !
1- Root of भसधदुर्वारक macerated in its own juice added with madhu for र्पान
2- Root of भसधदुर्वारक and swetha धगररकणणपका made into paste with water and consumed.
3- for नस्य the juice of कु ष्ठ with मधु can use.
4-In the case of black cobra bite,blood letting is done and paste of charti and nakuli applied
5-Drink prepared out of ghee, honey, manjishta, and griha-dhum
Vega Dushti Chikitsa
Prathama Raka Dushti Raktamokshana by sira vedhana
Dwitiya Mamsa Dushti Madhu, Ghrita and Yavagu Pana
Tritiya Medo Dushti Teekshna Virechana, Yavagu Pana
Chaturtha Kostha Pravesha Vamana, Yavagu Pana
Panchama Asthi pravesha Sheetalopachara, Virechana,
and Yavagu Pana
Shashtha Majja Dushti Sheetalopachara, Virechana,
and Yavagu Pana
Saptama Shukra Dushti Tikshna anjana, nasya, kakpada shaped incision on the
scalp and application of blood mixed flesh over the incision
External application of HINGU, MARICHA, VACHA ground in the juice
of KIMSUKA BARK on the bite mark subsides darvikara visha.
Lepa with tankana and grihadhooma ground in urine.
Lepana with paste of lasuna, maricha, ardraka and pippali ground
in the juice of arkapatra.
Internal administration of trikatu equal amount of pippali , maricha &
sringavera with kanji or water nullifies all visha.
Intake of paste of Ashwagandha with pure water.
Mixed paste of guduchi and kola(piper cubeba).
Oral administration of shirisha flower and seed of arka and equal amount
of vyosha is ground in arka kshira.
Saindhava ground in the juice of tambula patra and dhatura
patra is used as nasya in unconscious poisoned person.
Nasya with swarasa of tulasi & dronapushpi with maricha.
Nasya with hingu maricha & saindhav in human urine or tulasi
Trivrt visalya, madhuka, haridra, daruharidra, rakta manjistha,
aragvadha and the group of salts and trikatu-these should be
powdered finely, mixed with honey and preserved in a horn.
This anti-poisonous formulation destroys poison used as
This is known as MAHAGADA as it has great power.
It is prepared by grinding the fine powder of vidanga,patha,
triphala ajamoda, hingu, tagara, trikatu,chitraka and
pancha lavana with honey into a fine paste and kept
covering with the lid of same material
The name "cobra" is short for cobra-de-capelo, which is uses for "snake with hood", or
Zoological name- Naja naja
Latin name-naja tripudians
King cobra-राज नाग, राज सर्पप/ Naja bangarus ,Ohiophagus hannah
Common name- नाग(Hindi), Moorkan (Malayalam) Nagara Havu (Kannada)
Family - Elapidae
Common cobras are usually brown or black in color
Hood is present. Dorsal aspect of hood may have monocellate or binocellate mark
Ventral surface of hood have two dark spot
Are Cobras aggressive?
Most cobras are shy, and will usually run and hide when people are around. The exception is
King Cobra, who is aggressive and will rear up and stand his ground when confronted.
What unique power do they have?
This is one of those supernatural cobra facts that Cobras are the only snake in the world that
can spit their venom, and they are accurate up to about half their own length
How powerful is their Venom?
Cobras venom is not the strongest there is, but cobras can inject so much venom in a single bite
that they can kill an elephant.
Are they poisonous?
Cobras are not POISONOUS, they are VENOMOUS. This means that even though they have
deadly venom in their sacs
Are they great parents?
King Cobras are the only snake in the world that build a nest for their young, just like a bird,
but on the ground!
Can they hear ?
Cobras can hear, although they sense sound through contact with the ground much better
How old do they get?
Cobras typically live up to 20 years or more, when they’re in the wild.
Do they eat their own?
King Cobras, known also as the Ohiophagus hannah, eat other snakes! The Latin word for
“snake-eater” is ophiophagus.
How Long are they?
King Cobras are the longest venomous snake in the world! The average male grows 18 feet
long, and some have been known to grow more than 20 feet long.
All toxic snakes are venomous and not poisonous, well all of them except one The Asian
is both poisonous and venomous
The cobra is greatly respected and feared
and has its own place in Hindu mythology as
a powerful deity
The Hindu god SHIVA is often depicted with
a cobra coiled around his neck
VISHNU is usually portrayed as reclining on
the coiled body of ADISHESHA
Cobras are also worshipped during the
Hindu festival of NAG PANCHAMI
Snakes by nature are timid and they bite
humans, birds or other animals for the
Being touched by the feet
Accumulation of more venom
The Indian cobra's venom mainly contains a powerful post-synaptic
neurotoxin and cardiotoxin
The venom acts on the synaptic gaps of the nerves, thereby paralyzing
muscles, and in severe bites leading to respiratory failure or cardiac
The venom components include enzymes such as hyaluronidase that
cause lysis and increase the spread of the venom.
The venom of cobra is mainly made up of proteins and polypeptides of
neurotoxins and cardio-toxins
Snake Fatal dose Amount of venom
injected per bite
Cobra 12mg of dried
200-300mg 20min to 6 hour
Krait 6mg of dried
Russel viper 15 mg of dried
150-200mg 1-2 days
Saw scaled viper 8mg of dried
Pre-paralytic stage - characterized
by vomiting, headache, giddiness,
Paralytic stage –ptosis,
dysartheria, convulsion, bulbar
paralysis, respiratory failure, coma,
Symptoms start within 6-8 min
Sleepy , intoxicated
Nausea and vomiting
Burning pain, excessive salivation
Swelling and discoloration
sometimes associated with some
Cauterization should never be
attempted in viper bites
Avoid alcohol for both internal
and external use
Hot, chilli, sour , salt, oil, fruits ,
tubers, meat, fish, intercourse
should be avoided
Site of bite is irrigated with water or
ones own urine.
Assure the patient
Tourniquet is applied 2-3 inch above
the bite mark
Poison is sucked out to minimize the
poison level in the body
Never allow the patient to sleep
Cauterization only in the initial 1-2
min. poison gets neutralized at 100c
Allaying the anxiety and fear
Prevention of spread of venom
Use of anti-venom and other anti toxic therapies
Complete blood count
Blood group and cross-matching
20 min whole blood clotting test(20 WBCT)
Blood gas analysis
Liver function test
Kidney function test
Most of the deaths are due to shock rather than poison. It is
always advised to re-assure the patient by following points…
All the snakes are not poisonous
Poisons snakes are not fully charged
Even it is charged with poison, it cannot always inject lethal
Keep the patient warm calm and restful
Non sedating, non salicylate analgesic (paracetamol) is the best
Broad, sterile, firm bandage on the area of the bite and on the limb
In the case of bite on the trunk, head or neck, firm pressure over the bitten area
If bite is on extremity, firm ligature is applied few inches above the site of the bite.
The ligature is loosened for 90 sec once in every 10 min
Limb immobilizing to prevent spread of venom
Cross incision of 1cm long and 1/2cm deep over each mark is made and the blood
and lymph are drained
Draining is continued until anti venom is administered
Any interference with the bite wound may introduce
absorption of venom and increase local bleeding
Washing increases the flow of venom into the system
by stimulating the lymphatic system
Anti snake venom should not be administered as a routine measure. It should
be carefully and selectively given as it leads serious allergic reactions
Indications for antivenom administration are…
1) In coaguable blood
2) Spontaneous systemic bleeding
4) Neurotoxic or myotoxic features
5) Expanding local swelling
6) Tender regional lymph node
Before administration the anti snake venom should be tested sub
cutaneous as it produces serious anaphylactic reaction in sensitive
Cobra -5-20 ampoules
The anti venom powder is dissolved in distilled water or normal saline and
administered in appropriate dose as infusion in 500 ml of normal saline at a rate
of 15-20 drops per minute.
Flow should be completed in 1-2 hour so that further dose can be repeated, if
required(every 6 hour)
It is useful if given within 4 hour of bite
There is no absolute contraindication to ASV
ASV should not be used indiscriminately because it carries a
risk of severe adverse reaction
Patients must be closely observed for at least 1 hour after
starting IV antivenom so early anaphylactic shock can be
Poisoning is usually accidental
Rarely homicidal or suicidal
Cattle are sometimes poisoned by snake
Evidence of fang marks, local swelling, discoloration, blister
Froth at mouth and nostrils
Cellulitis around the bite mark
Immobilising and transporting snakebite victims to the hospital and
prompt administration of anti-snake venom remain the best way to
reduce morbidity and mortality.
It is also important to practice correct first aid measures, as otherwise
they may cause more harm than good.
Treatment modalities have their own significance in
neutralizing the poison in different ways.
Chaturvimshati Upakramas can be used judiciously even
in case of DARVEKARA Visha.
Application of Tourniquet also has certain limitations in
case of DARVEKARA Visha (cobra poisoning) considering the
danger of increasing the local effects of the necrotic venom.
Evidences are available regarding the clinical efficacy or anti-
venom activity of the formulations mentioned for the treatment of
Though there is certain ambiguity in the approach as
compared to modern medical science; the treatment modalities
emphasized in Ayurveda have a great significance and are
valuable particularly in remote areas, where medical facilities are