Issue : 01 DOI :
INTERNATIONAL
JOURNAL
OF
DIAGNOSTICS
AND
RESEARCH
Volume : 02
Copyright @ : - Dr.Arvind Kumar Gupta Inter. J.Digno. and Research IJDRMSID00049 |ISSN :2584-2757
49
Abstract
The diagnostic and therapeutic approach is basically Psycho-somatic, as it has been clear that the somatic disease is
turns into psychological one and vice-versa. Clinical evaluation of Manasa-Sadanam (i.e.; Anxiety and
Depression) in the patients of Vataja-Grahani will be verified by stipulated questionnaires of HAM-A and HAM-
D. Indians have shown this condition to be a fairly common G.I. condition, accounting for 30% to 50% of referral
to gastroenterology clinics. A drug combating Vataja-grahani will be given in one group, on the other group same
drug will be adminstered with a Medhyarasayan and in another group will be treated with a knowledge of Vataja
grahani as Control group. In a disease found frequently in the clinics presenting the symptoms of anxiety, tension,
fear, insomnia, poor memory and depressed mood etc. This features in some extent correlates the symptomatology
of Depression. ANOVA test reveals and F-table indicates that the critical value is 3.15 and F-test statistic is greater
than 3.15. So, results are statistically significant and mean score of depressed mood symptoms under HAM-A and
HAM-D Scale in 3 groups of patients treated with different drugs differ significantly. In the treatise of Ayurveda
during description of pathogenesis of Grahani roga, it is mentioned that dysfunction of grahani nadi is the main
causative factor for origin of the disease. A total of 90 patients treated at OPD and IPD Level from 2022-24 for
restoration of their health. It has been evaluated that Satva indicates mental strength of an individual. The
haematological tests i.e. ; Hb. %, T.L.C of W.B.C and ESR in first hour and the biochemical tests i.e. Blood sugar
(fasting), Serum Bilirubin, SGOT, SGPT, Total Serum Protein , Serum Albumin, Serum Globulin, Serum Amylase
and Serum Lipase etc. have showed no significant changes in this study.
Key words: Vataja grahani, Manasa sadanam, HAM-A and HAM-D.
P
ISSN No. : 2584-2757
Volume : 02
Issue : 04
DOI
: 1 0 . 5 2 8 1 / z e n o d o . 1 6 0 3 1899
Reg. No. : MAHA-703/16(NAG)
Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding author: Dr.Arvind Kumar Gupta
Article Info: Published on : 15/07/2025
Impact Factor : 1.013
Clinico-Psychological Assessment Of Manasa Sadanam In Vataja-Grahani
Dr.Arvind Kumar Gupta
1
, Dr. Apala Sengupta
2
1
Senior Ayurvedic Medical Officer, Department of Health & Family Welfare, Government of West Bengal.
2
Proffessor, Department of Rog Nidan & Vikriti Vigyan, I.P.G.A.E & R at S.V.S., Kolkata-9
Cite this article as: - Dr.Arvind Kumar Gupta (2025) ; Clinico-Psychological Assessment Of Manasa Sadanam In Vataja-
Grahani ;Inter.J.Dignostics and Research 2 (4) 49-60, DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 6 0 3 1899
G
A
R
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50
Introduction:
In the classics of Ayurveda, it has been mentioned
that Manasa sadanam is a distinct feature of Vataja
Grahani. In the treatise of Ayurveda; it has been
clearly shows that the somatic disease is turns into
psychological one and vice versa
[1]
. In the selected
patients the extent of Manas-sadanam will be
verified by SatvaPariksha
[2]
. In the recent era, the
term Manasa sadanam is classified as depression
and anxiety. Incidence of anxiety and depression in
irritable bowel syndrome is reported by some
authority. They had evaluated the patients through
the parameter of HAM-A and HAM-D scores. It
had been reported that among the patients at O.P.D
and I.P.D Level, Prevalence of Anxiety was 44 %
and depression was 84 %. In the present study
HAM-A and HAM-D will be measured in the
selected patients of Manasa Sadanam i.e; Avasada.
A drug combating disease will be given along with
a Medhya Rasayan. Hence, the study will be
framed in a group. A routine counseling will be
done in a group. Aaswasana
[3]
i.e.; Assurance will
be given routinely and to describe appraisal in
Chikitsa and the idea of Satva Pariksha also to
determine the frequency of patients Satva Pariksha
and Avasada fulfilling HAM-A and HAM-D.
Concept of Grahani Dosha, Grahani Roga and
Grahani Gada :- Acharya Caraka had mentioned the
term Grahani dosa during nomenclature of the chapter
while during description of the disease termed as
Grahani Gada. The specific reason for this type of
description is clarified by Acharya Chakrapani
[4]
. The
term “Grahani dosa” implies the malfunctioning of
Agni. The Agni is primarily located in the Grahani.
In the title of the chapter, no distinction is made
between the ‘Aashraya’ (the substratum i.e.
Grahani) & ‘Aashrayee’ (the substance i.e. Agni).
Thus ‘Agnidosa’ is implied by the term ‘Grahani
dosa’; though in a secondary sense; Grahani dosa
initiates Grahani Roga. Acharya Caraka described;
the way of formation of Grahani roga. Durbala
Agni brings about vidaha (a part of which is
digested the other part remaining without digestion)
of Aahar; which moves upwards & downwards in
gastro-intestinal tract. The Pakva (digested food) &
Apakva (undigested food) Aahara rasa moves
downwards & this condition is called Grahani-
Gada
[5].
Concept of Manasa-sadanam: The term Manasa
sadanam is mentioned in Charak Samhita in
context to Vataja Grahani
[6]
. The term ‘Mansa
sadanam’ is defined as “ Avasada ”
[7]
by Vijaya
Rakshit as abnormal mental condition recently
compared with the symptom of mental depression.
Hence in chronic case of Vataja Grahani along
with somatic disorders also the psychological
condition get disturbed. Ava-sāda, as, m. sinking
(as of a chair), Susr.; the growing faint (as of a
sound),ib.; failing, ex- Chaustion, fatigue, lassitude,
ib.; defeat, Malav.; want of energy or spirit
(especially as proceeding from doubtful or
unsuccessful love), L.; (in law) badness of a cause,
L.; end, termination, L.; (cf. nir-av.)
[8]
Mind is a
factor for receiving happiness and sadness in an
individual. The term Sadan implies “Avasada”
[9]
i.e; expression of depressive state clinically. This
Hridaya is also connected with Dasha Mahamula
Dhamani through which the Doshas pervade the
heart. Hence, there is exchange of mind & Dosha.
When Doshas get vitiated in excess it effect the
mind & vice-versa
[10]
.
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51
Methodology: Study is a interventional,
prospective, single blind randomized controlled
clinical trial with three groups. Clinical evaluation
of Manasa-Sadanam (i.e.; Anxiety and Depression)
in the patients of Vataja-Grahani will be verified
by Satva Pariksha and stipulated questionnaires of
HAM-A and HAM-D. A routine counseling along
with Aaswasana i.e., Assurance will be done in all
three groups. Evaluation of HAM-A and HAM-D
scores in the selected patients of Manasa-sadanam
with Vataja Grahani. A drug combating Vataja-
Grahani will be given in one group, on the other
group same drug will be administered with a
Medhya Rasayan and in another group will be
treated with a knowledge of Vataja Grahani as
Control group.
Psychological parameter of Manasa Sadanam
sequences in Vataja Grahani:-
The very statement of Caraka Samhita in Vataja
Grahani “Mansa-sadanam”; reveals the evidence
of “Avasada” in Vataja Grahani patients
[11]
.
According to different Acharyas, the following
different causative factors of Avasada in Vataja
Grahani is mentioned as follows:-
1. As per view of Caraka Samhita,
Asatmedriyaartha samyoga, Prajnaparadha
and Parinama are considered as general
etiological for all diseases
[12]
. Among these
etiological triad Prajnaparadha is very
specific in the causation of “Avasada” in
Vataja Grahani patient.
2. According to Maharsi Charaka; vitiation of
Manasika Dosas viz Raja Dosa and Tamo
dosa.
3. According to Maharsi Charak; Acquired of
undesired objects and not getting or loss of
the desired ones as the causes of
Manovikara
[13]
.
4. Acccording to Maharsi Susrutha,
Manobhavas i.e.; Krodha, Soka, Bhaya,
Harsa, Visada, Irshya etc. as the causes of
Mano-Vikara
[14]
.
5. Besides above causes According to
Maharisi Charaka, Avar Satwa (weak
psyche) has also been recognized as a
necessary predisposing factor for the
manifestation of Avasada in Vataja Grahani
patients.
Being associated with the soul, the mind, or
Satva governs the body. They are classified as
exceptional (Pravara), mediocre (Madhyama), or
inferior (Avara) based on their level of strength.
They are vulnerable to ego, delusion, fear, sadness,
and greed. Even stones that describe angry, scared,
hostile, terrifying, and nasty situations, or that show
them visions of the flesh or blood of humans or
animals cause them to crumble
[15]
.
Persons with ‘Avar Satva’ are affected with
Manovikara
[16]
i.e.; “Avasada” in Vataja Grahani.
In other words, persons with high Rajas and Tamas
and Avar Satva, if comes in contact with the causes
of Raja & Tama became sufferer and this leads to
recollection of fearful and negative or disturbing
memories along with false perceptions, wrong
recognition, failure to restrain from negative
memories and thoughts.
When the consequences of Manasa Sadanam
occurs in the patient of Vataja Grahani; then it
should be assumed that the Vataja Grahani Roga is
along with Avasada. In both the disease, the main
responsible factor for initiation of pathogenesis is
Agnimandya. The Srota towards the various
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directions of the system containing the Rasadi
Dhatus gradually get obstructed with the Ama.
According to Maharsi Charak; Hrdaya is a seat of
Rasa, Vatadi, Satvas, Buddhi, Indriya, Atma and
Ojus also emphasize that the seat of ‘Antaramana’
is Hridaya. In the context of Trimarmiya, Maharsi
Charak mentioned that Hrdaya is a seat of Dasa
Mahamoola Dhamanis, Prana, Apana, Mana,
Buddhi, Chetana and Mahabhutani
[17]
.
Effect of research drugs on subjective/clinical
parameter
[18]
of Vataja Grahani : - Drugs effect
was evaluated by the percentage relief of the
symptoms before and after treatment.
Table No. 1: - Showing the effects of the
research drugs on the subjective parameter of
Patients of Vataja Grahani.
Sl.
No.
Subjective
criteria
BT
(%)
AT
(%)
Curability
%
1.
Kharangata
89%
33%
74.15%
2.
Kantha aasaya
sosa
90%
13%
85.55%
3.
Kshuda
100%
8%
92%
4.
Trishna
100%
8%
92%
5.
Timir
69%
51%
26.08%
6.
Karna savana
59%
41%
30.5%
7.
Parsava-uru-
vankshan-griva
ruja
100%
10%
90%
8.
Visuchika
71%
12%
83.09%
9.
Hrid pida
69%
11%
84.05%
10.
Karsaya
59%
41%
30.5%
11.
Dourbalyam
100%
5%
95%
12.
Vairasyam
100%
!%
99%
13.
Parikartika
59%
16%
72.88%
14.
Griddhi sarva
rasanam
100%
5%
95%
15.
Manasa sadanam
100%
10%
90%
Sl.
No.
Subjective
criteria
BT
(%)
AT
(%)
Curability
%
16.
Jirne jirjyati ca
adhmanambhukte
swasthyamupaiti
100%
10%
90%
17.
Sa Vata Gulma
Hrid roga pliha
sanki ca manava
89%
21%
76.40%
18.
Chirad dukham
dravam suskam
tanu ama shabda
phenavat varca
89%
12%
86.51%
19.
Punah punah
srijet varca
100%
0%
100 %
20.
Kasa
19%
2%
89.47%
21.
Swasa
10%
1%
90%
Table No. 1: Shows the effect of Drugs which
revealed that 99% curability was achieved in
symptoms of “Punaha punaha srijet varca” and
“Vairasyam”. Next 95% curability achieved in
“Dourbalya” and “Griddhi sarva rasanam” and 92%
curability was found in “Kshuda” and “Trishna”.
90% in “Parsava-uru-vankshan-griva ruja”, “Jirne
jirjyati ca adhmanambhukte swasthyamupaiti” and
Swasa. 89.47 % was found in Kasa” and 86.51 %
curability was found in “Chirad dukham dravam
suskam tanu ama shabda phenavat varca”. 85.55 %
curability was found in “Kantha–aasaya sosa” and
84.05% curability was found in “Hrid pida.” 83.09
% curability was found in “Visuchika,” and 76.4 %
curability was found in “Sa Vata Gulma Hrid roga
pliha sanki ca manava.” 74.15 % curability was
found in “Kharangata,” and 72.88 % curability was
found in “Parikartika”. 30.5 % curability was found
in “Karna savana” and “Karsaya.” 26.08%
curability was achieved in “Timir.”
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Graph 1: Shows the Curability of Subjective parameter of
Vataja Grahani.
Table No. 2:-Shows the incidence of Depression
symptoms of HAM-D in 90 patients of Vataja
Grahani.
Sl.
No.
Depression
Symptoms
Patients
involved
Percentage
1.
Depressed mood
90
100%
2.
Feelings of guilt
72
80%
3.
Retardation
63
70%
4.
Agitation
54
60%
5.
Anxiety-psychic
64
71%
6.
Hypochondriasis
90
100%
Table No. 2: Shows that the severity of psychic
depression symptoms was found in the range of 100%
patients suffering from Depressed mood and
Hypochondriasis, 80% patients suffering from
feelings of gulit, 71% patients suffering from Anxiety-
psychic, 70% patients suffering from Retardation and
60% patients suffering from Agitation.
Table No. 3: Shows the HAM-D Score of 90
patients of Vataja Grahani.
Sl.
No.
HAM-D Score
Patients
involved
Percentage
(%)
1.
8-13 (Mild
depression)
15
16.67%
2.
14-18(Moderate
depression
40
44.45%
3.
19-22 (Severe
depression)
32
35.54%
4.
>23(Very
severe
depression)
03
3.34%
Table No. 3: Shows that the severity of psychic
depression symptoms was found in the range of
44.45% patients suffering from moderate
depression, 35.5% patients suffering from severe
depression, 16.67% patients suffering from mild
depression and 3.3% patients suffering from very
severe depression.
Graph 2: Shows the incidence of psychic depression
symptoms in 90 patients of Vataja Grahani.
0
10
20
30
40
50
60
70
80
90
100 %
80 %
70%
60 %
71%
100 %
DISTRIBUTION OF PATIENTS ON INCIDENCE OF
DEPRESSION SYMPTOMS OF HAM-D (n=90)
Depressed mood Feelings of guilt Retardation
Agitation Anxiety-psychic Hypochondriasis
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Table No. 4: Shows the HAM-A Score of 90
patients of Vataja Grahani.
Sl.
No.
HAM-A Score
Number
of
patients
Percentage
1.
<17 (Mild
severity)
38
42.22%
2.
18-24 (Mild to
Moderate
severity)
49
54.44%
3.
25-30 (Moderate
to severe)
03
3.34%
Table No. 4: Shows that the severity of psychic
anxiety symptoms was found in the range of 54.4%
patients suffering from mild to moderate severity of
psychic anxiety symptoms, 42.22% patients
suffering from mild severity of psychic anxiety
symptoms and 3.34% patients suffering from
moderate to severe anxiety symptoms.
Table No. 5: Shows the incidence of Anxiety
symptoms of HAM-A in 90 patients of Vataja
Grahani.
Sl.
No.
Anxiety
Symptoms
Patients
involved
Percentage
1.
Anxiety
81
90%
2.
Tension
90
100%
3.
Fear
63
70%
4.
Insomnia
54
60%
5.
Poor memory
72
80%
6.
Depressed mood
90
100%
Table No. 5: Shows that the severity of psychic
anxiety symptoms was found in the range of 100%
patients suffering from Tension and Depressed
mood, 90% patients suffering from Anxiety, 80%
patients suffering from Poor memory, 70% patients
suffering from Fear and 60% patients suffering
from Agitation.
Graph 3: Shows the severity of psychic depression
symptoms in 90 patients of Vataja Grahani.
Graph 4: Shows the severity of psychic anxiety symptoms
in 90 patients of Vataja Grahani.
0
5
10
15
20
25
30
35
40
8-13 (Mild
depression)
14-18(Moderate
depression
19-22 (Severe
depression)
>23(Very severe
depression)
16.67 %
44.45 %
35.54 %
3.34 %
DISTRIBUTION ON HAM-D SCORE OF PATIENTS (n=90)
8-13 (Mild depression) 14-18(Moderate depression
19-22 (Severe depression) >23(Very severe depression)
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Psychiatric co-morbidity:- Psychiatric disorders,
such as anxiety disorders, depression are more
common in patients with IBS; even mildly
symptomatic patients. However, stress plays an
important role in exacerbating IBS symptoms in
IBS patients. In depression; the Hypothalamic-
pituitary adrenal axis is hyperactive, as evidenced
by a non-suppressed response to the dexamethasone
suppressor test. Major depressive disorder is
characterized by one or more episodes of idiopathic
major depressive syndromes such as Depressed
mood, Irritability, Anxiety, Loss of interest or
pleasure, Worthlessness, Guilt, Hopelessness,
Helplessness, Thought of suicide, Change in
appetite or weight, Change in sleep, Decreased
libido, Trouble concentrating, Diurnal variation,
Ruminative thinking, Somatoform symptoms,
Psychotic symptoms. Many be of the anxiety
disorders may be understood as inappropriate
triggering of the stress response system, which is
commonly referred to the “ Fight or Fright
’’response
[19]
.
Patients with IBS frequently demonstrate increased
motor reactivity of the colon and small bowel to a
variety of stimuli and altered visceral sensation
associated with lowered sensation thresholds. These
may result from Central Nervous System (CNS) -
Enteric Nervous System (ENS) deregulation.
Patients with mild to moderate symptoms usually
have intermittent symptoms that correlate with
altered gut physiology and patients with severe
symptoms usually have constant pain and psycho-
social difficulties
[20]
. The psychiatric classification
is based on the number of somatic symptoms and
associated psychological symptoms such as
Hypochondriasis, Somatisation (Somatic
presentation of depression and anxiety) and
neurosis, Panic attacks are common. Acute
psychological stress and overt psychiatric disease
are known to alter visceral perception and gastro-
intestinal motility in both Irritable bowel patients
and healthy people
[21]
.
Graph 5: Shows the incidence of psychic anxiety
symptoms in 90 patients of Vataja Grahani.
Figure No. 1:- Showing Disturbance of Brain-Gut
interaction in Irritable Bowel Syndrome.
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General Management of IBS Patients:-
Reassurance:- Patients should be asked what they
are most worried about. Clearly it may be unwise to
state categorically that the patient has no disease
but it can be emphasized that the probability of
having disease is low.
Explanation:- Patients need a positive explanation
for their symptoms. It is unhelpful to say that
symptoms are psychological or ‘all in the mind’,
but useful to describe a plausible physiological
mechanism for the symptom that emphasizes the
link with psychological factors such as stress and
which demonstrates that the symptoms
are reversible.
Table No. 6 : - Showing the result of ANOVA
[22,23]
of the score in Group – A, Group - B &
Group - C on the basis of parameter of
Depressed mood symptoms of in patients.
Group A
Group B
Group C
Summation
∑x
A
= 63
∑x
B =
55
∑x
C =
45
∑x
= 163
∑x
A
2
=
147
∑x
B
2
=
117
∑x
C
2
=
75
∑x
2
= 339
Source
Df
Sum of
square
Mean
Square
F - Ratio
Groups
(Between
the
group)
3 -1
= 2
5.43
2.71
6.159
Error
(Within
groups)
87
38.35
0.44
Total
89
43.78
Table No. 6: Shows the ANOVA and it reveals that
at the degrees of Freedom (Df) 89 the Sum of
Squares is calculated as 43.78 and the F- Ratio is
inferred as 6.159 at significance level of 0.05, and
F-test has 2 numerator and 60 denominator degrees
of freedom—F
(2, 60)
. First step is to locate the F-
table for α = 0.05. Then find the column for 2
numerator DF and the row for 60 denominator DF.
The intersection of that row and column contains
the critical F-value. The F-table indicates that the
critical value is 3.15 and F-test statistic is greater
than 3.15, So, results are statistically significant and
mean score of depressed mood symptoms under
HAM-A and HAM-D Scale in 3 groups of patients
treated with different drugs differ significantly.
Figure No. 2:- Dietary management of IBS.
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57
EFFECT OF DRUG ON OBJECTIVE
PARAMETER: -
Drug effect was evaluated by the percentage relief
on Biochemical Parameters of before and after
treatment.
Table No. 7: Shows Biochemical Investigations
report of Before and After treatment of
Research Group (Group – A, N = 30) : -
Sl
.
N
o.
Objec
tive
Para
meter
Mean
Score
Rel
ief
%
S.D
.
S.E
.M
‘t’
Val
ue
‘P’
Val
ue
BT
AT
1)
Biliru
bin
Total
0.7
39
0.6
39
0.1
0.1
53
0.0
27
5.9
25
<0.
001
2)
SGOT
30.
9
22.
7
8.2
11.
649
2.1
26
3.8
8
<0.
001
3)
SGPT
36.
8
27.
5
9.3
11.
779
2.1
50
4.3
1
<0.
001
4)
Protei
n
Total
7.2
52
6.9
52
0.3
0.4
41
0.0
80
3.7
4
<0.
001
5)
Serum
Albu
min
4.1
8
3.8
9
0.2
9
0.1
87
0.0
34
9.0
8
<0.
001
6)
Serum
Globu
lin
3.0
8
2.7
9
0.2
9
0.0
84
0.0
15
19.
2
<0.
001
7)
Serum
Amyla
se
57.
1
48.
8
8.3
3.8
72
0.7
06
9.8
6
<0.
001
8)
Serum
Lipase
42.
4
37.
2
5.2
3.1
17
0.5
69
9,2
5
<0.
001
Table No. 7: Shows that ‘P’ – Values for
Biochemical Investigations report of Serum
Bilirubin, SGOT, SGPT, Protein Total, Serum
Albumin, Serum Globulin, Serum Amylase and
Serum Lipase is found to be less than <0.001 which
is inferred to be highly significant.
Results:
ANOVA test reveals and F-table indicates that the
critical value is 3.15 and F-test statistic is greater
than 3.15. So, results are statistically significant and
mean score of depressed mood symptoms under
HAM-A and HAM-D Scale in 3 groups of patients
treated with different drugs differ significantly. On
looking at Mean score of Depression mood
symptoms among three groups, showing that
curability of patients treated with drugs are
comparable in Group B and Group C but mean
curability is highest in the Group A Patients treated
with Research Drugs i.e., Chitraka and
Sankhapuspi powder
Discussion :
The effect of Group A drugs i.e., Chitak and
Sankhapuspi churna to decrease Depressed mood
symptoms in irritable bowel syndrome is very
much responsible for difference between three
groups. The study shows that ‘P’ – Values for
Biochemical Investigations report of Serum
Graph 6:Showing the effect of drugs evaluated by the
percentage relief on Biochemical Parameters of before and
after treatment.
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Bilirubin, SGOT, SGPT, Protein Total, Serum
Albumin, Serum Globulin, Serum Amylase and
Serum Lipase is found to be less than <0.001 which
is inferred to be highly significant.
Acknowledgements: I want to sincerely thank Dr.
Apala Sengupta, my mentor and principal advisor,
who is a professor and head of the Department of
Roga Nidāna Avum Vikṛti Vijñāna at the
I.P.G.A.E. & R at S.V.S.P. Hospital in Kolkata. It
was an immense honour to work and learn under
her outstanding direction, oversight, and
unwavering support for even the tiniest workplace
annoyance.
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23. https://www.statskingdom.com/180Anova1way.
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DOI: 1 0 . 5 2 8 1 / z e n o d o . 1 6 0 3 1899
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