Hyponatremia as an adverse event during Achhasneha – An observation

Abstract

Hyponatremia is defined as serum sodium <135 MEq/L. It is due to the imbalance in the proportion where total body water exceeds the total body electrolytes. Total body water is the total of the Extra Cellular Fluid (ECF) and the Intra Cellular Fluid (ICF). Sodium is the major electrolyte in the ECF and potassium in the ICF. Achhasneha (~administration of unctuous substance exclusively) is the therapeutic procedure of administration of unctuous substances in pure form orally, without mixing with any medicine or food or any other route. The presented case was admitted to the Ayurveda hospital for treatment of keratoconus. The patient developed hyponatremia during Achhasneha, which is a rare occurrence, with limited published scientific literature in this regard. On the 4th day of Achhasneha, the patient complained of Shiroruka (~headache) and Bhrama (~dizziness) from 9 am onward. Manifestations of Sneha jiryamana lakshana (~symptoms during digestion of ghee) were noticed. He was advised to rest and drink lukewarm water in small amounts (Ushna-alpavari) to aid the digestion of ghee. At around 2 pm, he complained of Shiroruka, Jadya (~dullness), Balakshaya (~loss of physical strength), Mukha shosha (~dryness of mouth) and went into Tandra (~lassitude), and Murchha (~syncope). He was prescribed with 20 mL of Dashamoolarishta (20 mL) and 125 mg of Gorochanadi gulika. Relief in the symptoms was noticed after 30 min. He was later advised to take rice gruel mixed with salt in his diet. The probable diagnosis inferred for the condition was euvolemic hypotonic mild hyponatremia of chronic origin. The presented case provided an insight into the untoward events and adverse effects of Snehapana during the treatment, further, alarming the physician to stay alert and to suspect hyponatremia during the Acchasneha, as its symptoms mimic that of Snehajiryamanalakshana. It is crucial to take a detailed medical history that links different symptoms and presentations, meticulously record every incident that occurs throughout Achhasneha, anticipate specific adverse events, and promptly address them within time.