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Chapter 20 – Unmada Nidana

The 20th chapter of Madhava Nidana deals with Unmada Nidana which is Insanity.

मदयन्त्युद्गता दोषा यस्मादुन्मार्गमागताः |
मानसो अयमतो व्याधिरुन्माद इति कीर्तितः || १ ||

madayantyudgatā dōṣā yasmādunmārgamāgatāḥ |
mānasō ayamatō vyādhirunmāda iti kīrtitaḥ || 1 ||

The doshas which have undergone provocation and traversed upwards through the channels of the mind get localized in the same and generate abnormality there. This disease is known as unmada. It is mainly a disease of the mind. 1

Varieties of Unmada (Insanity) –

एकैकशः सर्वशश्च दोषैरत्यर्थमूर्च्छितैः |
मानसेन च दुःखेन स च पञ्चविधो मतः || २ ||
विषाद्भवति षष्टश्च यथास्वं तत्र भेषजम् |
स चाप्रवृद्धस्तरुणो मदसंज्ञां बिभर्ति च || ३ ||

ēkaikaśaḥ sarvaśaśca dōṣairatyarthamūrcchitaiḥ |
mānasēna ca duḥkhēna sa ca pañcavidhō mataḥ || 2 ||
viṣādbhavati ṣaṣṭaśca yathāsvaṁ tatra bhēṣajam |
sa cāpravr̥ddhastaruṇō madasañjñāṁ bibharti ca || 3 ||

The three produced from each of the three doshas, fourth from a combination of all the three, fifth from grief and the like and the sixth from poison are the varieties of Unmada; their treatment should be appropriate to the cause related.

The disease is of five kinds:

  • 3 of them produced due to each of the 3 doshas
  • 4th occurs due to combination of all the three doshas while
  • The 5th is produced due to mental agony, etc.,

Thus, Unmada is of five types. There is a sixth variety of Unmada too. It occurs due to poisoning.

This disease is also known as mada, if it is not fully developed and is of recent onset. 2 – 3

Common etiology of Unmada (Insanity) –

विरुद्ध – दुष्टाशुचिभोजनानि प्रधर्षणं देवगुरुद्विजानां |
उन्मादहेतुर्भय – हर्षपूर्वो – मनो अभिघातो विषमाश्च चेष्टाः || ४ ||

viruddha – duṣṭāśucibhōjanāni pradharṣaṇaṁ dēvagurudvijānāṁ |
unmādahēturbhaya – harṣapūrvō – manō abhighātō viṣamāśca cēṣṭāḥ || 4||

The causes of Unmada include –

  • Regular intake of eatables that are incompatible, decomposed, and unclean;
  • Showing disrespect to Gods, the elders and the twice born;
  • Affection of the mind due to sudden emotions like fear, joy, and the like and violent physical activities. 4

Samprapti (Pathogenesis) of Unmada (insanity) –

तैरल्पसत्त्वस्य मलाः प्रदुष्टा बुद्धेर्निवासं हृदयं प्रदूष्य |
स्रोतांस्यधिष्टाय मनोवहानि प्रमोहयन्त्याशु नरस्य चेतः || ५ ||

tairalpasattvasya malāḥ praduṣṭā buddhērnivāsaṁ hr̥dayaṁ pradūṣya |
srōtānsyadhiṣṭāya manōvahāni pramōhayantyāśu narasya cētaḥ || 5 ||

In a person with a deficiency of Sattva or truthful bent of mind, the vitiated dosha gets localized in the channels of the mind due to the above etiological factors. It subsequently damages the heart, the seat of intelligence and the mental functions of the person are quickly deranged. 5

Common Symptomatology of Unmada (Insanity) –

धीविभ्रमः सत्त्वपरिप्लवश्च पर्याकुला दृष्टिरधीरता च |
अबद्धवाक्त्वं हृदयं च शून्यं सामान्यमुन्मादगदस्य लिङ्गम् || ६ ||

dhīvibhramaḥ sattvapariplavaśca paryākulā dr̥ṣṭiradhīratā ca |
abaddhavāktvaṁ hr̥dayaṁ ca śūnyaṁ sāmānyamunmādagadasya liṅgam ||6 ||

The common specific features of Unmada include –

  • A confused intellect and fickleness of mind
  • In coordination of gaze,
  • Incoherent speech
  • And mental vacuum and
  • Similar features. 6

Vata Type of Unmada –

रुक्षाल्प – शीतान्न – विरेक – धातुक्षयोपवासैरनिलो अतिवृद्धः |
चिन्तादिदुष्टं हृदयं प्रदूष्य बुद्धिं स्मृतिं चाप्युपहन्ति शीघ्रम् || ७ ||
अस्थानहास – स्मित – नृत्य – गीत – वागङ्गविक्षेपण – रोदनानि |
पारुष्य – कार्श्यारुणवर्णताश्च जीर्णे बलं चानिलजस्य रुपम् || ८ ||

rukṣālpa – śītānna – virēka – dhātukṣayōpavāsairanilō ativr̥ddhaḥ |
cintādiduṣṭaṁ hr̥dayaṁ pradūṣya buddhiṁ smr̥tiṁ cāpyupahanti śīghram ||7 ||
asthānahāsa – smita – nr̥tya – gīta – vāgaṅgavikṣēpaṇa – rōdanāni |
pāruṣya – kārśyāruṇavarṇatāśca jīrṇē balaṁ cānilajasya rupam || 8 ||

The factors that provoke vata in the body are –

  • Indulgence in eatables that are dry, scanty or cold;
  • Opting frequently for purgation and vomiting
  • Depletion of basic tissues
  • Fasting or
  • Starvation.

The vata in turn gets further excited by emotions like worry, particularly among the persons of a weak mind. This situation brings about derangement of intellect and memory. 7-8

Pitta Type of Unmada – –

अजीर्ण – कट् वम्ल – विदाह्यशीतैर्भोज्यैश्चिते पित्तमुदिर्णवेगम् |
उन्मादमत्युग्रमनात्मकस्य हृदि स्थितं पूर्ववदाशु कुर्यात् || ९ ||
अमर्ष – संरम्भ – विनग्नभावाः सन्तर्जनातिद्रवणौष्णय – रोषाः |
प्रच्छाय – शीतान्नजलाभिलाषः पीता च भाः पित्तकृतस्य लिङ्गम् || १० ||

ajīrṇa – kaṭ vamla – vidāhyaśītairbhōjyaiścitē pittamudirṇavēgam |
unmādamatyugramanātmakasya hr̥di sthitaṁ pūrvavadāśu kuryāt || 9 ||
amarṣa – sanrambha – vinagnabhāvāḥ santarjanātidravaṇauṣṇaya – rōṣāḥ |
pracchāya – śītānnajalābhilāṣaḥ pītā ca bhāḥ pittakr̥tasya liṅgam || 10 ||

The pitta is vitiated due to

  • Eating prior to the digestion of the previous food (Ajirnabhojana) and
  • Due to intake of pungent, sour, over – burnt, and very warm foods.

It moves fast, is lodged in the heart of the weak individual. In addition, it causes severe insanity in the manner it happens in the case of the vitiated vata.

The patient indulges in such activities as

  • making outcry,
  • getting naked,
  • getting frightened, and
  • running away without a purpose.

He gets intolerant and there is heat and feeling of fumes coming out of his body. Moreover, he desires to be in a shadow, to eat cold food and to drink cool drinks. There is yellowish lustre on the body. These are the signs and symptoms identified as the result of a pitta type of insanity. 9-10

Kapha Type of Unmada –

सम्पूरणैः मन्द विचेष्टितस्य सोष्मा कफो मर्मणि संप्रदुष्टः |
बुद्धिं स्मृतिं चाप्युपहत्य चित्तं प्रमोहयन् सञ्जनयेद्विकारं || ११ ||
वाक्चेष्टितं मन्दमरोचकश्च नारी – विविक्तप्रियता अतिनिद्रा |
छर्दिश्च लाला च बलं च भुक्ते नखादि शौक्लयं च कफात्मके स्यात् || १२ ||

sampūraṇaiḥ manda vicēṣṭitasya sōṣmā kaphō marmaṇi sampraduṣṭaḥ |
buddhiṁ smr̥tiṁ cāpyupahatya cittaṁ pramōhayan sañjanayēdvikāraṁ ||11||
vākcēṣṭitaṁ mandamarōcakaśca nārī – viviktapriyatā atinidrā |
chardiśca lālā ca balaṁ ca bhuktē nakhādi śauklayaṁ ca kaphātmakē syāt || 12 ||
The kapha is vitiated along with the pitta by indulgence in over – eating, lack of physical exercise and the like. This condition has been identified as kaphaja unmada and it produces derangement of intellect and memory.

Its characteristics features are

  • slow or weak voice as well as body movements,
  • anorexia,
  • desire for women and solitude,
  • excessive sleep,
  • vomiting and
  • excess salivation.

These symptoms are increased immediately after taking food. Moreover, the patient of the kaphaja unmada develops whiteness in nails, etc. 11 – 12

Sannipata type of Unmada –

यः सन्निपातप्रभवो अतिघोरः सर्वैः समस्तैः स च हेतुभिः स्यात् |
सर्वाणि रूपाणि बिभर्ति तादृग्विरुद्धभैषज्य विधिर्विवर्ज्यः || १३ ||

yaḥ sannipātaprabhavō atighōraḥ sarvaiḥ samastaiḥ sa ca hētubhiḥ syāt |
sarvāṇi rūpāṇi bibharti tādr̥gviruddhabhaiṣajya vidhirvivarjyaḥ || 13 ||

Sannipataja Unmada is generated by morbid increase in all the three doshas together by their respective causes. The features of all the doshas are seen in the patient and the medicines as well as the methods of management (for each type) being mutually contradictory this disease becomes unmanageable.

Shokaja Unmada (Insanity caused by grief) —

चोरैर्नरेन्द्रपुरुषैररिभिस्तथा अन्यैर्वित्रासितस्य धन – बान्धवसङ्गक्षयाद्वा |
गाढं क्षते मनसि च प्रियया रिरंसोर्जायते चोत्कटतमो मनसो विकारः || १४ ||
चित्रं ब्रवीति च मनो अनुगतं विसंज्ञो गायत्यथो हसति रोदिति चापि मूढः |

cōrairnarēndrapuruṣairaribhistathā anyairvitrāsitasya dhana – bāndhavasaṅgakṣayādvā |
gāḍhaṁ kṣatē manasi ca priyayā riransōrjāyatē cōtkaṭatamō manasō vikāraḥ || 14 ||
citraṁ bravīti ca manō anugataṁ visañjñō gāyatyathō hasati rōditi cāpi mūḍhaḥ |

Getting frightened by (sudden appearance or presence of) robbers, government officials (the police and like), enemies and others (wild animals, weapons and anything causing fear), loss of money (or wealth), death of relatives (such as wife, lover, sons, daughters, parents and the like) excessive desire for sex and such other factors generate great injury to the mind and produce unmada.

Person so affected talks indifferently and incoherently, he could even reveal secrets which are otherwise not to be disclosed. He would sing, laugh or weep without a sense on his own accord and would behave insensibly. 14

Vishaja Unmada (Insanity caused by poison) —

रक्तेक्षणो हतबलेन्द्रिय – भाः सुदीनः |
शयावाननो विषकृते अथ भवेद्विसंज्ञः || १५ ||


raktēkṣaṇō hatabalēndriya – bhāḥ sudīnaḥ |
śayāvānanō viṣakr̥tē atha bhavēdvisañjñaḥ || 15 ||

These are the symptoms caused by a patient afflicted by unmada generated by poisons –

  • Red Eyes
  • Loss of strength of body, senses and complexion
  • Helplessness
  • Black discolouration of mouth or face
  • Loss of consciousness

Incurability of Unmada —

अवाञ्ची वा अप्युदञ्ची वा क्षीणमांस – बलो नरः |
जागरुको ह्यसन्देहमुन्मादेन विनश्यति || १६ ||
avāñcī vā apyudañcī vā kṣīṇamānsa – balō naraḥ |
jāgarukō hyasandēhamunmādēna vinaśyati || 16 ||


The level of unmada which makes the patient inclined to keep his head constantly down or bent up, which makes the patient emaciated, weak and to remain awake continuously (without sleeping) is considered to be a fatal one. 16

Unmada caused by supernatural powers –

अमर्त्यवाग्विक्रम – वीर्यचेष्टो ज्ञानादि – विज्ञान – बलादिभिर्यः |
उन्मादकालो अनियतश्च तस्य भूतोत्थमुन्मादमुदाहरेत्तम् || १७ ||

amartyavāgvikrama – vīryacēṣṭō jñānādi – vijñāna – balādibhiryaḥ |
unmādakālō aniyataśca tasya bhūtōtthamunmādamudāharēttam || 17 ||

A patient of insanity having majestic powers of speech, valour, strength and activities, as well as knowledge, scientific erudition, power, etc. and in whom fits of insanity manifest at unpredictable intervals should be regarded as suffering from Bhutonmada. 17

Unmada caused by deva (God) –

संतुष्टः शुचिरतिदिव्य माल्पगन्धो निस्तन्द्रीरवितथसंस्कृत प्रभाषि |
तेजस्वी स्थिरनयनो वरप्रदाता ब्रह्मण्यो भवति नरः स देवजुष्टः || १८ ||

santuṣṭaḥ śuciratidivya mālpagandhō nistandrīravitathasanskr̥ta prabhāṣi |
tējasvī sthiranayanō varapradātā brahmaṇyō bhavati naraḥ sa dēvajuṣṭaḥ || 18 ||

The individual afflicted by Gods (devagraha) always looks contented, keeps himself tidy, wears divines garlands and unguents, has no sleep, speaks only truth and refined language, looks bright, has stable looks, and keeps giving boons to everybody. 18

Afflication caused by devashatrus (enemies of god i.e., demons) –

संस्वेदी द्विज – गुरु – देवदोषवक्ता जिह्याक्षो विगतभयो विमार्गदृष्टिः |
सन्तुष्टो न भवति चान्न – पानजातैर्दुष्टात्मा भवति स देवशत्रुजुष्टः || १९ ||
sansvēdī dvija – guru – dēvadōṣavaktā jihyākṣō vigatabhayō vimārgadr̥ṣṭiḥ |
santuṣṭō na bhavati cānna – pānajātairduṣṭātmā bhavati sa dēvaśatrujuṣṭaḥ || 19 ||

The person who gets profuse perspiration, speaks lowly of the Brahmins, perceptors and gods, gazes with a frown, is afraid of none, looks towards an unrighteous path, does not get satisfied in spite of plenty of food and drinks and has an impious disposition should be considered to be afflicted with the vitiation by the enemies of gods (asura graha). 19

Afflication caused by Gandharva grahas –

हृष्टात्मा पुलिन – वनान्तरोपसेवी – स्वाचारः प्रियपरिगीत – गन्ध – माल्यः |
नृत्यन् वै प्रहसति चारु चाल्पशब्दं गन्धर्वग्रह परिपीडितो मनुष्यः || २० ||

hr̥ṣṭātmā pulina – vanāntarōpasēvī – svācāraḥ priyaparigīta – gandha – mālyaḥ |
nr̥tyan vai prahasati cāru cālpaśabdaṁ gandharvagraha paripīḍitō manuṣyaḥ || 20 ||

The features of the person possessed by the gandharva graha include contentment; desire to roam about on riverbanks, gardens and the like. He is also seen indulging in virtuous deeds and remains fond of suitable company, songs, scents, and garlands. He would remain dancing, laughing and speaking merrily, even without a purpose or sense. 20

Affliction caused by Yakshagrahas –

ताम्राक्षः प्रिय – तनु – रक्तवस्त्रधारी गम्भीरो द्रुतगतिरल्पवाक् सहिष्णुः |
तेजस्वी वदति च किं ददामि कस्मै यो यक्षग्रहपरिपीडितो मनुष्यः || २१ ||

tāmrākṣaḥ priya – tanu – raktavastradhārī gambhīrō drutagatiralpavāk sahiṣṇuḥ |
tējasvī vadati ca kiṁ dadāmi kasmai yō yakṣagrahaparipīḍitō manuṣyaḥ || 21 ||

The individual afflicted by the Yakshagraha has coppery eyes. He would long to wear red, thin and beautiful attires. He would appear majestic in stature and bright. He would walk fast, speak less, has patience, would acquire good looks, and would remain enquiring what should he give and whom. 21

Affliction caused by Pitr grahas –

प्रेतानां स दिशति संस्तरेषु पिण्डान् शान्तात्मा जलमपि चापसव्यवस्त्रः |
मांसेप्सुस्तिल – गुड – पायसाभिकामस्तद्भक्तो भवति पितृग्रहाभिजुष्टः || २२ ||

prētānāṁ sa diśati sanstarēṣu piṇḍān śāntātmā jalamapi cāpasavyavastraḥ |
mānsēpsustila – guḍa – pāyasābhikāmastadbhaktō bhavati pitr̥grahābhijuṣṭaḥ || 22 ||

The person afflicted by the pitrgrahas remains in a calm temperament, he would constantly offer oblations and water to the ancestral souls on leaves or the kusha grass keeping a cloth on his right shoulder; would have strong liking for meat, jaggery and milk pudding and the patient would maintain a great reverence to the parents. 22

Affliction caused by Nagas –

यस्तुर्व्यां प्रसरति सर्पवत् कदाचित् सृक्कण्यौ विलिहति जिह्वया तथैव |
क्रोधालुर्गुड – मधु – दुग्ध – पयसेप्सुर्ज्ञातव्यो भवति भुजङ्गमेन जुष्टः || २३ ||

yasturvyāṁ prasarati sarpavat kadācit sr̥kkaṇyau vilihati jihvayā tathaiva |
krōdhālurguḍa – madhu – dugdha – payasēpsurjñātavyō bhavati bhujaṅgamēna juṣṭaḥ || 23 ||

The one possessed by Bhujangagraha would

  • Try to move on ground lying on his chest
  • Licking things nearby with tongue,
  • Getting into anger quickly.

He would also crave for jaggery, honey, milk, and puddings and the like items.

Affliction caused by Rakshasa –

मांसासृग्विविधसुराविकारलिप्सुर्निर्लज्जो भृशमतिनिष्ठुरो अतिशूरः |
क्रोधालुर्विपुलबलो निशाविहारी शौचद्विड् भवति स रक्षसैर्गृहीतः || २४ ||

mānsāsr̥gvividhasurāvikāralipsurnirlajjō bhr̥śamatiniṣṭhurō atiśūraḥ |
krōdhālurvipulabalō niśāvihārī śaucadviḍ bhavati sa rakṣasairgr̥hītaḥ || 24 ||

The one possessed by Rakshasa Graha would crave for eatables prepared with meat and blood, intoxicating drinks. He would reflect a complete absence of shyness, pity etc. and would remain very cruel, very brave, and angry. Moreover, he would have a great strength and would roam about at night and would hate cleanliness. 24

Affliction caused by Pischasa –

उद्धस्तः कृशपरुषो अचिरप्रलापी दुर्गन्धो भृशमशुचिस्तथा अतिलोलः |
बह्वाशी विजनवनान्तरोपसेवी व्याचेष्टन् भ्रमति रुदन् पिशाचजुष्टः || २५ ||

uddhastaḥ kr̥śaparuṣō acirapralāpī durgandhō bhr̥śamaśucistathā atilōlaḥ |
bahvāśī vijanavanāntarōpasēvī vyācēṣṭan bhramati rudan piśācajuṣṭaḥ || 25 ||

The insane that has been possessed by Pishacha graha would try to keep himself ever naked or with hands raised, would remain emaciated and hard.

Moreover, he would talk irrelevant, would emit bad smell, would remain very dirty, and would remain greedy for eatables and drinks. He could also remain running about and weeping alone in lonely and deserted places, forest, and the like. 25

Incurability of Unmada (Insanity) –

स्थूलाक्षो द्रुतमटनः स फेनलेही निद्रालुः पतति च कम्पते च यो हि |
यश्चाद्रि – द्विरद – नागादिविच्युतः स्यात् सो असाध्यो भवति तथा त्रयोदशाब्दे || २६ ||

sthūlākṣō drutamaṭanaḥ sa phēnalēhī nidrāluḥ patati ca kampatē ca yō hi |
yaścādri – dvirada – nāgādivicyutaḥ syāt sō asādhyō bhavati tathā trayōdaśābdē || 26 ||

A patient of insanity with the following traits could be considered incurable:

  • The one whose eyes have become protuberant,
  • Who walks fast, licks own froth
  • Who remains sleepy
  • Falls down and has convulsions or
  • who has gone insane after a fall from a hill, an elephant or a tree, etc

Moreover, insanity which has turned over thirteen years old also becomes incurable. 26

The time of affliction –

देवग्रहाः पौर्णमास्यामसुराः सन्ध्ययोरपि |
गन्धर्वाः प्रायशो अष्टम्यां, यक्षाश्च प्रतिपध्यथ || २७ ||
पित्र्याः कृष्णक्षये हिंस्युः, पञ्चम्यापि चोरगाः |
रक्षांसि रात्रौ, पैशाचाश्चतुर्दश्यां विशन्ति हि || २८ ||

dēvagrahāḥ paurṇamāsyāmasurāḥ sandhyayōrapi |
gandharvāḥ prāyaśō aṣṭamyāṁ, yakṣāśca pratipadhyatha || 27 ||
pitryāḥ kr̥ṣṇakṣayē hinsyuḥ, pañcamyāpi cōragāḥ |
rakṣānsi rātrau, paiśācāścaturdaśyāṁ viśanti hi ||28 ||

The Deva Grahas afflict individuals during the full moon day, the asura grahas or demons afflict during the dawn as well as the dusk. Gandharvas overpower the humans mostly on the eighth day of the each half of the month and the Yakshas on the first of every fortnight.

The invisibility of afflicting grahas –

दर्पणादीन् यथा छाया शीतोष्णं प्राणिनो यथा |
स्वमणिं भास्करार्चिश्च यथा देहं च देहधृक् || २९ ||
विशन्ति च न दृश्यन्ते ग्रहास्तद्वच्छरीरिणः |

darpaṇādīn yathā chāyā śītōṣṇaṁ prāṇinō yathā |
svamaṇiṁ bhāskarārciśca yathā dēhaṁ ca dēhadhr̥k || 29 ||
viśanti ca na dr̥śyantē grahāstadvaccharīriṇaḥ |

Just an image in the mirror, experience of heat and cold by the body, sunlight In the gem or heat in fire are present without being noticed materially so also the grahas are not perceived or felt physically even though they move into the body of the patient. 29

प्रविश्याशु शरीरं हि पीडां कुर्वन्ति दुःसहाम् || ३० ||

praviśyāśu śarīraṁ hi pīḍāṁ kurvanti duḥsahām || 30 ||

Having entered the body the grahas create intolerable pain or a pain that could be tolerated only with great will power. 30

The affliction – relation of human beings and super natural powers –

(तपांसि तीव्राणि तथैव दानं व्रतानि धर्मो नियमश्च सत्यम् |
गुणास्तथा अष्टावपि तेषु नित्या व्यस्ताः समस्ताश्च यथाप्रभावम् || ३१ ||

tapānsi tīvrāṇi tathaiva dānaṁ vratāni dharmō niyamaśca satyam |
guṇāstathā aṣṭāvapi tēṣu nityā vyastāḥ samastāśca yathāprabhāvam || 31 ||

Observance of austerities, charity, vows, right conduct, rigid discipline, truth, adherence to the eight extra- ordinary varieties, are the qualities found in the grahas. These qualities are there in a greater degree and larger quantity among the devagrahas and in the lesser amount among the others. The same qualities and characteristics manifest in part or whole in the person afflicted as per the graha concerned. 31

न तै मनुष्यैः सह संविशन्ति न वा मनुष्यान् क्वचिदाविशन्ति |
ये त्वाविशन्तीति वदन्ति मोहात्ते भूतविध्याविषयादपोह्याः || ३२ ||
तेषां ग्रहाणां परिचारका ये कोटि – सहस्रायुत – पद्मसंख्याः |
अस्रुग्वसा – मांसभुजः सुभिमा निशाविहाराश्च तथा आविशन्ति || ३३ ||)

na tai manuṣyaiḥ saha sanviśanti na vā manuṣyān kvacidāviśanti |
yē tvāviśantīti vadanti mōhāttē bhūtavidhyāviṣayādapōhyāḥ || 32 ||
tēṣāṁ grahāṇāṁ paricārakā yē kōṭi – sahasrāyuta – padmasaṅkhyāḥ |
asrugvasā – mānsabhujaḥ subhimā niśāvihārāśca tathā āviśanti || 33 ||)

However, the grahas by themselves do not enter into the bodies of human beings. Those who say so have no knowledge of demonology. But there are thousands and millions of servants or retinue of the grahas, who are fond of blood and flesh. It is only they who are terrific and who roam about at nights and try to enter the human body and possess the human beings in erratic ways. 32-33

इति श्रीमाधवकरविरचिते माधवनिदान उन्मादनिदानं समाप्तम् || 20 ||

iti śrīmādhavakaraviracitē mādhavanidāna unmādanidānaṁ samāptam || 20 ||

Thus concludes the chapter on Unmada Nidana.