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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 4  |  Page : 28-31

Pandemic COVID-19 Diseases and Rajyakshma in Charak Samhita: A conceptual study


Department of Samhita and Siddhant, A and U Tibbia College and Hospital, Delhi, India

Date of Submission13-Aug-2020
Date of Decision27-Sep-2020
Date of Acceptance28-Sep-2020
Date of Web Publication28-Dec-2020

Correspondence Address:
Nishi Arora
A and U Tibbia College and Hospital, Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_146_20

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  Abstract 


Introduction: This paper correlates the vastly detailed concepts of Janpadod dhwans and Rajyakshma from Charak Samhita to the novel coronavirus. The aim of this paper is to draw the attention of the experts toward the similarities between coronavirus and Rajyakshma, in hopes of finding some more effective measures of prevention as well as cure for the ongoing pandemic. Materials and Methods: In this paper, a little description was given about Adharm and immunity. The concept of pandemic/epidemic is explained with the term “Janpadod dhwans.” A detailed comprehensive exploration of corona versus Rajyakshma was done by thoroughly analyzing certain concepts in the ancient script Charak Samhita and by conducting meticulous research online. Results: It was deduced that every disease changes its mode of onset and course of progression with changing climatic conditions and timeline peculiarities. The diseases are not identical, but the author hopes that the similarities drawn can be of use to better understand the whole spectra of diseases that have come and those that have yet to come. Conclusion: A clear conclusion can be drawn that there are many similarities between COVID-19 and Rajyakshma in clinical presentation, as well as the preventive measures known so far. The role of good immunity is the key factor in both the cases.

Keywords: Adharm, COVID-19, Janpadod dhwans, pandemic, Rajyakshma


How to cite this article:
Arora N. Pandemic COVID-19 Diseases and Rajyakshma in Charak Samhita: A conceptual study. J Ayurveda 2020;14:28-31

How to cite this URL:
Arora N. Pandemic COVID-19 Diseases and Rajyakshma in Charak Samhita: A conceptual study. J Ayurveda [serial online] 2020 [cited 2021 Jan 17];14:28-31. Available from: http://www.journayu.in/text.asp?2020/14/4/28/304892




  Introduction Top


This article is about a novel coronavirus identified in Wuhan, China. It was first detected in December 2019. The virus has spread in all over the world. It was characterized as pandemic[1] (occurring over a wide geographic area and affects an exceptionally high proportion of the population) by the WHO (March 11, 2020).[2] It presents itself in many ways. In some patients, it is of a “mild” strain, it causes low-grade fever with mild cough or even without any symptoms. In moderately affected patients, there is prolonged fever and sporadic inflammation of lungs. When it attacks severely, it may involve almost every major organ, specially lungs. It causes viral pneumonia in these patients. The fever may be of high grade. Lowered oxygen levels and reduction in taste and smelling are also present. One thing that is common in all cases is severe weakness even after the patient becomes negative in COVID-19 testing.

The scientists and medical fraternities are still not very much sure about its real course. In this scenario, the author of this article decided to look back on the ancient Indian text Charak Samhita. The concept of pandemic/epidemic is explained with the term “Janpadoddhwans.” This concept says many things about today's condition of the world. The main and foremost cause was said to be “Adharm.” Most importantly, emphasis was given upon “immunity.” As far as the signs and symptoms of COVID-19 syndrome are concerned, astonishing similarity could be seen with “Rajyakshma” described in the text. In this paper, a little description will be there about Adharm and immunity. A comprehensive exploration of COVID-19 versus Rajyakshma will be done. We might be able to understand the disease better and also to find out some preventive and curative measures applying a holistic/integrated approach to serve humankind.


  Materials and Methods Top


For this paper, a few studies were read on the internet to gain an insight about the COVID-19 disease and it's probable impacts on the human body. For understanding about Janpadoddhwans and principle of Adharm, as well as immunity, Charak Samhita was explored. A disease named Rajyakshma was also studied to compare its features with the pandemic of the year.

Overview of coronavirus and it's features

Coronavirus is a family of viruses that cause illness such as respiratory diseases or gastrointestinal diseases. Once scientists determine exactly what coronavirus is, they give it a name, as in the case of COVID-19, the virus causing it is SARS-CoV-2. Here, SARS stands for severe acute respiratory syndrome.[3]

Typically, coronavirus presents with respiratory symptoms among those who will become infected; some will show no symptoms. The clinical picture shows mild-to-moderate and severe cases. Symptoms may include respiratory symptoms, cough, shortness of breath, breathing difficulties, fatigue, and sore throat. Some patients suffer diarrhea, chills, and sharp headaches also.

The virus that causes COVID-19 infects people of all ages. However, evidence to date suggests that two groups of people have a higher risk of getting severe COVID-19 disease,[4] people above the age of 70 years, and people with chronic illness.

Transmission of COVID-19

Current information indicates that human-to-human transmission is occurring. It may spread through respiratory droplets and direct or indirect contact with infected secretions. The topic is very vast, so it would not be talked about more than this, yet a most important fact from the Indian Council of Medical Research (ICMR) is very important to incorporate. It is about cycle threshold (CT) value test along with COVID-19 itself. ICMR's new rules suggest CT value number of cycles required to detect the viral antigen.[5]

More the viral load, the higher the risk. CT values between 17 and 24 are high load, and CT value from 24 to 31 is moderate viral load. Both have to be admitted in hospital immediately. Value above 31 is low viral load and can be treated under home quarantine under constant supervision.[6]

Next, we shall look at the concept of “Janpadodhwans” in Charak Samhita. While answering a question of Agnivesh (Disciple of Punarvasu Atreya), asking how people with different body constitutions, eating habits, lifestyles, etc., could get affected with the same diseases. Atreya said that it is due to the contamination of vital resources given to us by nature, namely, Vaayu, Udak, Desh, and Kaal.[7]

The mentor emphasized that, in the increasing order, Vaayu, Udak, Desh, and Kaal are more and more powerful components of Janpadoddhwans (destruction of a large population at one time).[8] The reason behind the disaster was said to be “Adharm,”[9] where Adharm was, by necessity, vaguely defined as the act of not fulfilling the duties that someone or something is bound to, lest they fall, which happens mostly at the state and society level according to Atreya in the literature in the case of Janpadoddhwans. The simple reason behind it being called Adharm is that an appropriately functioning state and society, which by definition, fulfills its duties, can see danger coming, and prepare for it, which is something that many countries have managed this year with COVID-19, like Singapore. Speaking further about who and what can escape the monster of disaster, Acharya said that only those who keep their being free of toxins before the onset of the disease, who follow a disciplined lifestyle and take the equivalent of immunomodulators (Rasayan) as part of their routine, can ride out the flood, and be safe from the monster. It reveals that, at that time, immunity levels were the major factor behind catching or not catching any given disease.[10]

Now, it is time to overview Rajyakshma. It was described in chapter eight of Chikitsa Sansthan Charak Samhita. Four causes were told, namely, Ayathabalarambh (working out of capacity limit), Vegadhaaran (forcefully stopping natural urges in the body such as feces or urine, etc.), Kshay (emaciation due to any disease, etc.), and Vishamashnaj (bad eating habits).[11] The disease was represented clinically with 11 symptoms. It may be called as a syndrome, rather than a single disease. It was clarified further that the patient may have any three, six, or all eleven symptoms to be diagnosed as Rajyakshma.[12] The eleven symptoms were kaas (cough), Anstaap (feeling of heat in shoulder region), Vaisvarya (change in voice texture), Jwar (fever), Parshvshool, (pain in lung area), Shiroruja (headache), Chhardan (vomiting), Shwas (difficulty in breathing), Varchgada (diarrhea), and Aruchi (disinterest in eating). However, Anstaap, Jwar, and heat in feet and hands were said to be the cardinal signs.[13]

Predominant signs were given, and among them, the most attention seeking were Pratishyaya (cold), unexplained weakness, increased irritability, and repulsion from food.[14]


  Discussion Top


It is the section to discuss about the facts gathered above from the modern description of COVID-19 disease and Rajyakshma from Charak Samhita. With a comparative study between the two, a few things are being highlighted here. First is, COVID-19 disease effects more severally in patients with low immunity. Patients at high risk are either old or have comorbidity. In Rajyakshma also, it happens in people weakened with age, or some disease or some other reasons. Kshay was said to be the most severe form of Rajyakshma too.[15]

Second, the Adharm which was told to be the major cause behind epidemics is exactly how the actions and inactions of China can be described, not to mention how the rest of the human world dealt with it, with people voluntarily offering themselves and those around them into the hands of death and disease, not wearing masks properly, and an uncountable number of other problems. All those are the most important kinds of problems because everyone can fix them.

Third is, when it comes to symptomatology, three major kinds of clinical presentations are found as per new guidelines by the ICMR on the basis of CT value, as described before in this paper. Rajyakshma was also measured on its Traiylakshan (three symptoms – mild), Shadlakshan (six symptoms – moderate), and Ekadash lakshan (11 symptoms – severe).

However, it was given as an added information that Anstaap, jwar, and heat in feet and hands were cardinal symptoms of all kinds of Rajyakshma.

In case of COVID-19, though these are not clearly defined, prolonged fever and overall heated body are told as the symptoms. Further, Aruchi (repulsion from food), Asyavairasya (problem with taste), and Swarbhed (sore throat) are other important similarities were also noticed.

Last but not least, in Rajyakshma, the text described some predominant symptoms too, whereas in COVID-19, no such warning signs are yet to be found.


  Result & Conclusion Top


A clear conclusion can be drawn that there are many similarities between COVID-19 and Rajyakshma in clinical presentation, as well as preventive measures. However, it must also be taken into account that every disease changes its mode of onset and course of progression with changing climatic conditions and timeline peculiarities. The diseases are not identical, but the author hopes that the similarities drawn can be of use to better understand the whole spectra of diseases that have come and those that have yet to come.

Suggestions

Clinical studies are required to explore the use of principles of treatment and medicinal compounds given in Rajyakshma in novel corona or COVID-19 disease. A holistic approach in enhancing the immunity may also become the part of the research.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
  References Top

1.
ICMR; 2020. Available from: https://www.icmr.gov.in. [Last accessed on 2020 Nov 02].  Back to cited text no. 1
    
2.
COVID-19: Epidemiology, Virology and Clinical Features. Available from: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-background-information/wuhan-novel-coronavirus-epidemiology-virology-and-clinical-features. [Last accessed on 2020a Sep 20].  Back to cited text no. 2
    
3.
WHO Director-General's Opening Remarks at the Media Briefing on COVID-19; 11 March, 2020. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19. [Last accessed on 2020b Sep 20].  Back to cited text no. 3
    
4.
Available from: https://www.merriam-webster.com/dictionary/pandemic. [Last accessed on 2020c Sep 20].  Back to cited text no. 4
    
5.
6.
CharakSamhita, Vimaan Sthaan, Janpadoddhwansniyan, 3/5-6. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 6
    
7.
CharakSamhita, Vimaan Sthaan, Janpadoddhwansniyan, 3/10. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 7
    
8.
CharakSamhita, Vimaan Sthaan, Janpadoddhwansniyan, 3/20. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 8
    
9.
CharakSamhita, Vimaan Sthaan, Janpadoddhwansniyan, 3/13-14. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 9
    
10.
CharakSamhita, Chikitsa Sthaan, Rajyakshmachikitisaadhyay, 8/13. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 10
    
11.
CharakSamhita, Chikitsa Sthaan, Rajyakshmachikitisaadhyay, 8/47. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 11
    
12.
CharakSamhita, Chikitsa Sthaan, Rajyakshmachikitisaadhyay, 8/52. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 12
    
13.
CharakSamhita, Chikitsa Sthaan, Rajyakshmachikitisaadhyay, 8/33-37. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 13
    
14.
CharakSamhita, Chikitsa Sthaan, Rajyakshmachikitisaadhyay, 8/24-26. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 12].  Back to cited text no. 14
    
15.
CharakSamhita, Chikitsa Sthaan, Ra-jyakshmachikitisaadhyay, 8/27. Available from: http://niimh.nic.in/ebooks/ecaraka/ [Last accessed on 2020 Aug 12].  Back to cited text no. 15
    




 

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