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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 4  |  Page : 54-57

COVID-19: Lessons and emerging theories in Ayurveda


Department of Samhita.Siddhanta, Shri Dhanwantry Ayurveda College and Hospital, Chandigarh, India

Date of Submission09-Aug-2020
Date of Decision04-Oct-2020
Date of Acceptance05-Oct-2020
Date of Web Publication28-Dec-2020

Correspondence Address:
J Nandeesh
Department of Samhita-Siddhanta, Shri Dhanwantry Ayurveda College and Hospital, Chandigarh - 160 047
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_191_20

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  Abstract 


Background: The current pandemic situation of COVID-19 has given an opportunity to explore the traditional medicines around the globe. Ayurveda, being the front runner among the traditional knowledge, has a key role to overcome the situation. It has a distinct advantage of approaching the disease from various perspectives such as principle-based approach and diagnosis-based approach. A pandemic situation like COVID-19 can be considered under various concepts such as janapadodhvamsa and aupasargika roga as per Ayurveda. During the initial wave of COVID-19 infection, the uncertainty of the pathological considerations and legal restrictions limited Ayurveda to the preventive strategy by modulating the immune system of the body. Gradually, there is a shift from preventive to curative approach in Ayurveda, owing to unsatisfactory results from the contemporary medicine. The management protocol has expanded by not only concentrating on the yuktivyapashraya cikitsa (internal medicines). Several methods of daivavyapashraya and sattvavajaya cikitsa (measures to improve the psychological and social well-being) are adopted which include social norms as well as dietary regimen. Trisutra theory of Ayurveda, i.e., hetu (cause), linga (clinical features), and aushadha (management) is well utilized to frame therapeutic guidelines. Materials and Methods: Classical Samhita is referred focusing mainly on Caraka Samhita and Sushruta Samhita. Information related to diseases affecting a larger population at the same time is compiled. The references obtained are presented in terms of roga pareeksha vidhi. Results: Attempt is made to analyze the present pandemic in classical terms. Discussion and Conclusion: Classical references can be very well used to understand the pathological aspects of pandemic like COVID-19. Role of larger community role is inevitable in the occurrence of pandemic and following Ayurveda lifestyle definitely prevents them.

Keywords: Ayush, holistic, pandemic, traditional medicine, trisutra


How to cite this article:
Nandeesh J. COVID-19: Lessons and emerging theories in Ayurveda. J Ayurveda 2020;14:54-7

How to cite this URL:
Nandeesh J. COVID-19: Lessons and emerging theories in Ayurveda. J Ayurveda [serial online] 2020 [cited 2021 Jan 23];14:54-7. Available from: http://www.journayu.in/text.asp?2020/14/4/54/304901




  Introduction Top


A patient visits a nearby clinic with the symptoms of fever associated with cough. He is examined and after considering due factors, prescribed with medicines for 3–5 days. Majority of such cases get resolved within the stipulated time. This is even true for other traditional practitioners with the difference being the ingredients and form of medicine prescribed. Millions of practitioners across the globe would not worry about such patients; unless, there was presence of any life-threatening complications. However, the scenario is not the same for a few months. The routine cases of fever and cough are perceived as potential life-threatening conditions. Uncertainty over the source and mode of transmission has only added to the trouble. This is how COVID-19 has changed the medical profession and routine life in the present times.

The world looks at all traditional medicines at that point when Western medicine fails to understand the condition and provide cure. All systems of medicine including Ayurveda and Unani came up with their ideology of understanding COVID-19 as a disease and planned the management. Ayurveda boasts of pioneers of medicine and surgery in the names of Caraka and Sushruta. An opportunity for each of the Ayurveda physician to analyze the disease from his/her perspective makes Ayurveda truly vibrant and also helps to think of management principles on various lines.

In the current scenario, we can observe an increased tendency to utilize the combined regimen to counter the disease. Viral diseases are said to be self-limiting and resolve without exhibiting major symptoms. Although it is difficult to frame the Ayurveda guidelines to combat COVID-19 through the modern research methodology, Ayurveda has emerged as the front runner in combating the pandemic by giving optimistic results. Most of the studies are said to be effective by shortening the phase of symptoms and also by preventing life-threatening complications. Thus, the day is not far to witness the global acceptance of Ayurveda in other ailments as well.


  COVID-19: Where Does It Fit? Top


General public is aware of the fact that Ayurveda believes in the treatment based on the individual.[1] However, very few are aware of a pandemic-like situation mentioned in Ayurveda. In the gurukula system of learning in olden days, Sage Agnivesha asks his teacher Punarvasu Atreya that how different individuals having different physical constitution (prakriti), food habits (ahara), age (vaya), and wholesomeness (satmya) may suffer from the same disease.[2] This may be the context where the concept of epidemics and pandemics begin in Ayurveda. Maharshi Atreya considers that such conditions are due to vitiated vayu (air), desha (place), jala (water), and kala (season).[3] The diseases arising as a result are known as “Janapadodhwamsa vyadhi.” An entire chapter named as “Janapadodhwamsiya Vimanam” has been dedicated to explain the causative factors and treatment of such conditions.[4] Atreya who begins with term janapadodhwamsa – “destruction of a community or human settlements” ends the chapter with deshodhwamsa – destruction of countries. COVID-19 that has become pandemic today is clearly a Janapadodhwamsajanya vyadhi as mentioned in Ayurveda texts.


  Etiopathogenesis of COVID-19 as a Pandemic Top


Unlike nija vyadhi where the etiopathogenesis is restricted to an individual,[5] janapada udhvamsajanya vyadhi has much broader scope for assessing etiology, as shown in [Figure 1]. The alteration in the normalcy of either vayu, jala, desha, or kala is attributed to a pandemic-like situation. Sometimes, even without the alteration of kala, a pandemic can occur due to wrong deeds performed by individuals such as kriti (deceitful), abhishapa (curse), raksha, krodha (anger), and adharma (unrighteousness).[6]
Figure 1: Samprapti of COVID-19

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Sometimes, the pollens of poisonous flowers or grasses, etc., lifted by the winds, invade a town or a village. The above two causes can develop a sort of epidemic with symptoms such as kasa (cough), shwasa (dyspnea), vamathu (vomiting), Pratishyaya (cough or cold), Shiroruk (headache), or Jwara (raised body temperature).[6] The commentator Dalhana adds Gandha-ajnana (decreased or loss of smell) and masurika (twak vikara) to the above symptoms. He further divides it as:

  1. Those which spread by air through nasal route cause kasa, shwasa, pratishyaya, gandha-ajnana, bhrama, and shiroruja. This may be termed as droplet type infection in present days.
  2. Those spread by twagindriya (skin) cause jwara and masurika. This may be termed as fomite transmission in present days.[7]


The spread of COVID-19 virus is found to be by droplet mode and fomite transmission. The role of air in spread of droplets can also be appreciated here.


  Analysis of COVID-19 as an Aupasargika Roga Top


The diseases that spread from person to person are called as aupasargika roga. Aupasargika roga is broadly categorized under daivabalapravritta vyadhi. It includes diseases that are the results of displeasure, leading to fury of deva gana (the natural forces in environment that protect the nature).[8] It can be divided into two subdivisions as the diseases that assume a contagious character (epidemic), or is purely accidental, and restricts itself to isolated cases (sporadic). Commentator Dalhana highlights the role of Raksho gana in diseases assuming the form of Aupasargikatva (contagious nature).[9] It could destroy individuals or communities immediately or at a predetermined time. Dalhana clearly states that upasargaja rogas are due to spread from an infected person to another, while Samsargaja are more potential in spreading from person to person.[9]

In general, aupasargika rogas spread through sexual intercourse or by touch or breath or through partaking of the same bed, and eating and drinking out of the same vessel with infected person, or through using the wearing apparel, unguents, and garlands of flowers previously used by a person afflicted with an infective disease.[10]

[TAG:2]Role of Community in Janapada Udhvamsajanya Vyadhi[11][/TAG:2]

The derangement in the quality of vayu, desha, jala, and kala is attributed to adharma as the root cause. Further, adharma occurs only due to the prajnaparadha (intellectual errors) of the community members. The probable pathogenesis can be depicted in short as below.


  Aushadha – Management of COVID-19 on the Basis of Classical Literature Top


Adharma karma (sinful act) committed during an individual's present life, and the previous life is responsible for the vitiation of the factors that determine the healthy living. Intellectual errors (prajnaparadha) are the cause for both these types of sins (i.e., sins in the present life as well as in the past). The measures that prevent pandemic at community level are as follows:[12]

  1. Sthana parityaga – Avoiding (rejecting) contact with contaminated or infected (to be adopted at primary level). Dalhana advises migration to a healthy or unaffected locality (to be adopted at secondary level)
  2. Shanti karma – Control or pacification of the senses. Averting of discomfort due to prevailing situation.
  3. Prayascita – Sorrow or regret for having done/committed something wrong/sin
  4. Mangala – Contact with happy or auspicious or blissful things
  5. Homa: The act of making oblation to deva
  6. Japa: Reciting Rik and Yajur and samaveda preceded by omkara
  7. Upahara – Offered to God with worship and devotion
  8. Tapa-upavasa


    • Upavasa – Fasting as per rules of upavasa. It includes practices, especially meditation and self-discipline.


  9. Niyama: Remaining silent (silence of mind)
  10. Daya: Sympathy or compassion to creatures around us
  11. Daana: Charity
  12. Abhyupagama – Acceptance of true words spoken by the authoritative
  13. Respect and follow the authoritative.


Above mentioned are the ways by which a Aupasargika roga is to be approached by healthy as well as the diseased. The methods mentioned here come under Daivavyapashraya Chikitsa. In the sequence of three types of Chikitsa, Acharya Charaka has mentioned daivavyapashraya chikitsa first owing to its faster action.[13]


  Use of Dhoopana Top


The use of dhoopa is for control of vedana (discomfort) and protection from raksho gana.[14] Sage Sushruta mentions powders of Guggulu, Agaru, Sarjarasa, Gaura sarshapa mixed with Lavana and Nimba patra and Ajya (Ghrita) to be used for dhoopana.[15]

Truthfulness, compassion for living beings, charity, sacrifices, worship of god, observance of right conduct, tranquility, prophylactic protection of oneself and seeking one's own good, residing in a wholesome country, service to those observing brahmacharya (celibacy) and following it, discussion of religious scriptures, constant association with the righteous, the well disposed, and those who are approved by the elders – all this with a view to protecting life has been termed “medicine” to those who are not destined to die in that critical time.[16]


  Vishesha Cikitsa – Specific Management Top


Those who did not engage in identical acts in their prior lives and those who are not destined to die during calamities, for their cure,

  • Panchakarma therapy (namely, emesis, purgation, enema-niruha, and anuvasana types and errhines) is considered the best
  • Assessment of khavaigunyata in the body – susceptibility of an individual to suffer from a particular group of diseases[17]
  • Introduction of rasayana dravya prayoga in relation to srotas having khavaigunya.


    • E.g., Pranavaha srotas – Chyavanaprasha, Agastya Hareetaki
    • Annavaha srotas – Chitrakahareetaki, Ghritakalpana
    • Rasavaha srotas – Ajamamsa rasayana.



  Discussion and Conclusion Top


The analysis done so far suggests the presence of concepts in classical literature with striking similarity in terms of etiopathogenesis of present pandemic. Daiva vyapashraya cikitsa takes the priority when the management is concerned followed by yuktivyapashraya cikitsa (internal medicine) because of Prjnaparadha being Samavayi karana (inseparable cause) for Janapadodhwamsa vyadhi. There is close resemblance in the lakshanas of Janapadodhwamsa vikara mentioned by Sushruta. Thus, adopting these principles in association with current management protocol definitely helps in overcoming the pandemic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
  References Top

1.
Caraka-Samhita, Sutrasthana, Deerganjivitiyamadhyaya, 1/123. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 01].  Back to cited text no. 1
    
2.
Caraka-Samhita, Vimanasthana, Janapadodhvamsaniyavimana, 3/5. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 01].  Back to cited text no. 2
    
3.
Caraka-Samhita, Vimanasthana, Janapadodhvamsaniyavimana, 3/6. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 01].  Back to cited text no. 3
    
4.
Caraka-Samhita, Vimanasthana, Janapadodhvamsaniyavimana, 3/1-2. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 01].  Back to cited text no. 4
    
5.
Caraka-Samhita, Sutrasthana, Tisraishaniyamadhyaya, 11/45. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 01].  Back to cited text no. 5
    
6.
Sushruta-Samhita, Sutrasthana, Ritucaryadhyaya, 6/19. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 6
    
7.
Dalhana on Sushruta-Samhita, Sutrasthana, Ritucaryadhyaya, 6/19. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 7
    
8.
Sushruta-Samhita, Sutrasthana, Vyadhisamuddeshiyamadhyaya, 24/7. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 8
    
9.
Dalhana on Sushruta-Samhita, Sutrasthana, Vyadhisamuddeshiyamadhyaya, 24/7. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 9
    
10.
Sushruta-Samhita, Nidanasthana, Kushthanidana, 5/33-34. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 10
    
11.
Caraka-Samhita, Vimanasthana, Janapadodhvamsaniyavimana, 3/20. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 01].  Back to cited text no. 11
    
12.
Sushruta-Samhita, Sutrasthana, Ritucaryadhyaya, 6/20. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 12
    
13.
Caraka-Samhita, Sutrasthana, Deerganjivitiyamadhyaya, 1/58. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 01].  Back to cited text no. 13
    
14.
Sushruta-Samhita, Sutrasthana, Agropaharaniyamadhyaya, 5/17. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 14
    
15.
Sushruta-Samhita, Sutrasthana, Agropaharaniyamadhyaya, 5/18. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 15
    
16.
Caraka-Samhita, Vimanasthana, Janapadodhvamsaniyavimana, 3/15-18. Available from: http://niimh.nic.in/ebooks/ecaraka/. [Last accessed on 2020 Aug 01].  Back to cited text no. 16
    
17.
Sushruta-Samhita, Sutrasthana, Vyadhisamuddeshiyamadhyaya, 24/10. Available from: http://niimh.nic.in/ebooks/esushruta/. [Last accessed on 2020 Aug 01].  Back to cited text no. 17
    


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Abstract
Introduction
COVID-19: Where ...
Etiopathogenesis...
Analysis of COVI...
Role of Communit...
Aushadha ...
Use of Dhoopa...
Vishesha Ciki...
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