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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 4  |  Page : 58-63

Pandemic COVID-19 in relation to Ayurveda: A brief review through Sushruta Samhita


Department of Shalyatantra, IPGT and RA, Gujarat Ayurved University, Jamnagar, Gujarat, India

Date of Submission19-Aug-2020
Date of Decision07-Oct-2020
Date of Acceptance15-Oct-2020
Date of Web Publication28-Dec-2020

Correspondence Address:
Foram Joshi
Department of Shalyatantra, IPGT and RA, Gujarat Ayurved University, Jamnagar - 361 008, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_199_20

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  Abstract 


Background: Being the foremost science of life, Ayurveda has upper hand in managing chronic as well as acute clinical conditions varying upon its perseverance in growing clinical strength of contemporary age. Materials and Methods: Classical references of contagious and communicable diseases have been mentioned by Sushruta were studied with clinical examples and their modes of transmission for understanding the cascade of COVID-19 conditions now and then. Results and Discussion: Current scenario of COVID-19 is a burning issue of human life which resembles with the classical narration of “Aupasargika Jwara” and pandemic threat with “Janapadodhwansa” term of Sushruta. Along with that, Sushruta has given methods of eradicating such clinical conditions by different measures such as rules of Sthana Parityaga (leave the contaminated place and self-quarantine), Anjali Pranaam (social greeting by maintaining distance), and Daana-Japa-Upahara, ethical practices of charity, chanting, and offerings by means of helping the needy people in crises in any way to survive in critical conditions. Conclusion: This article refers to enlighten the area of focus to revalidate the facts, concentrate, and implement for the betterment of humanity in terms of ethical practice of health science and human rituals to manage the life and life cycles.

Keywords: COVID-19, ethical practice of health, Sushruta


How to cite this article:
Joshi F, Dudhamal T. Pandemic COVID-19 in relation to Ayurveda: A brief review through Sushruta Samhita. J Ayurveda 2020;14:58-63

How to cite this URL:
Joshi F, Dudhamal T. Pandemic COVID-19 in relation to Ayurveda: A brief review through Sushruta Samhita. J Ayurveda [serial online] 2020 [cited 2021 Jan 22];14:58-63. Available from: http://www.journayu.in/text.asp?2020/14/4/58/304902




  Introduction Top


Infectious or communicable disease can be defined as an illness caused by another living agent, or its products, that can be spread from one person to another.[1] Communicable diseases are the big threat to life and life cycles since its beginning in microbiology. An epidemic, or outbreak, can occur when several aspects of the agent (pathogen), population (hosts), and the environment create an ideal situation for spread by rapid growth and lack of timely treatment.

COVID-19 is an acute viral infectious condition of the upper respiratory tract characterizing with fever, dry cough, and tiredness. Other symptoms that are less common and may affect some patients include aches and pains, nasal congestion, headache, conjunctivitis, sore throat, diarrhea, loss of taste or smell, or a rash on skin or discoloration of fingers or toes.[2]

The outbreak of COVID-19 began in Wuhan, China, in December 2019, and is now a pandemic affecting many countries globally. These symptoms are usually mild on initiation and may worse with the time and compromised immune level.

Sushruta Samhita is a treatise of Ayurveda comprising eight branches of clinical practice, in which he has narrated about the mode of transmission, management principles, and essential use of medicaments. Recent research on COVID-19 and Ayurveda recommends for Ayurveda management to be applied for defeating COVID-19.[3] Hence, it is essential to know the facts mentioned in Ayurveda about the communicable diseases and its prevention as prophylactic as well as therapeutic.


  Materials and Methods Top


References related to communicable diseases in Sushruta Samhita with Nibandhasangraha commentary by Dalhana were mainly searched. Aupasargika Vyadhi, Maraka, and Janapadodhwansa concepts, their clinical condition, and treatment aspect were referred.[4] Published articles on the National Centre for Biotechnology Information with COVID-19, communicable diseases, and social distancing techniques were accessed to justify the topic.[1],[3],[4]

Methods

Primary data collection was done by hand search method and exploration of concern-related published data was done through internet sources to justify the subject.


  Results Top


Transcripted information regarding causative factors, method of spread, the clinical condition of pandemic and epidemiology, prognosis, ways of combating communicable conditions, prevention, and cure was found in Sushruta Samhita. Acharya Dalhana has justified the references with possible scientific manner in his commentary on this treatise.

Definition of Swastha (healthy being) by Sushruta

Live beings having adequate balancing and equilibrium in the levels of all three Dosha Dhatu and Mala, along with optimum Agni (metabolic status), and consciousness of mind are termed as healthy by Sushruta.[5]

Description on clinical picture

Clinical conditions such as COVID-19 are considered to be transmitted by physical contact, droplet infection and contaminated food, utensils, and by touching cloths of infected person. In Kushtha Nidana (Diagnosis of Ayurvedic dermatological clinical conditions) of Sushruta Samhita, Sushruta has mentioned the way of transmission of communicable diseases. Social gathering, physical contact or touch, use of contaminated cloths, ornaments, and cosmetics, to unfollow the social distancing by sitting, sleeping, and taking meal together with the infected person, etc., can spread “Kushtha” (dermatological conditions), “Jwara” (clinical condition similar to various type of fever that spread due to bacterial and/or viral infections), “Shosha” (several types of infectious diseases causing emaciation), and “Netra Abhishyanda” (several types of infectious conjunctivitis and other ophthalmological disorders) [Table 1].[6]
Table 1: Mode of transmission narrated by Sushruta

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Pathophysiological aspect

The clinical condition of communicable disorders is supposed to be in inverse proportional to bodily immunity. Patients of communicable diseases are supposed to improve their bodily immunity along with the correction of systemic pathology to get rid of the disease.

Immunity concept has been termed as Vyadhikshamatva in Ayurveda. Vyadhikshamatva is again dependent on the optimum quality of Bala. Optimum quality of Oja[7] has been considered as Bala in Sushruta Samhita in terms of bodily strength and immunity. Again Oja is considered as Pranayatanam Uttama – the best resident for vitality.[8]

While describing epidemiology, Sushruta has described the role of contaminated air, water, land, and time in the development of contaminated food and medicines which further leads to development of “Janapadodhwansa” – an epidemiological cascade of diseases. It develops clinical features such as Kasa (coughing), Shwasa (breathlessness), Vamathu (vomiting), Pratishyaya (common cold), Shiroruka (headache), and Jwara (several fever) irrespective to Sharira Prakriti (natural body constitution) and Dosha (body physiology).[9]

Pathophysiological factors of COVID-19 can be understood in Ayurveda by “Samprapti Ghataka” [Table 2].
Table 2: Probable Samprapti Ghataka (pathophysiological factors) of COVID-19

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Management principles in communicable clinical conditions by Sushruta

Acharya Sushruta prescribes the treatment of infected patients as well as quarantines and asymptomatic positive cases of communicable diseases by suggesting them Sthaana Parityaga, Shanti Karma, Prayashchita, Mangala-Japa-Homa-Upahara, Tapa, etc., [Table 3][10]
Table 3: Management principles by Sushruta

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Along with this, Sushruta strictly recommended fumigation with several medicinal herbs for atmospheric purification, for twice a day in interval of ten nights[11],[12] [Table 4] and [Table 5].
Table 4: Methods of disinfection and sterilization by Sushruta

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Table 5: Essential medicaments for Dhoopana Karma

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In Sutrasthana chapter Agropaharaniya (preoperative measures in surgical practice), Sushruta has mentioned the rule of hospitalization, rule of quarantine, and Dhoopana karma – an Ayurvedic way to fumigate and disinfect the procedure room (OT) and Vranitagara (inpatient department/wards of hospital).[13]


  Discussion Top


Nidana parivarjana

Ayurveda recommends for Nidana Parivarjana as a first line of treatment in clinical conditions such as Jwara. Nidana Parivarjana is described with a view to avoid consuming causative factors to get diseased in terms of food and regimen both.

COVID-19 is a highly communicable and life-threatening disease. The prime minister of India announced complete lockdown in the entire country to reduce its spread in the population. This lead to a reduction in the physical contact and communication in people and reduced the fatality rate in India (2.82% due to COVID-19, as reported by central govt.), which is one of the lowest fatality rates in the world.[14]

Rationales of antimicrobial role of several medications used by Sushruta for fumigation purpose (Dhoopana)

Nimba (Azadirecta indica A. Juss) possess antimicrobial activity.[15] Neem leaves possessed good antibacterial activity, confirming the great potential of bioactive compounds and are being used in primary health care.[16] The phytoconstituents such as alkaloids, glycosides, flavonoids, and saponins are antibiotic principles of plants. These antibiotic principles are actually the defensive mechanism of the plants against different pathogens.[17] Sarshapa contains allyl isothyocynate as chemical composition. Mustard oil with Allyl isothyo cynate has antimicrobial and antifungal activity which helps to provide resistance against the pathogen of economic importance.[18]

The volatile oil of Guggulu (Commiphora mukul Stocks and Hook.) was found to be highly effective against Rhyzopertha dominica which suggested its role as a fumigant. The ethanolic extract of C. mukul exhibited best antibacterial activity at 5 mg/mL against multidrug-resistant Klebsiella pneumonia.[19] An active compound, 5 (1-methyl, 1-aminoethyl)-5-methyl-2-octanone, of the methanolic extract of Guggulu gum (resin of Commiphora mukul Stocks and Hook.) possessed significant antibacterial activity against Gram-positive bacteria and moderate activity against Gram-negative bacteria.[20],[21]

Natural salts such as Saindhava (rock salt) and sugar have been used as a preservative in many food items. Antimicrobial activity of salts against methicillin-resistant Staphylococcus auerus has been confirmed.[22] The oleoresin of the Shorea robusta Gaertn is called as Shala Niryasa, Rala, and Sarja Rasa which has the chemical constituents such as nor-triterpene, dammarenolic acid, asiatic acid, dipterocarpol, triterpenic acid, tannic acid, and phenolic content and possesses antibacterial, analgesic, and wound-healing effect.[23]

Nautiyal et al. observed antimicrobial effect of cow ghee and other medicines by Havana (medicinal smoke) and concluded that 1 h treatment of medicinal smoke helps in elimination of microbes by burning wood and a mixture of odoriferous and medicinal herbs (Havana Saamagri = material used in oblation to fire all over India), on aerial bacterial population which reduces over 94% bacterial counts by 60 min. They also reported the ability of the smoke to purify or disinfect the air and to make the environment cleaner, which can be maintained disinfected up to 24 h in the closed room.[24] They reported the bactericidal role of medicinal smoke treatment against pathogenic bacteria Corynebacterium urealyticum, Curtobacterium flaccumfaciens, Enterobacter aerogenes (Klebsiella mobilis), Kocuria rosea, Pseudomonas syringae pv. persicae, Staphylococcus lentus, and Xanthomonas campestris pv.

Rationales of the mode of transmission of viral/allergic/bacterial ailments through various modes

While describing the transmission of communicable diseases, Sushruta admits the social gathering, sharing of meals, utensils, physical contact, ornaments, etc., as a mode of transmission of disease. Current condition of viral pandemic COVID-19 (novel coronavirus disease) demands for these same principles in the spread of the disease across the globe and have received the status of pandemic clinical condition. Sushruta mentions about Janapadodhwansa, which verbally mean as destruction of normal conduction of life of entire city due to contamination of land, water, air, and time factors. The contemporary condition of COVID-19 has not merely achieved the level of severity up to citywide or statewide or countrywide only but also has crossed continents and has become pandemic, which can be considered as Vishwopadhwansa. Due to its nature of transmission by physical communication, viral and bacterial fever conditions spreading at a time in a large population with common cause of low immunity and common infectious source can be considered as ”Aupasargika Jwara.” Acharya Sushruta has mentioned all the dermatological clinical conditions that spread through physical contact, under the title of “Aupasargika Kushtha.” Samely infectious conductivities can be termed as ”Aupasargika Netra Abhishyanda” and systemic causes that create emaciation can be considered as ”Aupasargika Shosha.”

Rationales of recommended preventive and curative modalities to overcome communicable clinical conditions by Sushruta

Sushruta is having a unique way of describing solutions for epidemic and pandemic conditions. He has described the principles of clinical application together by fulfilling and following the aim of Ayurveda, i.e., health care of healthy and management of diseased patients. Sushruta has narrated the principles of preventive and curative aspects together, especially in epidemic conditions.[25]

Sthana Parityaga: (Leave the contaminated place)

Abundance of the contaminated place is the highly recommended as the first line of treatment to manage pandemic and epidemic conditions with a view to avoid the occurrence of infectious diseases and to reduce the transmission of infection to healthy population. The same is recommended by Sushruta by ”Sthana Parityaaga.” It also helps in social distancing, quarantining, and to minimize the physical touch and ultimately in reducing the rate of transmission of communicable infections. Different viral diseases which are having mode of transmission through any kind of physical or social contact are recommended to maintain social distancing.

Shanti Karma: (Avoid unnecessarily harming to others)

Shanti Karma” which verbally means as to spread the peace. It is an essential factor to reduce social threat of the pandemic condition of COVID-19. As per Dalhana, the commentator of Sushruta Samhita, Shanti Karma means to control one's own unethical desires, by avoiding unethical practice of harming others. Another meaning of Shanti Karma is described as chanting Vedic Mantras by Dalhana.[26] Anita et al. reported the significant effects of listening Vedic mantra and Indian classical music in reducing the level of anxiety, induced by invasive procedures in patients.[27]

Dhyana: (Meditation: A step of Ashtanga Yoga)

Meditation is an important tool for recovery of mental health and prevention from undesired threats. Furthermore, it appears to provide an accessible, self-care resource that has potential value for mental health, behavioral self-regulation, and integrative medical care.[28] Dhyana Karma has been recommended by Sushruta in the prevention of mental peace and releasing psychological distress.

Mangala-Japa-Tapa-Homa-Upahara: (Ethical practice of chanting, recitation, performing Havana and holy offerings to god)

Mangala – Auspicious works, Japa – chanting of Mantras, Tapa – strict rituals, Homa – medicinal smoke, Upahara – offerings, and Ijya – worshipping to God, are recommended by Sushruta to improve mental strength, peace, and health.

Prayashchita: (Self-realization of own did)

Prayashchita

Self-realization and regrets of one's own wrong and unethical behaviors which have harmed to others in any sense, have been mentioned as a prime important factor in breaking the chain of spread of destructive pathologies. Isolation and quarantine of infected and suspected cases of viral infectious diseases are having their important and significant role in preventing spread from carrier cases and diagnosed cases of viral diseases.

Anjali Pranaam: (Greeting socially with joined palms)

The WHO had declared hand hygiene as the first pillar to promote the Global Patient Safety Challenge.[29] Indian gesture to greet people using a folded hand is a unique way to communicate socially without touching each other. Greeting by bowing the head and looking at each other's eye, forearm pointing upward with palms spread and joined to each other is a technique of doing Namaste. The advantage of Namaste is-it is a nontouch technique; such greeting maintains the distance between two persons. This is ideal in preventing any infections to each other.[30] Reduction in spreading the infection rates has been believed by greeting people by Namaste instead of other ways such as shake hand and other physical contact.[31]

Niyama-Shocha-Dayaa-Daana-Deeksha: (Following ethical practice of hygiene, lawful behavior with human and animal life, charity, and dedication to rituals)

Niyama of Shocha: following daily rituals of personal hygiene, vegetarian diet with a view to behave lawfully with animal kingdom (Dayaa), financial help to needy people, charity or helping in educational, and other ways that improve their living standards (Daana) and following the lawful recommendations by higher authorities of persons (Deeksha), etc., are the actions which prevent the unlawful and unethical practices of human behaviors. They prevent humans by unhygienic habits, killing, and assembling animal and their parts, which lead to comparative less infection rates in slaughterhouses. Helping the needy people in their tough times may help in satisfying their needs and stability to life which may reduce the level of unethical and unlawful actions by them to fulfill their essential needs.

Abhiupagama-Devata-Bramhina-Guru: (Follow the instructions of Gazetted health officers, learned fellows, and heads of health departments)

Following the rituals declared and recommended by the stakeholders of health science and health governors of the society, learned fellows, and directors of health welfares are the moral and social responsibilities to reduce the occurrence of life-threatening episodes.


  Conclusion Top


Treatise of Sushruta comprises the concept of communicable diseases with virtual presentation in the descriptive manner of causative factors, mode of transmission, management principles, fumigation and disinfection techniques, etc. Contemporary modalities of dealing with various communicable ailments, especially pandemic and epidemic conditions such as COVID-19 require focusing on classical principles of management of Janpadodhwansa and Maraka mentioned in Sushruta Samhita.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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