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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 14  |  Issue : 4  |  Page : 16-21

COVID-19- Understanding the emerging viral disease through the concepts of Ayurveda


1 Department of Panchakarma, National Institute of Ayurveda, Jaipur, Rajasthan, India
2 Department of Swasthavritta and Yoga, Mahatma Jyotiba Fule Ayurveda College, Jaipur, Rajasthan, India

Date of Submission12-Aug-2020
Date of Decision22-Sep-2020
Date of Acceptance26-Sep-2020
Date of Web Publication28-Dec-2020

Correspondence Address:
Minu Yadav
Department of Panchakarma, National Institute of Ayurveda, Jaipur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_124_20

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  Abstract 


Introduction: Disease pattern is constantly changing yet infectious disease remain the major cause of mortality and morbidity in less developed countries. The world around has experienced many outbreaks and epidemic in the last few decades most recently being the COVID 19. The viral infections emerging in India can be classified in three major categories of respiratory viral infections, arboviral infections and bat-borne viral infections. There are seven variants of corona virus that are known to infect human. The SARS and COVID-19 are closely related and pose a threat to the global population. The life-saving drugs and antibiotics used against these infections are rapidly losing effectiveness and the viruses develops resistance against it. The mortality is higher in individual with low immunity, having respiratory tract related illnesses and metabolic disorders. Aim: To understand the currently prevalent pandemic COVID-19 through various Ayurvedic concepts which may further assist in knowing the disease pathology correctly. Data Source and Review Method: For the systematic review article, various Ayurvedic texts- Charaka and Sushruta Samhita with Chakrapani and Dalhana Teeka are studied. Peer-reviewed clinical studies, review articles, evidence-based articles published on-line, various websites are considered. Result: Ayurveda has vast treatment modalities like Rasayana, Panchakarma, Sadvritta etc which not only prevents the occurrence of viral infection but also avoids the spread and mortality. The ideas of Ojas, improving the Bala through Yukti, undergoing Ritu Shodhana can certainly add years to the life along with improving the quality of life. Conclusion: The emerging viral disease can be prevented by proper use of the knowledge and principles of Ayurvedic texts.

Keywords: Ayurveda, COVID-19, ojas, panchakarma, rasayana, viral disease


How to cite this article:
Yadav M, Mangal G, Garg G. COVID-19- Understanding the emerging viral disease through the concepts of Ayurveda. J Ayurveda 2020;14:16-21

How to cite this URL:
Yadav M, Mangal G, Garg G. COVID-19- Understanding the emerging viral disease through the concepts of Ayurveda. J Ayurveda [serial online] 2020 [cited 2021 Sep 19];14:16-21. Available from: http://www.journayu.in/text.asp?2020/14/4/16/304887




  Introduction Top


Ayurveda is believed to be the oldest healing system. It has emphasized on keeping the health of a healthy person and the prevention of diseases.[1] The disease pattern has constantly evolved over the years and infectious diseases have taken a toll in the last few decades. An estimate indicated that about 60% of infectious diseases and 70% of emerging infections of humans are zoonotic in origin. The currently prevalent COVID-19 is believed to have been transmitted from bats; however, it is not yet confirmed. Coronaviruses are a family of virus that range from the common cold to Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). There are seven variants of coronavirus known to infect humans. SARS and COVID-19 are the most closely related versions.[2]

Aim and objectives

To understand the currently prevalent pandemic COVID-19 through various Ayurvedic concepts, which may further assist in knowing the disease pathology correctly.


  Materials and Methods Top


For the article, various Ayurvedic texts, journals, articles, guidelines have been studied to obtain an understanding of the pandemic.

Symptoms of COVID-19

The symptoms of Coronavirus in an infected person ranges from dry cough, high fever, sore throat to difficulty in breathing. The most common symptoms of COVID-19 are fever, dry cough, and tiredness. Other symptoms that are less common and may affect some patients include aches and pains, nasal congestion, headache, conjunctivitis, diarrhea, loss of taste or smell and a rash on skin or discoloration of fingers or toes. These symptoms are usually mild and begin gradually.[3]

While it is affecting people of all age groups but older people, people with preexisting medical conditions, metabolic disorders, and immunocompromised people are at high risk of developing the disease.

Understanding COVID-19 through the concepts of Ayurveda

COVID-19 as a Sankramaka Roga

Sushruta was the first author to give a description about Sankramaka Roga or communicable diseases.[4] He has explained that Kushtha, Jwara, Shosha, Netraabhishyanda, Aupsargika Roga can be transmitted from infected person to others. The various means of transmission are-Prasangaata (constant close intimacy with the patient), Gatra-Sansparsha (frequent touch with the patient), Nishwasa (inhaling the expired air of the patient), Saha-Bhojana (eating together with the patient), Saha-Shayya-Asana (sleeping and sitting together), Vastra-Mala-Anulepana (wearing clothes, garlands, paste used by the patient). These various modes of transmission are also the cause of the spread of pandemic COVID-19.

Janpadodhwansha

Charaka has given a detailed description of the pandemic in the chapter of Janpadodhwansha where he has mentioned that the causes of it are mainly vitiated Vaayu (air), Udaka (water), Desha (land), and Kala (time).[5]

It is made of two words-“Janpada” meaning mass of people, and “Dhwansh” meaning destruction. When a large population gets afflicted with the disease, resulting in their mortality then it is said to be Janpadodhwansha. Sushruta has given the word “Maraka” and Bhela has referred to it as “Janmaara.” Charaka has included a separate chapter of Janpadodhwansha in the 3rd chapter of Vimana Sthana. Even when the people have different Prakriti, Aahara (diet), Bala, Ayu (age), still due to similar Vaayu, Udaka, Desha, and Kala, there is large scale mortality. The Vikriti (vitiation) of Vaayu, Udaka, Desha, and Kala results in the destruction of that region.

The vitiated air is not in accordance with the season, is polluted, containing smoke, fumes, etc., The air around us has been polluted to extreme levels by the smoke, dust, and firecrackers. The reduced oxygen in the air has resulted in the inadequate supply of “Ambar Peeyush/nectar of the sky/fresh oxygen to the tissues which cause various disorders like difficulty in breathing, allergies, respiratory tract illnesses, and more.

The continuous dumping of untreated chemical waste into the rivers, ponds has caused the vitiation of not just the land water but also the groundwater. There is a change in smell, color, and taste of water which has become unfit for consumption. The aquatic animals are gradually evolving to sustain in the unwholesome environment. The diseases coronavirus outbreak is said to have occurred in the wet market of Wuhan in China.

The vitiated land has abnormal changes in color, smell. The land is full of serpents, wild animals, flies, rats, etc., is full of fallen, dried, damaged crops. There are constant flooding, earthquakes, natural calamities occurring around. The herbs and plants grown in such land are either unhealthy or of less potency.

The abnormal seasons like extreme summer in summer season, appearance of rain in spring season, cold season etc.

Among all the four major factors of Janpadodhwansha, the Kala is said to be the most superior. The above description suggests the gravity of Kala in the development of any pandemic.

Role of Prana-Vaha Srotas

The various symptoms of vitiation of Prana-Vaha Srotas are mentioned and can be correlated to currently prevalent COVID-19.

Charaka has mentioned the cause and symptoms of vitiated Prana-Vaha Srotas as prolonged and obstructed respiration, frequent respiration, and associated with pain and sound.[6],[7]

Various disorders occurring due vitiation of Prana-Vaha Srotas are-Kasa, Shwasa, Hikka, Hridroga etc.

Sushruta has mentioned that the injury to Prana-Vaha Srotas results in Krodha, Vinamana, Moha, Vepana, and death.[8]

The Chikitsa of Prana-Vaha Srotas is like Shwasa Roga Chikitsa.[9]

An important Shloka mentioned by Charaka regarding the patient fit for treatment, among the types of Shwasa Roga-Maha-Shwasa, Urdhwa-Shwasa, and Chhinna-Shwasa should not be treated as it takes away the life of the patient very soon.[10]

The patient infected with the corona virus develops difficulty in breathing at the end stages, which sometimes results in mortality. This severe difficulty in breathing can be correlated with Chhinna-Shwasa condition.[11]

Role of Rasa-Vaha Srotas

There is vitiation of Rasa-Vaha Srotas, which leads to anorexia, tastelessness, nausea, heaviness of the body, body ache, fever, etc.[12] People who take excessive stress and tension along with excessive heavy and cold food develop the vitiation. Fever is an important symptom of COVID-19, the role of Rasa-Vaha Srotas cannot be neglected. Improper and unhealthy diet, fast paced world, and technology have contributed to the increased stress level in the population. This further has made us susceptible to emerging viral diseases.

Vata-Shleshmika Jwara

The symptoms of Vata-Shleshmika Jwara mentioned by Charaka include Shiro-Ruka, Pratishyaya, Kasa, Santaapa, Tandra, Parva-Ruka, etc.[13]

Another kind of Jwara can be correlated to corona-Vatolbana Kapha-Madhya Pitta-Heena Sannipataja Jwara. Its symptoms include headache, difficulty in breathing, anorexia, and vomiting.[14] These symptoms closely related to the symptoms of COVID-19.

Role of Agni

Agni plays a chief role in Arogya (disease-free state) and life. It is clearly stated in Charaka Samhita that a proper state of Agni is responsible for Bala, Arogya (health), Ayu (longevity), and Prana.[15]

In Chikitsa Sthana 15th chapter, a detailed explanation is given about Agni and its action. Jatharagni is the chief substance responsible for disease and health. In its normal state, it is responsible for Ayu, Varna, Bala, Swasthya, Utsaha, Upachaya, Prabha, Ojas (~immunity). All the vital functioning of the body is dependent on Agni. When Agni is diminished (or extinguished), the person attains death and in the equilibrium state, it helps in the attainment of long and healthy life.[16]

Concept of Guru and Laghu Vyadhita

Charaka describes that there are two kinds of patients-Guru Vyadhita and Laghu Vyadhita.[17] Sometimes due to strong Shareera and Mano-Bala, the patient with the serious disease may appear to be suffering from mild diseases. On the contrary, the patient with mild disease may look as suffering from serious complications due to impaired physical and mental strength.

Hence, it is very important to properly examine the patient to avoid the wrong diagnosis. In the current scenario of COVID-19, it is very important to take a proper history and examine the patient as it can be misleading for a simple flu in the patient who has strong physical and mental strength.

Trividha Bala and its importance

An interesting concept of Bala is mentioned by Sushruta and Charaka. According to him, Bala is of three types-Sahaja (constitutional), Kalaja (seasonal or age), and Yuktikrita (acquired).[18]

Sahaja Bala is the inherent characteristic present since birth. This depends on the physical and mental status of the parents. The child of a physically and mentally strong parents will have more strength. This can also be compared to innate immunity present in an individual since birth.

Kalaja-Bala which differs as per the season and age. A loss of strength is seen in Aadana-Kala, whereas there is increased strength during Visarga-Kala. This can also be understood that diseases can prove more fatal during the Aadana-Kala. The strength is more in the middle age, whereas reduced strength is seen in childhood and old age. In the currently prevalent pandemic of COVID-19, we have come across its increased effect higher in the old age.

Yukti-Krita Bala is that which is acquired through healthy dietary practices and activities. The inherent qualities and innate immunity cannot be changed, but through healthy habits of exercise, Aahara, Sadvriita, one can be free from diseases and live a long life.

This type of Bala is also dependent on an equilibrium state of Agni. A balance of Trayopstambha (Aahara, Nidra, Brahmcharya) can also bring about a healthy state of Dosha and Dhatu.[19]

It is noted that certain viral infections occur in a specific period of the year (Ritu-Sandhi Kala) when either the weather is favorable for viral potency, or there are potent vectors to primarily infect individuals with low immunity.

Vyadhikshmatva

It is defined as the resistance towards disease. It can be correlated to the antibodies produced in the body. Chakrapani has explained it in two form, one- which attenuate the manifestation of the disease and other, which prevents the manifestation of the disease.[20]

The current treatment modality used against COVID-19 includes plasma therapy where the blood from a person recovered from coronavirus is collected, and the plasma is extracted from it, which contains antibodies. These antibodies further prevent the severity of the disease.

Ojas

It is the essence of the seven Dhatu of the body and is responsible for the strength and vital functioning of the body. It is mentioned as one among the ten seats of Prana (life) and superior among them (Pranayatanamuttamam).[21] The diminution in Ojas results in the death of the person.[22]

Ojas is the sap of one's life energy, which, when enough, is equated with immunity and, when deficient, results in weakness, fatigue, and ultimately, disease. In short, Ojas is the energy of the entire physiology and sustains the life of an individual. Therefore, Ojas is considered a vital nectar of life.[23]

Treatment

At present, no specific drug or vaccination is available against the virus and intense research is going on globally to find a vaccine against the disease. Although some drugs have been used empirically, the present emphasis is more on prevention of the spread of the infection. Home isolation for the suspected cases, quarantine of the positive cases, social isolation, and self-imposed curfew are some adopted strategies, showing promising results.

Possible scope of Ayurveda

Charaka, while explaining Janpadodhwansha has mentioned the treatment of the upcoming pandemic. He stated that the treatment for it is the proper use of Panchvidha-Karma (Panchakarma), Rasayana (rejuvenation therapy).[24] The physician should use the medicine collected before the onset of the pandemic. He also highlighted the importance of Sadvritta and Achara-Rasayana, as the root cause of Janpadodhwansha is Adharma (sinful acts).

The Ministry of AYUSH, Government of India, has issued an Ayurvedic immunity-boosting advisory for self-care during the COVID-19 crisis. It includes Ayurvedic medicines for promoting immunity like Chyavanprasha, turmeric powder with milk, herbal tea/decoction (~Kadha/Kwath) made from Basil (Tulsi), Cinnamon, black pepper, dry ginger, and procedures like Gandusha (~oil pulling), application of Sneha (cow's ghee) within nostrils and the daily practice of Yogasana, Pranayama, and meditation. The above advisory and guidelines mostly focuses on immunomodulation and symptomatic treatment of the diseases. Further investigation into the treatment protocols based on Dosha Prakopa Awastha (~aggravation or accumulation of toxins) and Prakriti (~constitution) may play a vital role in the management of COVID-19.

Self-taught Pratimarsha Nasya (~errhine therapy), Shiro-Padaabhyanga (self-oil massage of head and soles of feet), Gandusha (~ oil pulling), and Shirodhara through automated machines are some of the options that can be explored for the benefit of patients under isolation or quarantine.

The long-term adverse effects of lockdown and information overload on mental and physical health must not be ignored. Use of Medhya and Balya Rasayana therapy for the prevention of recurrence in recovered patients and Shodhana and Rasayana therapy as rehabilitation can be explored to help restore the original state. Invariably, Ayurveda advises proper Ahara (~diet) and Nidra (~sleep) and Achara Rasayana (~behavioral therapy of Ayurveda) to maintain the state of health.

Rasayana

It comprises two words-Rasa and Ayana. It is the movement of Rasa and succeeding Dhatu towards their destination (highest quality level). A Rasayana is herbal preparations designed to rejuvenate the body, mind, and self at the deepest possible level. Sushruta has given the definition of Rasayana Tantra as the one which does Vayah-Sthapana (longevity), provides excellent quality of Medha (intelligence), Bala (strength) and also cures the diseases.[25] Chakrapani has mentioned that it is the therapy that cures the disease and Jara (old age).[26] Various classification of Rasayana is mentioned in the classics like Kutipraveshika, Vatatapika.[27] The classification given by Dalhana-Kamya Rasayana, which enhances Bala-Buddhi, Naimittika Rasayana is the one which is helpful in treating the disease e.g., Yograja in Pandu Roga and Ajashruka Rasayana can be taken daily like milk, Ghee.[28]

The Rasayana helps in the attainment of longevity, intellect, enhanced retention power and youthfulness. The overall physical strength, strength of senses, lustre, speech is improved.[29]

Rasayana like Chyavanprasha, should be given in respiratory tract illnesses like Kasa (~cough), Shwasa (~difficulty in breathing, bronchial asthma). It improves the retention power, intelligence, provides Arogya (~disease free state), longevity, and improves Uro-Roga (~diseases of chest region), Hrid-Roga (~diseases of heart) etc.[30]

Pippali Rasayana is said to be best for Kasa, Gala-Roga (~diseases of the throat), Vishama-Jwara (~fever with irregular nature, action, and time of onset). Since no clear pathophysiology of the coronavirus is known, this Rasayana might be beneficial.

Naimittika Rasayana impact like Shilajatu correct the hyperglycaemic episodes and produce their effect by enhancing the Agni and Ojas status in the patients, thereby improving metabolic and immune status.[31]

The potency of Rasayana can be understood by the Shloka mentioned by Charaka, saying that just like the Amrita (nectar) is for the Gods, Sudha for the Naga, similarly the Rasayana is for the humans.

Panchakarma

It involves five purificatory procedures for overall well-being. Acharya Charaka has highlighted the benefits of Sanshodhana as Agni-Vriddhi (increase in the digestive fire), Vyadhi-Upshanti (disease subside), normalcy or equilibrium of the components of the body. The person attains a disease-free long life and delayed aging. Various Panchakarma procedures are mentioned in each Ritu like Basti for Vata-Prakopa in Pravrit Ritu, Virechana for Pitta-Prakopa in Sharad Ritu, and Vamana for Kapha-Prakopa in Vasanta-Ritu. Other procedures like Abhyanga (medicated oil massage), Jentaka Sweda are mentioned in Hemanta Ritu, Raktmokshana in Sharad Ritu, Nasya in Vasanta Ritu are also mentioned.

It is also highlighted by Sushruta that before intake of Rasayana, the body should be subjected to Shodhana because if the channels of the body are not clean, the Rasayana effect will not be achieved to the maximum extent. It is compared to an unclean cloth, which does not take up the color.[32]

The toxins accumulated in the body are expelled out as a part of Ritu-Shodhana, which enhanced the tissue growth, neural functions and promoted healthy physical and mental state. A recent study on the cellular effects of Panchakarma revealed changes in several metabolites across many pathways. A significant reduction in 12 phosphatidylcholines and other metabolites, including amino acids, biogenic amines, acylcarnitine, glycerophospholipids, and sphingolipids were observed in the Panchakarma group. The significant alterations in plasma metabolites are consistent with metabolic changes in the gut microbiota and host metabolism that promote general health and well-being.[33]

Panchakarma therapies ensure rapid blood circulation, continuous cerebral blood flow, and efflux of toxic matter through increased lymphatic drainage.[34]

Seeing the benefits of Panchakarma therapy, it is important to indulge in the practices of it like Abhyanga, Pratimarsha Nasya, Ritu Shodhana, which further enhance the well-being and immunity of the person.

Concept of Sadvritta

One who practices Sadvritta or the noble principles attains Arogya and control over the sense organs.[35]

Various principles discussed under Sadvritta include-one should offer an oblation to the fire (perform Yagya), should wear Prasshata-Aushadha (~good herbs), one should clean excretory passages and feet frequently, one should not consume food without washing hands, feet, and face or without cleaning the mouth. Similarly, one should not indulge in yawning, sneezing, or laughter without covering his mouth.[36]

Even in the ancient times, proper hygienic practices were given due importance. The idea behind consuming food after proper cleaning of hands, feet, face, and covering the face on sneezing, yawning, laughter, etc., can be correlated with the current practice to avoid the spread of infectious viral diseases like COVID-19.

Changes in weather and environment can be predicted with geo-ecological and climatology advanced technologies. Adequate arrangements and planning can be made before the start of an epidemic, which is most likely to occur in that specific weather. The morbidity can be minimized by quick identification of various vectors that could worsen the impact or facilitate the spread of infections. In newly emerging COVID-19, where there is limited scientific knowledge, a vigilant observation can help to prepare, plan, and manage any future outbreaks. Further, early detection may help in rapid implementation of effective measures, which are the key to reduce the risk of disastrous spread.


  Conclusion Top


It is not the first time in history that a Pandemic has happened. Various references in history gives us an idea about it. The earlier known respiratory epidemic were the SARS and MERS, and Swine-flu. Ayurveda has existed since the time immemorial; the concepts given in the Sutra-Rupa have hidden and deeper meaning within them. One must understand the concepts of Ayurveda and practice them in daily life. The ideas of Ojas, improving the Bala through Yukti, consumption of Rasayana, undergoing Ritu Shodhana can certainly add years to the life along with improving the quality of life. Following a proper daily regimen, eating the food as per the season, following Sadvritta can further increase the growth of healthy tissues in the body. The emerging viral disease can be prevented by proper use of the knowledge of Ayurvedic texts. One must properly examine the Dosha, Dushya and plan the treatment accordingly. The disease of COVID-19 may be new, but the principles for its prevention and control can be understood through Ayurveda.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
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