To study the Ayurveda perspective of Covid 19

Nidan- Hetu of Covid 19

Sushruta, had well-explained about epidemic diseases. Sushruta, in sutrasthan 6th chapter, narrated about ‘vyapanna rutu’ as a cause of epidemic diseases. Now a days, we are facing lots of changes in climate and ‘rutuviparyay’ means conditions opposite to that particular season. This is happened all over the world. Sushrut tells that this changes in season occur due to, ‘adharma’. ‘Dharma’ means, the right things, disciplines, rules, commitments, which we are supposed to follow, while leaving in a civil society. When we don’t follow this, it is called as ‘Adharma’. Now a days our lifestyle, our selfishness, increased and reduced the importance of dharma, and everyone is leaving for their own happiness, instead of caring for Mother Nature. As per Ayurveda, this may be the reason for seasonal variation. Seasonal variation leads to vitiation of water and herbs, medicines, which leads to outbreak epidemics. Marak-means-epidemics- this term is evolved by Sushruta.1

Atharvaveda also explains about the spreade of disease from 2 types of worms, one which we can see with eyes and another which we cannot see. Worms are mixed with mountain, forest, food products, animals and liquids, which ultimately enter in body through food, water and wound. To treat this with earth, water, fire, sun, some Mantras are explained.

Bahujana sadharana hetu2, 3, 4- common etiological factors-

Common factors pertaining entire community-Water, air, desha-land, Kala-seasonal variation. As per text these are common etiological factors for all communicable diseases, out of these-Air and kala responsible for covid-19.

A] Evitable factors-

Adharma-Violation of stipulated behavior

Prajnyapradha-Wrong behavior

Shasraprabhava- Wars, weapons

Curse

Poisonous flowers smell

Bhutasanghata- pathogens, uncleanliness

Sexual contact with affected person

Physical touch, close breathing, sharing meal with affected person, sharing bed, bench, ornament, clothes etc.1

Less immunity

B] Inevitable disastrous factors

Abnormal variation in seasonal cycles

Air vitiation

Cosmic changes

Pathogenesis of covid-19

Less immunity, Air vitiated with virus- exposure to vitiated air- sudden vitiation of all three dosha- sthansashray-affected sytems- primarily nose-upper respiratory tract, digestive system, blood and circulatory system- if not treated-lower respiratory tract, multiple organ involvement.

Anshansha kalpana-

Dosha involved- Vata-prana, udan,saman,vyana, apana

Pitta- pachak, sadhak, bhrajaka

Kapha- Avlambak, Sadhak, bodhak

Dhatu- Rasa, rakta, mamsa,meda,

Mala- sweda, mala,mutra

In latter stages all dosha, dhatus and malas are invoved.

Considering its rapid spread and onset of symptoms, high grade fever, blood vitiation (crp increased-inflammation), nausea, vomiting, increase in stickiness of blood (styan-increase in d-dimmer), covid 19 is considered as sannipatik jwara. All three doshas are prominent. Intensity of dosha vitiation may vary according to patient’s symptoms.5

Symptoms

Asymptomatic-people with good immunity may not have any symptom.

Mild symptoms- patient having non-specific symptoms of upper respiratory tract such as, cough, cold, sore throat, nasal congestion, fever, malaise, headache. They do not have signs of dehydration, sepsis, shortness of breath,

Moderate symptoms- High grade fever, dyspnea, anosmia, nausea, abdominal discomfort, low oxygen saturation, pulmonary ground glass opacities in CT lungs, with score more than 10.

Fatal symptoms- oxygen saturation very low, unable to breath, inflammatory marker test- increased, in cytokine storm, multiple organ involvement, cardiac symptoms etc.

As per Ayurveda ‘vyadhi-kshamatva’ plays important role to protect us from these epidemic diseases.6 Vyadhikshamatva is a body’s capacity to inhibit disease to manifest and increase its symptoms. Chakrpani, commentator of Charaka describes concept of vadhikshamatva as body’s natural response to prohibit contact of disease producing factors with body, and also to inhibit entry and progress of disease in body. Charak explains that this vyadhikshamtva, is not equal for all individuals. Obesity, people with bad food and behavior habits, malnourishment, weak, physically disturbed people have less immunity. Vyadhikshamatva is directly dependent upon strength of individual. Ayurveda explains about strength examination parameters, such as body proportion, muscle strength, muscle tone, sense organs strength, functioning organs strength, mind situation, capacity to tolerate thirst, hunger, sun, wind exposure, capacity to work and to do exercise, capacity of digestion etc.7, 8, 9 Vydhikshamatva is of 3 types, sahaj-means by birth, kalaj-over the period of time (youth have good vyadhikshamava as compared to childhood and old age and in winter season we have good strength) and third is adaptive vyadhikshamatva means with specific life style changes, use of medicines we can increase our ‘vyahikshamatva.2

If ‘vyadhikhamatv’ is good, although patient exposed to virus, he may not suffer from disease, or he may be symptomless, or with minimal symptoms.

Treatment plan6, 2, 3

Sushruta given common treatment plan for all epidemic diseases

Leave the infected place- sthanparityag

Quarantine

Hom- dhum sevan- to purify atmosphere

Cleanliness- Niyam

Daivavyapashray treatment- chanting mantra-pray God – mental peace is important in this scenario, as fear induces many diseases, as we can see now.1

Treatment can be done under 2 heads-

1] Preventive and 2] curative

1] Preventive

# Advice to implement, all ‘vyadhikshamatva’ increasing habits, food and medicines.

# Proper following of daily regimen-dincharya-as per Ayurveda.

# Dhupana- fumigation of air with, tulsi (holy basil), nimb (Azadiracta Indica), nirgudi, ajwain, camphor etc.

# Prohibit vitiation of earth, water, air, climate, with proper purification methods.

# Collect food, medicine from unaffected area.

# instruct people to follow ‘Dharma’

# Instruct people to follow good habits, speak truth, follow kindness, good morals.

# Daily do Abhyanga (body massage) with sesame oil, or medicated oil, take steam bath, steam inhalation, clean body after coming at home.

# Nasya- nasal drops of cow’s ghee, sesame oil or medicated oil, to prevent virus entry and to increase strength of nasal mucosa.

# Daily exercise, sun salutations, body strengthening yoga-asana-, pranayama, (anulom-pratilom).

# Avoid over exertion, exposure of morning breeze, late night sleep, day time sleep, suppression or initiation of natural urges of body,

# Preventive measures to avoid vitiation of earth, air, water and climate.

# Rakshoghna medicine- preventive measures against small germs- dhupan with guggule (Comnifera mukul), agaru, tulsi, nirgudi, tejpan, ela (cardamom), twak (cinnamon), camphor etc, and medication.

# Panchakarma treatments- Body purification done with panchakarma to avoid accumulation of dosha in body, thereby prevents disease. Vamana, nasya, play major role to prevent covid 19.

# Rasayana- After panchakarma patient should administer Rasayana herbs like Guduchi (Tinspora cordifoia), Amla (Emblica officinalis), Ashwaganda (Withania somnifera), Pippali- Long pepper (piper longum), Licorice, Garlic, Tulsi etc. Pippali can be used as chaushshta pippali yoga (64 pippali course) to give strength to respiratory system.1 One can use readymade rasayana preparations such as chyavanprash, amlaki rasayan,agastiprash, makarprash etc.1 Gold medicated water will be beneficial.

# Light, unctuous, warm, freshly cooked diet fortified with spices like black pepper, long pepper, cardamom, cinnamon, ajwain, cumin, garlic, tulsi, ginger, turmeric is preferred. Change in diet is not recommended, the food with which you are habitual since birth is nourishing for that particular person, so it is recommended. 8

# Drink luke-warm water, medicated water (shadangodak- musta, parpat, usheer -vetivir, chandan -sandalwood, dry ginger, medicated water), water mixed with honey is also good.

# Steam inhalation-helps to prevent accumulation of cough in upper respiratory tract.

# Neti- Among six purification methods as per Yoga, Neti is very easy and effective purification method to clean upper respiratory tract. In Pune, at Dinanath mangeshkar hospital, all 600 doctors serving covid 19 patients, regularly do neti, and not a single doctor get affected due to corona.

# Community sanitization- spraying of decoction made from nimb, nirgudi, shigru, curry leaves, nilgiri added with alum, camphor and cow’s urine will be effective for community sanitization.

# Vagbhata narrates that disinfection can be done with sunrays.10

# Daiv-vyapashray treatment- mahamrutunjay mantra, omkar, shiva prayer, vishnusahasranam.11, 4

This is a swasthvritta aspect of covid-19 treatment according to symptoms, we may discuss detail treatment protocol in next article.