COVID-19 An Ayurvedic Approach

Ayurveda is ancient in its origin but its concepts like Janapadodhvamsa (epidemics) and Aupasargika Roga (communicable diseases) still holds importance in this modern era.

Charaka Samhith; one of the classical text in Ayurveda written in 1000BC states that, the Vaidya (physician/Ayurveda Doctor) should foresee the epidemics and take needed measures to prevent and control it. Charaka describes the epidemics in the chapter named Janapadpdhwamsa which means mass people get afflicted with diseases and destroy the whole region and inhabitants there.

Diseases and its causes can be classified into several groups by many factors and pathology behind it. In general the diseases can be classified in to two groups.

  1. Those common to all living beings in general (Epidemics)
  2. Those specific to individual ( eg. Diseases due to wrong food and regimens or specific fault done by the individual and the body constitution)

Eventhough there is dissimilarity in the physical constitution, mentality, food habits, strength and adaptability of human beings, still there are some factors common to all individuals and vitiation or contamination of these factors with pathogens and toxins leads to the simultaneous manifestation of diseases with same types of symptoms, leading to the destruction of that particular region or country. (Caharak Samhitha).

Factors which are common for all the inhabitants of a country are air, water location and season and it get vitiated or destabilized by adharma (the wrong doings) of the mankind. Adharma is the opposite of dharma. Dharma is a unique word in Sanskrit language and in Indian civilization and there is no appropriate equivalent word for it in English language.

Nature impels man to keep doing something without any cessation. There for he should learn the proper methods of doing things and by doing so, cleanses his mind, acquire good character and habits and then transcend the habits and become a good person for his family, society and for the entire world. Ayurveda advise one to follow Dharma that which nurtures the subjects and, in turn, the society.

So dharma is not just rules and regulation, it is the proper and right way of doing things for the welfare of the entire world and any action against that is adharma. Charaka says, this adharma also leads to the formation of demoniac unseen agents which kills the mass people.

Ayurveda also says the most root cause of all kind of diseases is pranjaparadha (Intellectual blasphemy) which means willfully ignoring one’s inner knowing and going against norms, intuition and common sense.

Ayurveda states that this adharma and pranjaparadha leads to the destabilization or vitiation or the contamination of water, land, rain, season, farming etc. which in turn bring epidemics and destroy the region or the entire country.

Mode of Spread of Communicable Diseases

Susruth (350BC) in his book named Susrutha Samhitha grouped some diseases under the heading Aupasargika rogas and described its mode of transmission. Aupasargika rogas are those infectious diseases communicated from one person to another; Communicable Diseases.

The mode of spread of infectious diseases has been described clearly by Sushruta in reference to Kustha (skin diseases), Jwara (pyrexia), Shosha (tuberculosis), Netrabhishyanda (conjunctivitis) etc., spread from human beings to human beings due to Prasangat (sexual route), Gatra-samsparsat (body contact), Nihshwasat (Droplet infection), Saha-bhojanat (taking food with diseased person), Saha-shayyasanat (sitting or sleeping with infected person), Vastramalyaanulepanat (using clothes, cosmetics and ornaments of patient).

COVID-19

COVID-19 is a newly discovered Corona virus infectious disease. Corona means “crown,” and the viruses are named for the proteins on the outside of the viruses that look like crowns and were identified in the mid of 1960s. Corona Viruses are a large family of viruses that cause illness ranging from common cold to more severe disease such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).

Virus – Viruses are the smallest microorganisms causing human diseases. Their genome is composed of either DNA or RNA and this genome structure is used as the basis of Virus classification.

The virus genome is enclosed in a protein shell and in some cases a lipid envelope. Unlike bacteria which can grow in cell free medium, all viruses are obligate intracellular pathogens. Glycoprotien on the surface of viruses recognize specific cellular receptor and thus infect specific cells and produces specific diseases.

Mode of spread of SARS CoV-2

Corona viruses are zoonotic. This means they first develop in animals before developing in humans. For the virus to pass from animal to humans, a person has to come into close contact with an animal that carries the infection.

A new study found the virus may have originated in bats and then spread to humans via a snake or pangolin. “They found that the sequence of the corona virus strain assembled from metagenomes of pangolin was 99 percent identical to that of infected people in the recent coronavirus outbreak,”  If a person contracts the virus, the result is the disease called COVID-19. (Corona Virus Disease 2019). Once the virus develops in people, being it as a respiratory virus, corona viruses can be spread from person to person through respiratory droplets. If the nearby infected person doesn’t cover his/her mouth and nose while sneezing or coughing, they could potentially spray you with respiratory droplets from their nose or mouth. The droplets that land on you will likely contain the virus or perhaps you meet someone who contracted the virus, and they touched their mouth or nose with their hand. When that person shakes your hand, they transfer some of the virus to your hand. If you then touch your mouth or nose without washing your hands first, you may accidentally give that virus an entry point into your own body. It’s also possible that the  virus can be transmitted via touching virus-contaminated surfaces and then touching your mouth or nose.

Studies suggest that corona viruses may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment).

It’s possible that someone with a novel corona virus infection could transmit it to others even if they don’t show any symptoms, or have such mild symptoms that they don’t really know they’re sick.

Incubation Period

An incubation period is the time between when you contract a virus and when your symptoms start. Currently, according to the Centers for Disease Control and Prevention (CDC) the incubation period for the novel coronavirus is somewhere between 2 to 14 days after exposure.

More than 97 percent of people who contract SARS-CoV-2 show symptoms within 11.5 days of exposure. The average incubation period seems to be around 5 days.

Signs and Symptoms

Symptoms of COVID-19 are usually mild and develop slowly.

The main symptoms are:

  • Fever (low grade fever that gradually increases in temperature)
  • shortness of breath
  • cough that gets more severe over time
  • fatigue

Other less common symptoms may include:

  • achiness
  • nasal congestion
  • sore throat
  • runny nose
  • diarrhoea, nausea or a runny nose.(Very Rare).

COVID-19 has more respiratory symptoms than a cold, which usually causes a runny nose, congestion, and sneezing. Also, a fever isn’t too common with a cold. The flu has similar symptoms to COVID-19. However, COVID-19 is more likely to cause shortness of breath and other respiratory symptoms.

About 80 percent of people recover from the symptoms of COVID-19 without needing any special medical treatment. However, some people can become seriously ill after contracting COVID-19. Older adults and people with compromised immune systems are at the highest risk of developing more severe symptoms.

Treatment

Currently there is no specific treatment approved for COVID-19, and no cure for an infection, although treatments and vaccines are currently under study. Instead, treatment focuses on managing symptoms as the virus runs its course.

Complications

The most serious and specific complication of a SARS-CoV-2 infection is a type of pneumonia
that’s been called 2019 novel coronavirus-infected pneumonia (NCIP).

Researchers have seen the following complications in people who have developed COVID-19:

  • Novel Coronavirus Infected Pneumonia (NCIP).
  • Acute Respiratory Failure leading to death
  • Acute Respiratory Distress syndrome (ARDS)
  • Acute Liver Injury
  • Acute Cardiac Injury
  • Acute Kidney Injury
  • Secondary Infection
  • Septic Shock
  • Disseminated Intravascular Coagulation
  • Irregular heart rate (arrhythmia)
  • Cardiovascular shock
  • Severe muscle pain (myalgia)
  • Fatigue
  • Heart damage or heart attack
  • Acute Respiratory Distress Syndrome (ARDS)
  • Rhabdomylosis (Extremely rare condition)

Prevention

The most effective ways to protect yourself and others against COVID-19 are to frequently clean your hands, cover your cough with the bend of elbow or tissue, and maintain a distance of at least 1 meter (3 feet) from people who are coughing or sneezing.

  • Wash your hands frequently for at least 20 seconds at a time with warm water and soap.
  • Don’t touch your face, eyes, nose, or mouth when your hands are dirty.
  • Don’t go out if you’re feeling sick or have any cold or flu symptoms.
  • Stay at least 3 feet away from anyone who is coughing or sneezing.
  • Cover your mouth with the inside of your elbow whenever you sneeze or cough. Dispose any tissues you use right away.
  • Clean any objects you touch a lot. Use disinfectants on objects like phones, computers, utensils, dishware, and doorknobs.

An Ayurvedic Perspective of COVID-19

According to Ayurveda daily routine and dietary habits play a major role in health and diseases. If our digestive fire is normal, our immunity will remain powerful and thus no infection can overrule. Ayurvedic herbals and preventive aspects help to detoxify the liver, improve digestion and boost up immunity. Ayurvedic preparations have anti-viral, cleansing and antioxidant properties. They are excellent for balancing Vata and Kapha, which are the prominent Dosha in COVID19 or any similar respiratory tract infections.

This COVID19 can be correlated to Abhinyasa Jwara and Abhishanga Jwara described in Ayurveda.

Abhinyasa Jwara: is one of the thirteen types of Sannipataja Jwara where all three Doshas are vitiated and affect rasavaha and pranavaha srotas ( nutritional system and respiratory system).

Bhuthabhishanga jwara is one among the aganthuja jwara (fever caused by external factor) due to the infectious microorganism like bacteria, virus etc.

It severely affects the circulation of Rasa dhathu and thereby causes the depletion of Ojas; factor responsible for life and death, which results in death of patient. As the microorganism is the direct factor for the causation of this Abhinyasa Jwara (COVID19), it can be categorized as a Bhutabhisanga Jwara; a type of Agantuja Jwara.

Agantuja jwara are at first an independent malady without any primordial symptoms but later they get mixed up with the signs and symptoms of nija jwara(Fever due to intrinsic factors). However agantuja jwara has its own independent etiological factors and therapeutics.(charak Samhitha Chikitsa Sthana 3/128-129)

Management

Ojas is the product of a healthy digestive system, which helps the body in resisting infection. Low Ojas is the lack of immunity at the physical level and the absence of mental strength at the mind level. We can prevent the spread of epidemics by strengthening the Ojas and enhancing our body immunity. According to Ayurveda daily routine and dietary habits plays a major role in any disease. If your digestive fire is normal, your immunity will remain powerful and thus no infection can overrule you. So one should follow the ideal dietary regimen especially during the periods of epidemics.

The treatment can be divided in following steps:

  1. Nidana Parivarjana
  2. Shamana Chikitsa (Pacification Therapy)
  3. Shodhana Chikitsa (Purification Therapy)
  4. Rasayana Prayoga (Rejuvenation Therapy)
  5. Pranayama, yoga, meditation etc.

Nigraha Hetu (Coping factors): Sage Sushruta while describing the four Nigraha Hetu i.e. four factors which should be duly employed in order to successfully cope up with a disease, which are sanshodhana (purification), sanshamana (pacification), ahara and achara (regimes of diet & conduct), included adravyabhuta chikitsa (non pharmacological techniques) in the form of Achara (code of conduct/custom/ manner of action/good behavior).

Preventive and Prophylactic

  • Nidanaparivarjana (Refrain from etiological factors): Ācārya Suśruta has mentioned that ‘Nidāna Parivarjanam’ is the foremost treatment principle of any disease in this world i.e. abstinence from the disease causing factors can treat the disease.
    • Avoid or limit contact with people who are showing symptoms of COVID-19 or any respiratory infection.
      1. Stay at least 3 feet (1 meter) away from anyone who is coughing or sneezing. Use mask.
      2. Avoid personal contact, such as kissing, sharing cups or food or cloths etc. with sick people.
    • practice good hygiene
      1. Wash your hands frequently for at least 20 seconds at a time with warm water and soap.
      2. Cough or sneeze into your elbow or by covering your mouth and nose with tissues.
      3. Put used tissues in the bin or a bag immediately.
      4. Don’t touch your face, eyes, nose, or mouth when your hands are dirty.
      5. Clean any objects you touch a lot. Use disinfectants on objects like phones, computers, utensils, dishware, and doorknobs.
      6. Fumigate the room and premises with herbal preparations like Aparajitha Choorna.
    • Social distancing to prevent bacteria and viruses from spreading.
      • Don’t go out especially if you’re feeling sick or have any cold or flu symptoms.
  • Ahara (Diet); If your digestive fire is normal, your immunity will remain powerful and thus no infection can overrule you. So one should follow the ideal dietary regimen.
    • Always choose warm and light food.
    • Avoid cold heavy and oily food.
    • Drink boiled warm water. Tulasi, Ginger, black pepper tea is beneficial.
    • Shadanga paneeya for drinking
    • Avoid Regular use of sweets, butter, cheese, paneer, Dairy products especially curd and butter.
    • Avoid Refrigerated, re warmed, day old stale food, etc.
    • Avoid Non-vegetarian food.

Treatment

Treatment based on shadkriyakala (vyadhikriyakala); stage wise disease management should be adopted here. Acharya Susrut in susruthasamhitha suthrasthan 35th chapter named aturopakramaneeya(clinical observation) states that, in aupasargika rogas (Communicable Diseases) the treatment should be specific to the disease and its accompanying symptoms. A violent unfavorable symptom should be first attended and checked in a case where it would be found to have grown stronger and more distressing and dangerous than the original malady.

Clinically, the immune responses induced by SARS-CoV-2 infection are two phased. During the first stage; incubation and non-severe stages, a specific adaptive immune response is required to eliminate the virus and to stop the advancement of the disease to the next severe stage.

Therefore, strategies to boost immune responses at this stage are certainly important. For the development of an endogenous protective immune response at the incubation and non-severe stages, the host should be in good general health and body constitution.

  • To improve the immunity in this one can have Indukantham and guduchyadi kashayam with tab Sudarsanachoornam or Tab.Mahasudarsanachoornam.
  • Shadangapaneeyam for drinking, (Musta, parpata,Usira,Chandana,Udeechya,Sundi)
  • Tab.Guduchi,Haridra and Tulasi
  • Avoid food substances which are burning, heavy, unwholesome and antagonistic.
  • Patient should abstain from excessive exhaustion and over eating.

However, when a protective immune response is impaired, virus will propagate and massive destruction of the affected tissues will occur. The damaged cells induce innate inflammation in the lungs that is largely mediated by pro-inflammatory macrophages and granulocytes. Lung inflammation is the main cause of life-threatening respiratory disorders at the severe stage. Therefore, good general health may not be advantageous for patients who have advanced to the severe stage: once severe lung damage occurs, efforts should be made to suppress inflammation and to manage the symptoms where some times life supportive measures become necessary.

  • Ayurveda consider individual patient constitution and variations in disease manifestation and its stages. So Ayurveda adopt an individualized care approach.

After discharge from hospital too there may some patients remain or return viral positive and others even relapse.

  • In Ayurveda specific rasayanayogas are adviced to improve the health and to prevent the relapse of the disease.

Medicines

Though there are numerous medicines advised in Ayurveda Classics to treat the disease with the same signs and symptoms above mentioned(Abhinyasa Jwara, Abhishanga Jwara), the specific medicines has to be given based on the individual constitution, vitiation, disease and its specific manifestation and stages. So the medicines given here should be used under the strict supervision of qualified Ayurveda Physician.

  1. Kashayam
    • Shadangam Kashayam, Guluchyadi Kashayam, Indukantham Kashayam
    • Amruthotharam Kashayam, Dasamoolakatuthrayam Kashayam, Panchathikthakam Kashayam
  2. Tablets
    • Tab.Sudarsanachoorna, Tab.MahasudarsanaChoorna, Sooryaprabha, Tribhuvanakeerthirasa, Lakshmivilasarasa, Mrityunjayarasa,  Vilwadi Gutika, Arogyavardhini Vati.
  3. Arishtam
    • Amritharishtam, Sudarsanasavam, Vasarishtam, Kanakasavam
  4. Choornam
    • Thaleesapatradi Choornam, Sitopaladichoornam, Rasnadi Choornam
  5. Vatakam
    • Vyoshadivatakam
  6. Ghritam
    • Indukanthamgritham, Kalyanakaghritam, Sathavari Ghritam, Vidaryadi Ghritam.
  7. Lehyam
    • Pippalirasayanam, Gulardrakam, Agasthyarasayanam, Brahmarasayanam, Chyavanaprasam.
  8. Thailam
    • Anuthalam
    • Lakshadi Keram, Balaswagandadi Thailam

References

https://www.who.int/news-room/q-a-detail/q-a-coronaviruses

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30251-8/fulltext

https://annals.org/aim/fullarticle/2762808/incubation-period-coronavirus-disease-2019-covid-19-from-publicly-reported

Davidson’s Principles and Practice of Medicine.

https://www.webmd.com/lung/coronavirus-complications#2

https://www.cdc.gov/coronavirus/2019-ncov/index.html

https://www.who.int/health-topics/coronavirus#tab=tab_3

https://jamanetwork.com/journals/jama/fullarticle/2761044

Bibliography

Caraka Samhita- English Translation and critical exposition on Cakrapani datta’s Ayurveda deepika by Vaidya Bhagavan Das and Dr.Ram Karan Sharma Published by Chowkhamba Sanskrit Series Office, Reprint 2016.

Davidson’s Principles and Practice of Medicine, edited by Christopher Haslett, Edwin R. Chilvers, John A.A. Hunter, Nicholas A. Boon Published by Harcourt Publishers Ltd, Churchill Livingstone,18th edition ,1999

Susrut Samhitha, Text with English translation By Kaviraj Kunjalal Bhishagratna , prologued and edited by Dr.Laxmidhar Dwivedi, published by Chowkhamba Sanskrit Series Office, Reprint 1999

Ashtanga Hridayam, Arunodaya Vyakhyanam By P.M.Govindan Vaidyar, Puplished by Devi BookStall, Kodungalloor, 9th Reprint 2002

MadvaNidanam , Sararthadeepika vyahyana collated by Vaidya S.Janardhanan Pilla, Published by Devi Bookstall, Kodungalloor, 4th Reprint, 1998.

Sahasrayogam, Vaidyapriya Vykhanam, by Velayudha Kurup published by Devi Book stall, 1st edition 2017.

Bhaishajya Ratnavali, Malayalam Commentary by M.Narayanan Vaidyar, Published by M.Narayan Vaidyar,Kannur Print 1997

A Text Book Of Kayacikitsa by Dr.Parameswarappa.S.Byadgi and Dr.Ajay Kumar Pandey, Published by Chowkhambha Publications, New Delhi,2nd Edition, 2015.

61 thoughts on “COVID-19 An Ayurvedic Approach”

  1. I believe that our Own Ayurveda has its own remedies for almost all kind of illness.
    You clearly mentioned the Covid 19 in Ayurvedic perception.

    1. Dr. Siju Muraleedharan BAMS, MD

      ya, You are right, there is solution for many of the health issues we are facing now.
      Thank You.

  2. I am already taking 20 ml Amritharishtam and 10 ml Indukantham Kashayam as a precautionary measure. I am not a qualified doctor, but know little about Ayurvedam and medicines. Is there any problem if I take it continuously?

    1. Dr. Siju Muraleedharan BAMS, MD

      Dear Vijayan sir,
      Cerainly Amritharishtam will boost up your immunity but it is an ayurvedic preparation specifically mentioned for fever, flu etc.. kind of condition.
      so it is not a good idea to take that regularly unless you have such kind of illness or surrounded by those having flue or such contagious diseases.
      You can find more details on Amritharishtam in the below given link.
      https://ayurvedam.co/amritharishtam/
      instead I prefer you to take Dhatryarishta and Saraswatharishtam, in a regular basis for 2 months.
      Indukantham kashayam is very good to have in this present condition, it improve your digestion, overall metabolism, pacify vata and improve immunity.
      in the first out break of chikungunya ( 2007) all our neighbors got infected by chikengunya virus then we prepared Indukanthakam kashayam and served to all our patients and kalari students. and none of those had this medicine doesnt got infected by this virus. done the fumigation with aparajitha choornam.
      You can have indukantham kashayam for 41 days it will improve your metabolism and over all immunity but not specific for corona Virus -2 (COVID- 19)
      take tulasi leaves or its juice every day morning.
      boil milk with ginger and haldi ( turmeric) to that. this milk you can use for making tea too.
      in this summer it is also very good to have guloochyadi kashayam (Guduchyadi).
      chyavana prasham which you can take in a regular basis is a good rasayan to boost up your immunity.
      There are many medicines mentioned in ayurveda like Tulasi, Haldi, Kiriyath (chiretta ),Thriphala etc…specific for each individual and health conditions, take those with the guidance of ayurveda doctor.

  3. ശ്രേഷ്ം മായ വൈദ്യ പരമ്പരയിൽപ്പെട്ട ഡോ.സിജു മുരളീധരന്റെ covid – 19പം ന ങ്ങളും പ്രതിവിധികളും ഏറെ ഉപകാരപ്പെടും. രോഗം വരുന്നതിന് മുമ്പുതന്നെ പ്രതിരോധ ശക്തി നേടിയെടുക്കാനുള്ള കഴിവ് ആയുർവേദത്തിനേ ഉള്ളു. ജനങ്ങൾക്ക് ഇത് ആശ്വാസമായി ഭവിക്കട്ടെ

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