Understanding of Pandemics
Dr Gururaja derebail,M.S(Ayu)PhD scholar(Japan)
Introduction
World has become very small due to
technological developments. We can reach any part of the earth within few
hours. Diseases appeared at one part can also reach our country within few
days. But even before its arrival we can see statements in newspapers “Ayurveda
has medicine”.
It is really surprising for me how and
why they make such statements. Are we not degrading our self? We should think
before giving such statements.
Ayurveda mentions
about औपसर्गिक व्याधि. जनपदोध्वंस is also a wonderful concept. There are also references about diseases
came from foriengners.eg phiranga .Over the period of time from charaka till
today many new diseases has been added. Ayurveda always welcomes new thoughts. Whenever
such new disease arises we should discuss before coming to any conclusion.
Pandemics- Pan-all Demos –people.
Spreading through human population
across a large region.
WHO criteria-
Emergence of the disease new to
population
Agents infect humans causing serious
illness.
Agents spread easily and substantially
among humans
H1N1(H-Hemaglutinin,N-Neuraminidase)
Started in Mexico - America- Worldwide
Host –Swine.
Animal to Human transmission.
Now human to human transmission.
WHO has pandemics alert
grading.According to this
Phase
6-Human to Human , substantial number ,more than one country.[ see WHO
guidelines ]
Ayurveda
Even though there are explanations
regarding
जनपदोध्वंस-अधर्म-साधारण हेतु.
[ विप्रकर्ष निदान ]
दूषित
वायु
औपसर्गिक
व्याधि-निश्वासात् [ सन्निकर्ष ]
संसर्गजव्याधि
आगन्तु
व्याधि [ लक्षणतः ]
अभिषङ्ग
and सन्निपात ज्वर
concept
Here every theory holds good to some
extent
To get
a comprehensive picture of the disease is not so easy.
Discussion
Modern science says this is due to a virus
.
But we don’t accept infection theory
If we follow dosha dushya vighatana in
some cases we get good result but we find difficult to generalize it.
We say it is our greatness, that we
treat patients not disease.
I accept we have many positive points.
Are we capable of treating pandemic
outbursts??????
OR
Is there any need to accept infection theory?
Lacuna
1 Difficulty in explaining औपसर्गिक सम्प्राप्ति.
2 दूषित
जल ,वात-related vyadhis Where acute dosha
vitiation occurs we say it is due to achaya prakopa…or…pradhanika hetu…….there
is missing link between the nidhana to Vyadhi pradurbhava. We find it difficult
to understand in terms of kriya kala.
3 In many vyadhi if we fail to get
result from sneha sweda etc vidhi, then we should consider it as raktaja
vyadhi.this shows again our limitation.
4 In Jwara explanation, we can get the
references about fever in Elephants and Horses.Charaka`s period Human and
Elephant relation was more common, But presently Human and Pig,Birds are more
so we find Swine Flue.In Charaka We fail to get the references regarding animal
to human transmission. We may apply Aupasargika reference here to understand
this.
5 रक्तज कृमि - invisible.
krimi management prakrutivighata treatment is explained which is similar to the
concept of antibiotic theory.
Even in Veda we can find the
references like “yatudhana” “Sarpa”.
6 Explanation about राक्षस, पिशाच is available in ulcer
management where secondary infections are more common. Without antibiotics we
find it difficult to manage post operative cases. Dhupana is mainly a
disinfection procedure.
7 Many विष concepts
like mushaka visha convey some diseases rather than simple bite.
8 Drugs ,which act on vyadhi ,not on
dosha dushya ,are mainly to the diseases of infectious origin and even Rasa
drugs.
9Now all ayurvedic doctors know about
infections and many prefer antibiotics.
10 Modern investigation-प्रत्यक्षप्रमाण (they are
making alpam apratyaskyam)
11 Take H1N1 virus we can see the same
virus everywhere.
We should take this in to
consideration.
12Symptoms of vishama jwara depending
on dhatu, when the infection is on particular dhatu fever appears.eg
Malaria,Rakta and Organisms in Blood.
13Ama pachana is nothing but removal
of the infection eg Kala is also one in that -Time require to develop immunity
against that oraganism.
14Vyadhi kshamatva is nothing but
Immunity and resistence .Vaccination is a Yukti kruta bala.Sucess of
vaccination on many diseases cannot be rejected.
15 In modern success rate will not
vary much depending on the doctors.But In Ayurveda success rate mainly depends
on the doctors. (About 60% not get good results)
16 If we observe the health system in
developed countries and their way of managing epidemics, is really appreciable.
There are some limitations but we cannot discard.
17 Modern people say many
complications of the disease which are rare or 5%but they will try to prevent
even that but in our case, if our treatement succeeds then we say ayurveda is
great, but we just escape or say ayurveda has limitations when the case becomes
serious later shift to modern, it is not good. I feel ,we could have prevented
those cases if we had started modern medicine from the beginning.
Our
approach:-
1Dosha dushya and Samprapti.
2Change in season resulting in dosha
vitiation and roga
3 Importance to Agni and Bala.
4Concept of Ama ,If we correct the
agni and remove ama then the disease cures.
5 Even modern medicine has many lacunas
like In many people even though the organism is present person will not show
any symptoms or carrier stage so It means organism is not the main cause for
the disease. We can’t vaccinate for each disease. Viruses also change their
structure .Organisms develop resistance against the antibiotics so later more
powerful drugs are needed ,In future somewhere it should stop Eg is
Tuberculosis –new resistance stains are coming.
Relation to seasons and Body – this is
the point where we have credits. Every species on this earth react to seasonal
changes even micro-organisms. Many infectious diseases also rise during
seasonal changes.
What happens
if we accept?
Our approach differs- One as dosha dushya
Other specific to organism.
Preventive aspect.
If a Patient who belongs to one desha
,gets disease in other place, then moves to some other country. Then our theory
like-
1यस्य देशस्य यो जन्तुः……
2Seasons are different at different
places.
3Even simple disease becomes असाध्य.
We escape by saying viral diseases do
not have treatment. [ tamiflu].
What we
should do
Welcome new concepts
Know our limitation
Don’t go away from our basics.
Convey right message to the society.
Don’t always
say same that our drugs improve resistance power.To develop resistence takes
sometime,so if we find few drugs which act on oraganisms then I think we can
control the disease better. We should target those wicked organisms also. [Not
by extracting principle chemical]
For example
I think drugs like Kirathatikta,Parpata these are effective against some
organisms.or Sudharshana khada are good but not up to the mark, we cannot say
confidently that it works.
Pandemic-
Ayurvedic Plan of management
Iteology
and Pathogenesis -Prajnaparadha- Main cause
Viprakrusta nidana- Pig to Pig
Sannikrusta- Pig to Man and Man to Man
Vyabhichari- weak Virus stains due to
change in season or place.
Pradhanika- Potent stains due to improper
drug management resulting in fatal acute complications.
Cause Treatment
Origin- Adharma-
Janapadodwamsa Daivavyapasraya and
Shudda Vayu etc
SwasthaVruttha-Personal
Society
– Need government help.
Spread- Aupasargika-Niswaasaath
Mask ,Dhupana, Improve the bala
Vyadhi- Aganthu- Vyatha purva Improve
Bala,Lakshanatah treatment.
Achaya
prakopa Treat
Dosha and lakshana
Lakshana- Jwara (Sannipata) Jwara management Doshaja and Abhishangaja
Infection – Krimi Management- Apakarshana- Bheshajena Apakarshana
Prakritivighata- Change the
environment unwholesome environment for organism.
Nidana Parivarjana- Quarantine.
Pishacha etc supernatural powers Daiva vyapasraya.
Sadhyaasaadhyata – Kastasaadhya Vyaadhi
Note Asaadhya symptoms according to Ayurveda.
Ayurvedic
Preventive Measures –
Swasthavrutta-Food-Rasa-Tikta Rasa
good for Jwara and infections
Promote Seasonal Customs –
Saptaparna kashaya,Amalaki etc
Vegetables –
Karavella,Kusmaanda,Phalandu,Lasuna.Shatavari.
Avoid-Cabbage,Cauliflower
Fruits – Orange,Jambo ,
Amalaki ,Dadima
Avoid – Grapes.
Preparations-Shadanga Paniya
–Drink enough water.
Drinks – Green tea ,Lemon
tea,Kuthanbhari kashaya.
Preparations Tambuli–Mandukaparni,Kakamachi,Shunti,Methika,Kasamarda,Parnayavani,Bhrungaraja
etc which are good for respiratory system and to maintain Agni.
Avoid – Oily and Spicy items,Chats,Junk foods,Cold
water,Tender coconut.
Fasting,Heavy
exercise,Irregular food habits, Jagarana
Dinacharya-Usually
infection spread by droplet infection so We should improve the bala of nasal
and pharyngeal mucosa.
Improve
the Bala of nasal mucosa by-Anutaila Nasya, Jala Neti.
Give strength to pharynx – By
Irimedadi taila kavala
Gandusa of
Pancha valkala kashaya.
Salt water
gargle etc
Improve the strength of Respiratory
system – Pranayama.
Improve general strength by –
Abhyanga,Yoga,Meditation.
Rutucharya-
Encourage the Shodana in respective Rutus
Government
and Insurance companies should consider this.
Hygiene
Of the hands- Promote awareness about regular washing of the hands.
Drugs
–Improve the General Bala
Swarnayoga – Navaratna yoga,Swarna Malini vasanta,Makaradwaja.
Children-Kumarakalyana rasa
Diabetic patient-Vasanta
Kusumakara rasa
Old age and other degenerative patients- Yogaraja guggulu ,Shiva Gutika.
Swasa patients- Swarna malini vasanta,Agatsya rasayana,Arogyavardhini.
Females - Chandraprabha
General drugs- Arogya vardhini rasa, Muktayukta Kamadugha rasa.
Leha – Chyavanaprasa,Narasimha rasayana.
Arista- Kumaryasava ,Draksharista , Pippalyasava.
Specific to Disease-Fever is the main
symptom in these infectious conditions so the drugs told in Jwara chikitsa can
be used- Mrtyunjaya rasa,Amrutarista,Pippalyasava.
Folklore preparations like-Kashaya of
Amruta,Shunti,Kirata tikta,Majjige soppu etc
Specific to organisms- Study of the
effect of Kashaya or drugs on those specific organisms
Depending upon symptoms etc these drugs may vary.
That is left to physician’s choice.
Disinfection Method- Maintain the Hygiene
in city.
Provide
clean drinking water
Dhupana in every house and in public
places.
Grow Neem ,Aswatha trees in the
city.
Public Daivavyapasraya treatment.
Treat pets as pets not as your
brother or partner.
Control of Vectors- mosquitoes or
Hosts –pigs
[Direct relation is not established in
Ayurveda.]
Don’t oppose vaccination.[ should have
the knowledge about company lobby]
Use of Mask is not proved But don’t oppose,
nor support by saying wear Neem oil masks.Further research is needed.
Scope
for research- Need to get clear knowledge about these preventive measures.
Like
For how long we should take, what might be the mode of action etc.
Treatment-1 According
to Samprapti
2 Target the organism
3 Treat the symptom
4 Manage the complications
If
you have any doubt or you are not confident about yourself refer the patient.
But discuss your problem with others.
Scope
for research-I feel many drugs in our science are good against infections or
organisms .There is a need to identify and record it so that we can improve our
treatment.
Alert
scale - accept WHO
guidelines.
Implication
of WHO grading for Ayurvedic Management-
WHO
Grade
|
Monitoring
- Assessment
|
Action
plan
|
Phase1-Only
animal infection
|
Observe
the symptoms in animals, complication etc
Their
reaction, Plants they eat etc.
|
Plan
the treatment in animals
Observe
the people who come in contact with infected animals
|
Phase2-Potential
pandemic treat-Animal virus caused infection in humans
|
Monitor
the symptoms, severity, and epidemic threat.
Inform
all doctors about possible outburst ,its nature,Gather information from Old
Vaidya about their experience.
|
Treat
the patient accordingly.
Cosider
the seasonal dosha vitiation,Protect others by following Swasthavruttha and
Drugs which improve the bala ,Disinfection measures like dhupana etc
|
Phase
3 –Sporadic incidents but no human to human transmission.
|
Assess
the symptoms at different Desa,Kaala
Effect
of different drugs.
Good
communication between Doctors.
|
Form
a committee to assess and monitor the situation.
Educate
the people about preventive measures.
|
Phase4
Human to Human transmission
|
Increase
surveillance.
|
Limit
the movement of affect population
Gather-monitory,Drug,etc
resources .
Form
many local working bodies to collect the information.Exchange the views and
findings.
|
Phase5
and Phase6
More
countries
|
No
need to discuss
|
|
Post
pandemic period
|
Share
the experience.
Review
the lessons learnt
Evaluate
the pandemic characteristics etc
|
Evaluate
the total operation.
Replenish
the Resources
Fill
the lacuana
|
Conclusion-
1
Sometimes
I feel there is a need to evaluate our self. शास्त्रमेवादितः परीक्षेत…
( refer Charaka Samhita,Vimana sthana
for Shaastra pariksha.)
2 We should not lose our identity and
also dignity. Someone has to take ATREYAs role it may be an institute or
committee to make conclusive remarks on any subjects.
3To improve Surgery, Ulcer and Fever
management we need to accept infection.
4Truth has many faces and Infection is
also a truth and result is in front of us it is left for us to accept it or reject.
I think Present need is “accept.”
5 Know the limitations not to limit you
but to grow yourself.
6 Only by proper study we can develop
our science not by statements or by misguiding the public.
7 Government should consider and
support Ayurveda whenever such pandemic threat appears. Ayurveda should be
included in National Pandemic Management. Then only Reporting system,
Monitoring etc in Ayurveda will develop.
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