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A REVIEW OF PANCHAKARMA THERAPIES WITH RESPECT TO BALA (IMMUNITY) FOR PREVENTION AND MANAGEMENT OF COVID-19 INTERNATIONAL AYURVEDIC MEDICAL JOURNAL

Authors:
  • National Institute of Ayurveda Jaipur

Abstract

Introduction: Worldwide prevalence rate of COVID-19 is increasing day wise, and estimated at 6.6% in the Indian population in August 2020, the curable medicine and immunization for COVID-19 is not available yet. The disease COVID-19 can be compared with Janapadodhansa Vyadhi (Epidemic) mentioned in Ayurveda. Panchakarma therapies are advised in Janapadodhansa Vyadhi. Virus is very prominent, and it is the common cause mentioned in both. The Ayurved fraternity and people have fear about Panchakarma therapies in the COVID-19 era. Aim: need of current situation is to find applicability effectiveness of Panchakarma therapies. Methodology: By critical literary search of Classical Ayurvedic texts, electronic media, PubMed, indexed Journal, Google scholar is carried out and observations were recorded. Observation and Results: Panchakarma helps to increase Bala (Immunity) and improves immunomodulation effect of Rasayana (Rejuvenation) medicine. Fever, Headache, Common cold, Cough, Dyspnea, these are common symptoms found in COVID-19 and Panchakarma therapies are indicated in the same. Conclusion: Panchakarma Therapies, are independently advocated for improvement of Bala (Immunity) and as a preoperative measure for improving immunomodulation property of Rasayana (Rejuvenation) medicines. These principles of Panchakarma Therapies can be applied in prevention and treatment of COVID-19 disease.
Review Article ISSN: 2320 5091 Impact Factor: 5.344
A REVIEW OF PANCHAKARMA THERAPIES WITH RESPECT TO BALA
(IMMUNITY) FOR PREVENTION AND MANAGEMENT OF COVID-19
Vedpathak S1, Bapat V2, Tanwar V3
1Professor and HOD, PG Department of Panchakarma, NIA, Jaipur, Rajasthan, India
2Panchakarma Vaidya, NIA, Jaipur, Rajasthan, India
3Panchakarma Vaidya, NIA, Jaipur, Rajasthan, India
Corresponding Author: drsurendravedpathak50@gmail.com
https://doi.org/10.46607/iamj.3408112020
(Published online: November 2020)
Open Access
© International Ayurvedic Medical Journal, India 2020
Article Received: 31/10/2020 - Peer Reviewed: 06/11/2020 - Accepted for Publication: 08/11/2020
ABSTRACT
Introduction: Worldwide prevalence rate of COVID-19 is increasing day wise, and estimated at 6.6% in the Indian
population in August 2020, the curable medicine and immunization for COVID-19 is not available yet. The disease
COVID-19 can be compared with Janapadodhansa Vyadhi (Epidemic) mentioned in Ayurveda. Panchakarma ther-
apies are advised in Janapadodhansa Vyadhi. Virus is very prominent, and it is the common cause mentioned in
both. The Ayurved fraternity and people have fear about Panchakarma therapies in the COVID-19 era. Aim: need
of current situation is to find applicability effectiveness of Panchakarma therapies. Methodology: By critical liter-
ary search of Classical Ayurvedic texts, electronic media, PubMed, indexed Journal, Google scholar is carried out
and observations were recorded. Observation and Results: Panchakarma helps to increase Bala (Immunity) and
improves immunomodulation effect of Rasayana (Rejuvenation) medicine. Fever, Headache, Common cold,
Cough, Dyspnea, these are common symptoms found in COVID-19 and Panchakarma therapies are indicated in the
same. Conclusion: Panchakarma Therapies, are independently advocated for improvement of Bala (Immunity)
and as a preoperative measure for improving immunomodulation property of Rasayana (Rejuvenation) medicines.
These principles of Panchakarma Therapies can be applied in prevention and treatment of COVID- 19 disease.
Keywords Ayurveda, Bala, COVID-19, Janapadopdhansa, Immunity, Immunomodulator, Panchakarma, Ra-
sayana, Rejuvenation.
INTERNATIONAL
AYURVEDIC
MEDICAL JOURNAL
Vedpathak S et al: A Review Of Panchakarma Therapies With Respect To Bala (Immunity) For Prevention And Management Of Covid-19
doi:10.46607/iamj.3408112020 | IAMJ November 2020 | www.iamj.in
5169
1. INTRODUCTION
In this era, large number of people are suffering from
the disease COVID-19, second serological survey
study conducted by Indian Council of Medical Re-
search (ICMR), Delhi, India, showed that, one in 15
people aged 10 years and above were exposed to
COVID-19 by August 2020 with prevalence of the in-
fection estimated at 6.6% in the population, adults at
7.1%, urban slums at 15.6%, non-slums and rural areas
4.4% in population1. CoVs (Corona Virus) are positive-
stranded RNA virus with a crown-like appearance
(Coronam is the Latin term for crown) due to the pres-
ence of spike glycoproteins on the envelope. In 2020
the W.H.O. announced that the disease caused by this
new CoV was a ‘COVID-19’, which is the acronym of
‘Coronavirus Disease 2019’. At present no medicine is
available to cure and vaccinate for immunization of
COVID-19 and it’s a well-known fact. We can co-re-
late the COVID-19 disease with Janapadodhansa
Vyadhi (Epidemic) described in Ayurveda, because
symptoms of both are very similar. Panchakarma are
more useful for patients who suffer from such kind of
diseases, that they find procedures and death on similar
level. In such conditions Panchavidha Karma namely
Vamana (Emesis), Virechana (Purgation), Basti (Drug
enema), Nasya (Errhine) and Raktamokshana (Blood-
letting) said to be beneficial. Panchakarma therapies
are advised in the treatment of Janapadodhansa Vyadhi
(Epidemic), seems to be neglected in overwhelming
fear of COVID-19 pandemic. If we neglect classical
treatment protocol and expect result from Ayurveda
treatment then it could be the forbidden fruit. Present
literary study is aimed to find efficacy of Panchakarma
on the basis of Bala (immunity) and improving im-
munomodulation effect of Rasayana (Rejuvenation)
medicines for prevention and treatment of COVID-19
disease.
2. Methods
Literary study deals with, Step I- To study different as-
pects of COVID-19 disease and its probable co-relation
with Janapadopdhansa Vyadhi (Epidemic) mentioned
in Ayurveda.
Step II- To Check literature about Panchakarma Thera-
pies can improves Bala (Immunity), as well as its im-
munomodulation enhancing property of Rasayana (Re-
juvenation) medicines. With keen evaluation of Classi-
cal Ayurvedic texts, electronically published and In-
dexed scientific Journals and printed peer reviewed re-
search articles literary review is conducted, and finally
report will be prepared an interpretation and synthesis
of outcome.
3. Review Of Covid-19 And Janapadodhansa
Vyadhi (Epidemic)
Corona virus is transmitted from human to human in a
chain, symptomatic patient is the most source of
spreading infection of COVID-19. Due to the possibil-
ity of transmission before symptoms, the individuals
who remain asymptomatic could transmit the virus,
thus isolation is the best way to control this epidemic.
Other symptoms are flu, and rhinovirus, it may be
transmitting through respiratory droplets particle size is
less than 5 to 10 micrometers, from coughing and
sneezing. Incubation period is generally within 3 to 5
days and 2 weeks considered longest. Contamination
occur in floors, computer mice, and patient’s bed, hand-
rails of staircase, door etc. also in air up to 4 meters
from patient2. Causes of Janapadodhansa Vyadhi (Ep-
idemic) mentioned in Ayurveda are, however without
unnatural season, there is possibility of death of people
because of: Abhishap (Malediction, Blight) or Kritya
(magic), Anger of Rakshasadi (Demons), or production
of disease due to air pollution, or Visha (Virus)3, or
Aushdha (Medicines), or Pushpagandha (Smell of
flowers), being spread in the region4. Vayu (Air), Jala
(Water), Desha (Region), and Kala (Season) are viti-
ated due to unnatural seasons, Shastra Prabhav
(Fighting by weapons), Rakshogana (Organism, virus),
Vividha Bhuta Sanghata (various groups of ghost), Ab-
hishapa (malediction, blight)5 Rains in Hemanta Rutu
(pre-winter) considered to be unnatural thing,
Suryasantapa (Sunrays) perceived during Sharad Rutu
(autumn) can produce Pittaprakopa (exaggerated
Pitta)6 Symptomatology of COVID-19 described as
follows: Fever, malaise, dry cough, and dyspnea. This
may be present with mild, moderate, or severe illness.
Vedpathak S et al: A Review Of Panchakarma Therapies With Respect To Bala (Immunity) For Prevention And Management Of Covid-19
doi:10.46607/iamj.3408112020 | IAMJ November 2020 | www.iamj.in
5170
Asymptomatic or Pauci-symptomatic, Mild disease:
like non-pneumonia and mild pneumonia, Severe dis-
ease: dyspnea, respiratory frequency is greater than or
equal 30/min. SpO2 is less than or equal 93%,
PaO2/FiO2 ratio or P/F and the percentage of oxygen
supplied is less than 300, and /or lung infiltrates less
than 50% within 24 to 48 hours. Critical disease: res-
piratory failure, septic shock, and/or multiple organ
dysfunction (MOD) or failure (MOF)7 Symptoms of
Janapadodhansa Vyadhi (Epidemic) in Ayurveda de-
scribed as: At any given time, people suffer with same
symptoms of a single disease8. Amongst them some
common symptoms are Kasa (Cough), Shwasa (Dysp-
nea), Vamathu (Vomiting), Pratishaya (Common
cold), Shirorug (Headache) and Jwara (Fever)9. Batal-
ika Pitka (Watery blisters) present on the body parts
like Kakshaya (Upper and lower extremities), Urumula
(Origin of the thigh), Tala of Pani and Pada (Palm and
sole), Kantha (Throat), Shrotram (Ear), Vasti (Bladder)
and Hrudaya (Heart)10. Pathology of Janapadodhansa
Vyadhi (Epidemic) described in Ayurveda as per fol-
lowing: At a time people suffered from symptoms of a
single disease i.e. Janapadodhansa Vyadhi (Epidemic)
even if they have different Prakruti (Constitution),
Ahara (Diet), Deha (Body), Bala (Power), Satmya (Ad-
diction), Mana (Mind), and Ayu (Age). This happens
because of Vikriti (Vitiation) in Samanya Bhava (Gen-
eral causative factors) like Vayu (Air), Jala (Water),
Desha (Region), Kala (Season). And because of Unnat-
ural Nakshtra (Stars), Grahagana (Planet), Chandra
(Moon), Surya (Sun), Vayu (Wind), Agni (Fire), and
Disha (Side), etc. as well as unnatural Rutu (Seasons)
affects immediately on properties of the medicines that
gets destroyed11. When patient have severe symptoms
then deaths occurs in population so Janapadodhansa
disease is also called as Janamar. Mostly it is a Pitta
and Shleshma Pradhan disease, associated with Vata-
shonita12. Contamination spreading through: house,
bed and sitting site, vehicle, Mani (Gem), Ratna
(Stone), and other contaminated utensils13. Vayu (Air),
Jala (Water), Desha (Region), Kala (Season), Chitraka
(Plumbago Zeylanica), Dhanyeshu (Rice, grains etc.),
Moolaphaleshu (Ground roots and fruits)
Humans can also suffer from the said Vyadhi14. Treat-
ment of Janapadodhansa Vyadhi (Epidemic) stated in
Ayurveda as: Sthanapridyaga (Shifting residence),
treating the said disease we should use uncontaminated
medicines and water. For Kalyana (Fortunate), it is ad-
vised to collect the medicines before Bhumi (Soil) gets
vitiated due to unnatural Rutu (Season), and prepare
good quality medicines, such medicines should be used
in the patients; considering Ayurvedic properties like
Rasa, Virya, Vipaka and Prabhava. Good quality med-
icines can cure the epidemic without any difficulty.
Panchakarma are more useful for patients who suffer
from such diseases, that they find procedures and death
on similar level15. Panchakarma namely Vamana (Em-
esis), Virechana (Purgation), Basti (Medicated enema),
Nasya (Errhine), Raktamokshana (Bloodletting) and
Rasayana treatments are most beneficial when admin-
istered as per protocol16
4. Panchakarma Therapies Have Bala (Immun-
ity) Enhancing Potential
Vigor of seven Dhatus (Rasa to Shukra) is known as
Oja; and Bala (Immunity) is another name of Oja
(Vigor)17. Bhahudosh Awastha Laxana- Balanash (im-
munocompromised state) is mentioned in symptoms of
Bahudoshavastha in which Panchakarka therapy are
especially indicated18. Panchakarma therapies increase
Bala (Immunity) as mentioned in its benefits of per-
forming Panchakarma therapies19. Laxanas of
Prakrutistha Purusha (Signs of normal human health)
occurs when cleansing is done through Panchakarma
therapies20.
5. Understanding Concept Of Mala (Root
Causes) With Present Perspective
There are two types of body Dhatus, one is Malabhuta
and another is Prasadbhuta, out of these Malabhuta
Dhatus can produces difficulties in the body, therefore
they are known as Sharirasya Badhakaraha (Harmful
elements) of the body, elements that stick to Srotas (eg.
Ama, undigested food constituents, saturated choles-
terol, etc.), differently produced and excreted Malas
from the eyes, ears, nose, etc. ripened Dhatu means
Vranotpattijanya Puya (Ulcerative pus) of Rasa
(Plasma), Rakta (Blood), Mansa (Muscle), Meda (Vasa
Vedpathak S et al: A Review Of Panchakarma Therapies With Respect To Bala (Immunity) For Prevention And Management Of Covid-19
doi:10.46607/iamj.3408112020 | IAMJ November 2020 | www.iamj.in
5171
excreted from Mansa), Asthi (Bone), Majja (Bonemar-
row), Shukra (Semen), decreased or exaggerated Vata,
Pitta and Kapha Doshas, (Vata means Eerana that fills
the gaps and the minute and large pores of the body.
Pitta means Fluids like gastric juices used for digestion
and nutrition, pancreatic juice and blood or much of the
substances latent in these fluids are included in Pitta
Dosha. Kapha denotes all fluids and solid parts of the
body like saliva, lymph, plasma, fat, mucus mem-
branes, and mucus when they are at their proper places
are called as Kapha Dosha)21. Kapha denotes mucus in
terms of mucopolysaccharides22. Any other body con-
stitute produced eg. endocrinal, allergic conditions etc.
and also, Androgen, T-cells, and Thyroxine are related
to Pitta (mesomorphic or andrus), Kapha (endomor-
phic or thymus), and Vata (ectomorphic or thyrus), re-
spectively23, thus all these can be harmful to immune
system, or produce disease in the body, therefore they
are called as ‘Mala’ 24.
6. Shodhana (Cleansing) Gives Booster To Im-
munmodulators Like Rasayana (Rejuvenation)
Cleansing of Mala present in the body by administrat-
ing Panchakarma therapies is essential before Ra-
sayana (Rejuvenation) medicines like Brahmarasayan,
Amalak rasayan, Chawanprash rasayan and Vajikarna
(Aphrodisiac) medicines like Madhuyashti yoga, Ama-
lak yoga, Vidaryadi yoga otherwise it does not produce
desired immunomomodulatory effect, just like painting
on a dirty cloth25. Koshtha means Mahasrotas (Ali-
mentary canal)26, Koshtha includes the organs
Amashaya (Stomach), Agnyashaya (Pancreas), Pa-
kashaya (Intestine), Mootrashaya (Kidneys & Blad-
der), Rudhirashaya (Liver & Spleen), Hrudaya (Heart),
Unduk (Caecum) and Phuphus (Lungs)27. Cleansing of
Mala present in all above organs is achieved by admin-
istering Panchakarma therapies which further gives
booster to immunmodulators like Rasayana (Rejuvena-
tion) and Vajikarna (Aphrodisiac) medicines. Srotas in
the body are Pranavaha (Air channels) Udakavaha
(Water channels) ,Annavaha (Food channels),
Rasavaha (Essence channel), Raktavaha (Blood chan-
nels), Mansavaha (Muscle channels), Medovaha (Fat
channels), Asthivaha (Bone and cartilage channels),
Majjavaha (Bone marrow channels), Shukravaha
(Ovum and sperm channels), Mootravaha (Urinary
channels), Purishavaha (Excretory channels), Sveda-
vaha (Sweat channels)28, Artavavaha (Menstrual chan-
nels)29. Cleansing of Mala present in all above Srotas
(Channels) is done by administering Panchakarma
therapies which is prerequisite for Vajikarana (Aphro-
disiac) medicines and improved sexual power and
Balapradam (Immunomodulation). Rasayana pro-
motes nutrition by explicitly enriching the nutritional
value of Rasa by enhancing Agni, i.e. digestion, metab-
olism, and absorption (by Srotoshodhana). Conse-
quently, any medication that improves Rasa’s con-
sistency would enhance the health of all body tissues.30
7. DISCUSSIONS
Both diseases are identical in nature, Janapadodhansa
is epidemic, COVID-19 is also epidemic, declared by
WHO. Virus is very prominent cause of both disease.
Janapadodhansa Vyadhi caused due to Visha (Virus),
and disease COVID-19 caused due to Corona Virus
(CoV). Infection of Visha (Virus) and CoV transmitted
by droplet of coughing and sneezing. Both disease hav-
ing similar signs and symptoms, Janapadodhansa
Vyadhi have Laxanas (Symptoms) like Kasa (Cough),
Shwasa (Dyspnea), Vamathu (Vomiting), Pratishaya
(Common cold), Shirorug (Headache), Jwara (Fever)
and Batalika Pitka (Watery blisters), disease COVID-
19 have signs and symptoms like fever, malaise, dry
cough, and dyspnea. Contamination occurred in uten-
sils, Vayu (Air), Jala (Water), Desha (Region), Kala
(Season), medicines and food items etc., are mentioned
in Janapadodhansa Vyadhi (Epidemic). And floors,
computer mice, trash cans, and sickbed, handrails as
well as in air up to 4 meters from patients etc., are men-
tioned in disease COVID-19. Anyone can get infected
from this disease, in Janapadodhansa Vyadhi (Epi-
demic) it has been mentioned that, at a time people hav-
ing different Prakruti (constitution), Ahara (Diet),
Deha (Body), Bala (Power), Satmya (Addiction), Mana
(Mind), and Ayu (Age), suffer from a single type of dis-
ease. The same is observed in disease COVID-19, that
anyone can get infected, those who come to close with
the patient. In the treatments of both disease it has been
Vedpathak S et al: A Review Of Panchakarma Therapies With Respect To Bala (Immunity) For Prevention And Management Of Covid-19
doi:10.46607/iamj.3408112020 | IAMJ November 2020 | www.iamj.in
5172
mentioned that quarantine of the patient is necessary to
avoid further spreading. Panchakarma procedures are
more beneficial for patients who suffer from such kind
of diseases, that they find procedures and death on sim-
ilar level. We observed above similarities between
COVID-19 and Janapadodhansa Vyadhi (Epidemic).
Therefore, we can consider Symptomology, Treatment
protocol etc. of Janapadodhansa Vyadhi (Epidemic)
mentioned in Ayurveda for prevention and manage-
ment of COVID-19. Panchakarma therapies have po-
tency to improve Oja (Vigor) and Bala (Immunity),
cure Balanasha (immunocompromised state) and ac-
quiring of Prakruti Purusha Laxana (Signs of normal
human health), considering this fact we can advocate
Panchakarma therapy individually to improve Bala
(Immunity) in patients of COVID-19. In preoperative
measures, Snehana (Oleation) and Swedana (Sudation)
procedures are done to well prepare Mala (Root causes)
to come out easily from logged places, and then ex-
pelled out from the body by Shodhana (cleansing) po-
tency of Panchakarma Therapies. Because of detoxifi-
cation of all organs including Koshtha, Srotas and
whole body, Agni Vyapara (Metabolism) gets en-
hanced, pre-existing diseases get cured, Body homeo-
stasis is obtained and ultimately Bala (Immunity) gets
improved at this state body is ready for regeneration
and this regeneration is achieved by Rasayana (Reju-
venation) and Vajikarna (Aphoristic) medicines which
again possess immunomodulation potency. With this
fact we can advocate Panchakarma therapies to im-
prove immunomodulation potency of Rasayana (Reju-
venation) medicines in patients of COVID-19. With the
above discussion we can conclude that Prayojan (Aim)
of Ayurveda i.e. to prevent from disease and maintain
health of desired and to cure agony of the persons can
be achieved by Panchakarma therapies in current sce-
nario of COVID 19 pandemic.
8. CONCLUSIONS
We observed that, Janapadodhansa Vyadi (Epidemic)
and disease COVID-19 are very similar. Panchakarma
therapies independently bears immunity enhancing po-
tency and it acts as immunomodulator when used prior
to Rasayana (Rejuvenation). Panchakarma therapies
can be administered independently and as a preopera-
tive measure of Rasayana following work place guide-
lines in the healthy individuals and in asymptomatic or
mild symptomatic patients of COVID-19.
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doi:10.46607/iamj.3408112020 | IAMJ November 2020 | www.iamj.in
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Source of Support: Nil
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SARS-CoV-2 infection associated respiratory disease- COVID-19 has evolved into a pandemic but, being a new form of virus, pathogenesis of disease causation is not fully understood and drugs and vaccines against this virus are still being tested so that no effective drugs or vaccines have been advised by regulatory authority. In this context, the Ministry of AYUSH, Government of India has recommended ‘Ayush Kwath’ to improve the immunity and combat the infection. Our objective of this literature review is to review the role of immunity in pathogenesis of COVID-19 and role of Ayush Kwath against the virus and regulation of immunity. Current review was conducted using a search of available literature on COVID-19 and immunity, Vyadhikshamatwa, Ayurveda and COVID-19, Rasayana, Coronavirus, SARS-CoV-2, immunomodulatory effects of medicinal plants; Tulsi/Holy Basil/Ocimum sanctum, Dalchini/Cinnamon/Cinnamomum zeylanicum, Sunthi/Ginger/Zingiber officinale and Marich/Black Pepper/Piper nigrum. Ayurveda, being an ancient science have both medicinal and cultural values and had stimulated our kitchen and influenced what we ate in different seasons and the remedies we used for common ailments. Herbs such as Tulsi, Marich, Sunthi, Dalchini are the most commonly used and easily available drugs in home. Thus, Ayush Kwath due to its immune-modulatory, antiviral, anti-oxidant, anti-inflammatory, anti-platelet, anti-atherosclerotic, hepato-protective, reno-protective properties; seems to be effective in immuno-regulation for controlling viral infections like COVID-19. Further pre-clinical and clinical trials need to be done for the evaluation of safety and efficacy of this polyherbal formulation.
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Ayurveda is one of the oldest health sciences of the world with concepts of tridosha and prakriti being core philosophies. These core concepts allow implementation of ways for not only personalized medicine and treatment but also personalized prevention. In the light of modern or current science, evidence has surfaced connecting the concepts of tridosha and prakriti with metabolic pathways, chronic diseases, and various genotypes. Such evidence has thrown up insights about the universality of Ayurvedic concepts as well as their apparent association with concepts in current science. This review was undertaken to consolidate the evidence of such associations which exist between prakriti and metabolic systems, chronic diseases, and genotypes with the objective that a case can be made for drawing out the clear linkages that might exist for prakritis being distinct phenotypes representing certain genotypes. A corollary to such discoveries can be the possibility of newborns being screened for their prakriti by genetic testing, which will enable the prevention of various chronic diseases for such children via the implementation of various dietary, lifestyle, and habitual changes, as required, from an early age. This implementation of preventive practices from an early age may result in such children leading healthy, disease-free, more productive lives. Thus, eventually, this can be an opportunity to practice personalized preventive health, which is not a possibility in other systems of medicine especially western systems of medicine. Personalized preventive health is one step further than personalized medicine and is a very novel idea with far-reaching implications.
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