COVID -19 &

AYURVEDA :-some
thoughts
RAJEEV BHASKARAN PILLAI

Medical Practitioner

Ayus Arogya Kendra,

Perumbavoor, Kerala

Email: drbrajeev@gmail.com

Phone: 9447575905
Role of Private Ayurveda Practitioners

 Today, Ayurveda is alive & kicking and expanding exponentially because of a

major and dominant role played by private practitioners. There are a good
number of passionate physicians across the country, who have dedicated their
life to Ayurveda & serving through their honest practice without any
grandeur, glare of publicity or hype.
 In clinics of those unsung heroes of Ayurveda, one gets a real opportunity to
appreciate the beauty of what our Acharyas have promulgated.
Theorems and principles of Ayurveda
Practice
 Ayurveda is the Shastra which encompasses in-depth medical theorems and
principles which are evolved after close and constant experimentation and
also best peer reviewed for many centuries in human subjects by expert
Ayurveda scientists who were clinicians themselves.
 Thus these scientifically validated and established theories and principles are
the most reliable and pertinent evidence base to precisely guide and monitor
Ayurvedic clinical practice.
Ayurveda- ‘Evidence Based Medicine’

 Ayurvedic evidences insist to illicit the true scientific

rationale behind the effectiveness (not efficacy) of any
therapy and “administer after knowing” their optimised use
with respect to the medical situation.
 This being the science & rationale behind a drug and its
action, ayurvedic treatment doesn’t look at treating a
pathogen, instead it refurbishes immune response, at
different levels, to fight against intrusion while strengthening
the host to resist the virulence of infection.
 Scope of Ayurveda protocols

1. Possibility of standardisation of treatment protocols with respect to the

medical situations.
2. Evidence based guidelines will accurately optimise the diagnostic and
therapeutic decisions of Ayurveda practitioners.
4. Abandon the unnecessary excessive expenses in treatment and indiscriminate
exploitation of raw drugs.
5. On the target, fast and accurate therapeutic accomplishment (cure).
6. Simplification and clarification of the complexities and subtleness of Medicine.
7. The guidelines will accurately fit to the unique state and stage of a disease of
the individual and thus provide the best individual patient care.
Drug Research & Ayurvedic Concepts

 Predominantly, drug researches done in the field of Ayurveda in the last six
decades have not enriched the Ayurvedic understanding or Ayurvedic
concepts; however, these researches have created a better understanding of
Ayurveda by the modern medical fraternity.
 The researches done in the last 60 years on Herbal Pharmacology have led
confirmation of few concepts like Reverse Pharmacology and use of whole
crude drugs in place of isolation of fractions for clinical trials
 However, all these efforts lead to the enrichment of the knowledge of the
modern medicine and inclusion of some Ayurvedic herbs in modern Materia
Medica.
Clinical knowledge & Research

 The quest for knowledge generates out of inquisitiveness, which ultimately

leads to better understanding and explanation of various phenomena.
 In all ancient sciences, the methods adapted to increase understanding or
knowledge base, are mainly experiential, observational and inferential.
 In the process of development of knowledge the perspective regarding a
scientific concept or criteria of classification may change based on the logical
interpretations and experimental evidences.
EBM & Ayurvedic Clinical Trials

 Methods of exchange of knowledge or testing, presentation and spread of new

knowledge were relevant to those days.
 At times subjectivity used to take center stage on the practical level but the
ultimate objective has always been to search and arrive at truth.
 It is my strong view that the regime of EvidenceBasedMedicine(EBM) clinical
trial with its evidence-based hierarchy is not fit for Ayurvedic clinical trials
EBM clinical trial regimens limit the use of :-

 Prakriti,
 Dosha Anubandha-Anubandhyatwa,
 Arambhaka and Anugami Dosha Vikalpa,
 Swanidana Prakopa, Awaranajanya Prakopa,
 Prakriti SamaSamveta-Vikritisamasamveta,
 Amavashtha-pakvavastha, which leads to variation of dose, dosage, form,
rout of administration etc.
 Aushadhikaala, Anupaana, Sahapaana, Pathyaapathya, therapeutics like
Panchakarma procedures to be adopted, etc.
Pinpointed Ayurvedic Diagnosis

 Hence, if the desired results of actual clinical practices are to be recorded,

the protocols should be prepared on these lines, supported by EBM suitable
for the purpose.
 Ayurveda requires research in the areas of diagnostic principles of Ayurveda
so that the Ayurvedic diagnosis can be made more pinpointed leading to more
effective treatment strategies.
Challenges

 Health care professionals unable to prove that they prevent disease, improve
health or restore function will not be reimbursed for their service
 Ayurveda cannot justify its existence on the basis of what it does for patients,
it will cease to be a profession in all too short time.
 Instead of viewing increased accountability as a problem or threat, we must
view it as an opportunity to document the positive contributions Ayurveda
makes to the public it serves.
 The bridge between what Ayurveda Physicians believe they contribute to
improving patient function and the documentation of those improvements is
clinical research.
JWARA in COVID19

 Jwara is a disease of Rasavaha Srotas having its origin from Amashaya,

resulting due to Agnimandya and presented with Santapa (raised body
temperature), Swedaavrodha (anhidrosis) and Angamarda (body ache) as its
cardinal features.
 All most all the infectious diseases (viral/bacterial) presenting with raised
body temperature as predominant feature have been categorized under
Jwara.
ROGI & ROGA PAREEKSA
Pariksa (Examinations)

1. Rogi Pariksa 2. Roga Pariksa

The person (patient/Rogi) Disease (Vyadhi/Roga)
Constitution of Patient Nature of Disease
Bala (Strength of the patient) Bala (Strength of disease)

 Dvividha Pariksa Nidana

 Trividha pariksa  Purvarupa
 Caturvidha Pariksa  Rupa
 Pancavidha Pariksa  Upasaya
 Sadavidha Pariksa  Anupasaya
 Astavidha Pariksa  Samprapti
 Dasavidha Pariksa  Sadhya Asadhyata
 Sadanga Pariksa  Arista Laksana
 Srotasa Pariksa
Differential diagnosis : Jwara and it’s
stage.
 On the basis of predominance of Dosha and Dhatugata Avastha, Jwara has
been classified into various types and while deciding the line of treatment, all
these types are to be considered.
 For deciding the line of treatment, differential diagnosis among the Doshic
varieties:-
1 Sama – Nirama Avastha,
2.Nava- Jirna Avastha
3.Dhatugata Avastha or other presentations like
4.Punaravartaka Jwara 5.Oupasargika Jwara are considered.
Clinical Diagnosis:

 Patient should be diagnosed on the basis of

1. History of illness & travel,
2. Degree of fever,
3. Onset,
4. Associated symptoms,
5. Chronicity, Complications , co-morbidities like Cardiovascular
disease,●Diabetes mellitus●Hypertension●Chronic lung
disease●Cancer●Chronic kidney disease●Obesity..etc
PATHYAA- Do’s -

 Aahara: Shadanga Paniya (medicated water prepared by Musta, Parpataka,

Ushira, Chandana, Nagara, Udichya), Tarpana prepared of the Laja Saktu
(Churna of perched paddy) mixed with honey, sugar and juices of fruits,
Mudga Yusha.
 Yavagu (gruel), odana (boiled rice) and Laja (popped or perched paddy), Peya
prepared with Laja / Yava added with Nagara, Pippalimula, Amalaki,
Mrudvika, vegetables like Patola, Karavellaka, Karkotaka.
 Vihara: complete bed rest, staying in well ventilated room with hygienic
conditions
APATHYAA-Don’ts –

 Aahara: Heavy food, curd, green peas, black eyed beans, lentils, yellow gram,
black gram, raw vegetables and salads, refined foods such as white flour
(Maida), contaminated water or food, sprouts, cold food and beverages, junk
foods, fried food, bakery items.
 Vihara: Physical and mental exertion like physical exercises, exposure to cold,
breeze, suppression of natural urges, taking bath with cold water etc.
BHESHAJAM- Selection of DRUGS

 Considering different factors like pharmacodynamics, absorption,

penetration, route of administration, distribution, preservation, receptors &
clinical applications, Acharyas developed multiple dosage forms but with
stringent criteria.
 For any formulations, under any category, to be called an ideal therapy, it
must alleviate a disease but never aggravate or affect other normally
functioning system.
 Behind this safety framework, there was a sound & rational view about
synergistic and modulating activity of medicines and their pharmacokinetics.
Prasastha Bheshajam

 The Karma-activity, Veerya-active principle, Adhikarana-

site of action, Kaala-half-life, Upaya-bio-synthesis and
Phala-efficacy are explained lucidly by Acharya Charaka.
 The healing property of a drug is not just due to its
inherent quality alone (this is the reason why clinically
some drugs shows certain activity but not able to replicate
the same when its active participants are isolated )
 Bahukalpam, Bahugunam , Sampannam & Yogyam
Importance of Rasaoushadhas

 In order to substantiate the legitimate role of Rasoushadhas, we need

to relook at stringent methodology prescribed to prepare, precautions
to be followed and research done to substantiate safety and
effectiveness in management of intractable conditions using mineral
preparations
 Mineral and metallic ingredients are treated with plant and/or animal
substances, compatible with human body and processed to make it
harmless. The processing techniques are much superior & stringent
than those followed during Samhita period, which were confined to
quenching techniques
BHASMA: Nano-Medicine of Ayurveda

 Bhasmas are the most ancient form of

administration of nano-medicine. Analgesic, anti-
inflammatory, immunomodulatory, anti-oxidant,
free radical scavenging, activities of bhsmas have
been identified and nano-technology is held
responsible for all these properties due to its
target-oriented technology. Novel nano-
technological application has given new thrust to
Ayurvedic pharmaceutics
Ayurvedic Pharmacopeia

 Each physician is having divergent views right from

correlation of pathophysiology to selection of medicines,
but all are having potential to ameliorate COVID-19
symptoms viz., ease the respiratory distress, quicker
clearance of chest infection, better control over fever,
reducing inflammation, boosting the immunity by
detoxification, bringing down the pathogenicity &
transmissibility of SARS-CoV-2, which in turn improving the
rate of recovery & decrease the mortality
 Category-I General public (excluding Doctors, Health workers,
COVID-19 confirmed and suspects.)

 Prevention and Curative part of management:

1. General immunity enhancers like Haridra, Tulasi, Twak, Shunti,
Maricha, Ajamoda, Jeeraka, Dhanyaka, Lashuna, Guduchi,
Tailaparni can be taken preferably after consulting Ayurveda
doctors.
2. Chyavanaprasha, Haridra khanda, Agastya Haritaki
Rasayana, Vasavaleha,Pippali Rasayana, Indukanta Ghrita, with medical advice.
Category-II Doctors, Health workers, and all
those who handle COVID-19 confirmed and
suspected cases.
 Dashamoola Katutraya Kashaya, Amruthotharam
Kashaya, Nimbamrutadi Kashaya, Nayopayam
Kashaya, Amritharista, Dashamoolarista, can be
used in prophylactic dose.
 AgastyaHaritaki Rasayana, Vasavaleha, Vyoshadi
Vataka,Talisadya Churna, Karpooradi Churna,
Amrithaprasha Ghrita, Pippalyadi Ghrita,
Indukanta Ghrita,
Category-III COVID-19 suspects kept in
quarantine.
 Dashamoola Katutraya Kashaya, Amruthotaram
Kashaya, Kiratha Tikthakam Kashaya,
Nimbamrutadi Kashaya, Nayopayam Kashaya,
 Samshamani Vati,Dasamula Rasayana, Pippali
Rasayana , Mathala Rasayana, Ashwagandha
Rasayana, Brahma Rasayana, as per individual
requirements after assessing Rogi-Roga Pariksa
Category-IV COVID-19 confirmed cases with
mild to moderate symptoms.(Isolation ward)

 Shadangam /Kiratha tikthakam Kashayam / Vettumaran / Surya

prabha Gulika
 Tribhuvana Keerthi Rasa, Naradiya Lakshmi Vilasa Rasa,
Swasanandam
 Sudharshana Ghana Vati, Amritharista, Dashamoolarista,
Pushkaramoolasava, Somasava,
 Thamboola Rasayanam, Pippali Rasayanam, Chathushashti
Prahari pippali
 Maha lakshmi Vilas Rasa, Kaphaketu Rasa, Shwasakutara Rasa
can be given after individual assessment.
Category-V COVID-19 confirmed cases -
critical illness in ICU without multi-organ failure

 Brihat Shwasa Kasa Chintamani Rasa, Maha

Mruthyunjaya Rasa,
 Hemagarbha Pottali Rasa, Mallasindhura Rasa,
Siddha Makara Dhwaja
 Vasakarista, Kanakasava, Somasava , Kasthuri
Kalpa Rasayana can be administered in patient
centric doses.
Preventing exposure in the community —

 If community transmission of SARS-CoV-2 is present, residents should be encouraged to

practice social distancing by staying home as much as possible and maintaining six feet (two
meters) distance from others when they have to leave home. In particular, individuals should
avoid crowds and close contact with ill individuals.
●Diligent hand washing, particularly after touching surfaces in public. Use of hand sanitizer that
contains at least 60 percent alcohol is a reasonable alternative if the hands are not visibly dirty.
●Respiratory hygiene (eg, covering the cough or sneeze).
●Avoiding touching the face (in particular eyes, nose, and mouth). The American Academy of
Ophthalmology suggests that people not wear contact lenses, because they make people touch
their eyes more frequently .
●Cleaning and disinfecting objects and surfaces that are frequently touched.
These measures should be followed by all individuals, but should be emphasized for older adults
and individuals with chronic medical conditions, in particular.
Prevention: Natural Home remedy
Prevention: Kabalam &Gandusham
–REHABILITATION

 APATHYAA-Don’ts Aahara: Heavy food, curd, green peas, black eyed beans,
lentils, yellow gram, black gram, raw vegetables and salads, refined foods
such as white flour (Maida), contaminated water or food, sprouts, cold food
and beverages, junk foods, fried food, bakery items. Vihara: Physical and
mental exertion like physical exercises, exposure to cold, breeze, suppression
of natural urges, taking bath with cold water etc.
 Regular use of the following: Indukantham Kashayam, Indukantha Ghritham ,
Agasthya Rasayanam
 Vardhamana Pippali Rasayanam under medical supervision
 Abhyangam, Sneha- Swedopachara as per medical advice
 Following Hritucharya … to regain health
Ayurveda –Need of the hour

 When a premier organization like WHO allegedly compromised & ignored the
timely dissemination of facts, it won’t be a surprise if our decision-making
bodies are prejudiced against Ayurveda to safeguard their interests. At this
juncture arises one important moral, ethical & even legal question, which
demands an honest attention of yours.
 Till date, when there is no specific conventional treatment available to
prevent or to mitigate SARS- CoV-2, as admitted by WHO, why ayurvedic add-
on intervention, involving classical medicines, which are already approved
under D&C Act and are extensively used in treating different ailments, is
denied when the pandemic is unleashing havoc?
ARISE & AWAKE…
Acknowledgments & References

 Highly indebted to Dr.Niranjana Murthy. M.D.(Ayu.) Managing & Medical Director, PENTACARE
AYURPHARMA,BANGALORE-560003 for allowing me to use his ideas/words / approach in this article.
 Dr Rajkumar & Dr Remya Krishnan, HODs Rajiv Gandhi Ayurveda Medical College Mahi,Puducherry for the
concept of Science Based Evidence Based Ayurveda “SBEBA”
 Charaka Samhita, Ni. 8/23.
 Sushruta Samhita, Su. 1/32 & CS Su.1/68
 Savrikar, S. S., & Ravishankar, B. (2011). Introduction to 'Rasashaastra‘
 Biological Evaluation of“Mahamrutyunjaya rasa”-Pallavi D, et al.,
 TN Sathya, Balakrishna Murthy PNV. Vardhini, Genotoxicity evaluation of certain Bhasmas using Micronucleus and Comet
assays, Internet journal of Alternative Medicine, 2009:
 Dr.Niranjana Murthy. M.D.(Ayu.) Managing & Medical Director,PENTACARE AYURPHARMA,BANGALORE-560003.
 Rasa Rathna Samuccaya. by Vagbhata. 28/1.
 Almeida JP, Figueroa ER, Drezek RA. Gold nanoparticle mediated cancer immunotherapy.Nanomedicine,2014;10:503