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<big>'''Abstract'''</big>

<big>'''Abstract'''</big>

<div style="text-align:justify;">This chapter describes causes of environmental calamities leading to annihilation of communities (not limited to epidemics), along with their remedial measures. The queries and solutions about effects of afflictions caused due to such calamities on individuals whose constitution, immunity, lifestyle adaptations are “different”. Any contamination of four factors - vayu (air), udaka (water), desha (land), and kala (season) - results in outbreak of epidemics. To manage these outbreaks, one has to get hold of drugs that are potent in all aspects (rasa, guna, virya, vipaka etc.) well before any outbreak. Per [[Ayurveda]], sins of the present life or the misdeeds of the past life are the root cause of the vitiation of these four etiological factors of epidemics. Negative emotions like greed, anger, ego, mutual fight, and curses of the wise and the learned can destroy mankind. Characteristics of vitiated (polluted) vayu, jala, desha and kala were explained. Life-span of the individual depends on the daiva (predetermined based on the deeds of past life) and purushakara (human efforts in the present life). Administration of cold substances to cure diseases caused by heat or hot substances, and vice versa, was also discussed in the context of jwara and this principle is applicable to other diseases also. All therapies are broadly classified into two categories i.e., apatarpana (depletion therapy) and brimhana (nourishment therapy). Apatarpana (depletion therapy) includes of langhana (reducing therapy), langhanapachana (reducing therapy and digestion of amadosha), and doshavasechana (elimination of doshas). Patients who are unsuitable for shodhana (elimination therapy) is also highlighted. </div>

<div style="text-align:justify;">This chapter describes causes of environmental calamities leading to annihilation of communities (not limited to epidemics), along with their remedial measures. The queries and solutions about effects of afflictions caused due to such calamities on individuals whose constitution, immunity, lifestyle adaptations are “different”. Any contamination of four factors - [[vayu]] (air), [[jala]] (water), desha (land), and kala (season) - results in outbreak of epidemics. To manage these outbreaks, one has to get hold of drugs that are potent in all aspects (rasa, [[guna]], virya, vipaka etc.) well before any outbreak. Per [[Ayurveda]], sins of the present life or the misdeeds of the past life are the root cause of the vitiation of these four etiological factors of epidemics. Negative emotions like greed, anger, ego, mutual fight, and curses of the wise and the learned can destroy mankind. Characteristics of vitiated (polluted) [[vayu]], [[jala]], desha and kala were explained. Life-span of the individual depends on the daiva (predetermined based on the deeds of past life) and purushakara (human efforts in the present life). Administration of cold substances to cure diseases caused by heat or hot substances, and vice versa, was also discussed in the context of jwara and this principle is applicable to other diseases also. All therapies are broadly classified into two categories i.e., apatarpana (depletion therapy) and [[brimhana]] (nourishment therapy). Apatarpana (depletion therapy) includes of [[langhana]] (reducing therapy), [[langhana]]- [[pachana]] (reducing therapy and digestion of amadosha), and [[dosha]]vasechana (elimination of [[dosha]]). Patients who are unsuitable for shodhana (elimination therapy) is also highlighted. </div>

'''Keywords''': ''Vayu'' (air), ''udaka'' (water), ''desha'' (land), ''kala'' (season),contamination, epidemics, lifespan, ''daiva'' (predetermined), ''purushakara''(human effort of present life).

'''Keywords''': [[Vayu]] (air), [[jala]](water), ''desha'' (land), ''kala'' (season),contamination, epidemics, lifespan, ''daiva'' (predetermined), ''purushakara''(human effort of present life).

''Janapadodhvansa'' literally means destruction or annihilation of communities or settlements. Epidemics and outbreaks of highly communicable diseases have blighted mankind since time immemorial. Ayurvedic scholars and exponents of antiquity like Sushruta and Charaka recorded these in their works on ''aupasargika roga'' and ''janapadodhvansa'' respectively, according special importance to the topic.  

''Janapadodhvansa'' literally means destruction or annihilation of communities or settlements. Epidemics and outbreaks of highly communicable diseases have blighted mankind since time immemorial. Ayurvedic scholars and exponents of antiquity like Sushruta and Charaka recorded these in their works on ''aupasargika roga'' and ''janapadodhvansa'' respectively, according special importance to the topic.  

An astute observation of practitioners such as Charaka was that vitiated ''vayu'' (air), ''jala'' or ''udaka''(water), ''desha'' (land) and ''kala'' (season) were key factors responsible for causing epidemics. Sushruta refers to the concept of ''janapadodhvansa'' while discussing ''ritucharya'' (seasonal regimen) under the title ''Maraka''.[Su.Sa.Sutra Sthana 6/17]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> In Ashtangasangraha, the concept of ''janapadodhvansa'' was described under the chapter entitled Viruddhanna Vijnaniyam.<ref>Vridha Vagbhata. Sutra Sthana, Cha.9 Viruddhannavijnaniyam Adhyaya. In: Shivaprasad sharma, Editor. Ashtanga Sangraha. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012</ref>  The therapeutic modalities are incorporated in the disease prevention protocol in Ashtanga hridayam.<ref>Vagbhata. Sutra Sthana, Cha.4 Rogaanutpadaniyam Adhyaya. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>  

An astute observation of practitioners such as Charaka was that vitiated [[vayu]] (air), [[jala]] or ''udaka''(water), ''desha'' (land) and ''kala'' (season) were key factors responsible for causing epidemics. Sushruta refers to the concept of ''janapadodhvansa'' while discussing ''ritucharya'' (seasonal regimen) under the title ''Maraka''.[Su.Sa.Sutra Sthana 6/17]<ref name=Susruta>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> In Ashtangasangraha, the concept of ''janapadodhvansa'' was described under the chapter entitled Viruddhanna Vijnaniyam.<ref>Vridha Vagbhata. Sutra Sthana, Cha.9 Viruddhannavijnaniyam Adhyaya. In: Shivaprasad sharma, Editor. Ashtanga Sangraha. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012</ref>  The therapeutic modalities are incorporated in the disease prevention protocol in Ashtanga hridayam.<ref>Vagbhata. Sutra Sthana, Cha.4 Rogaanutpadaniyam Adhyaya. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>  

The causative factors of ''janapadodhvansa'' (epidemics), characteristics of vitiated factors and remedial measures to treat the conditions are described. It is strongly recommended collecting and stocking drugs potent in all attributes (like ''rasa, guna, veerya,'' and ''vipaka'') necessary to tackle the catastrophic conditions associated with any epidemic. Agnivesha was inquisitive to know about common morbidity among the individuals with dissimilar constitution, dietetic habits, physical strength, suitability, mental faculties , etc.  

The causative factors of ''janapadodhvansa'' (epidemics), characteristics of vitiated factors and remedial measures to treat the conditions are described. It is strongly recommended collecting and stocking drugs potent in all attributes (like rasa, [[guna]], veerya, and vipaka) necessary to tackle the catastrophic conditions associated with any epidemic. Agnivesha was inquisitive to know about common morbidity among the individuals with dissimilar constitution, dietetic habits, physical strength, suitability, mental faculties , etc.  

Atreya began his discourse with a discussion on the environmental factors that are common to all inhabitants of a region, i.e., ''vayu'', ''udaka, desha,'' and ''kala''. These four factors, when not polluted or contaminated, are vital not only for our survival, but for the survival of all life-forms. By nature, air, water, land and seasons are indispensable factors in their progressive order.  

Atreya began his discourse with a discussion on the environmental factors that are common to all inhabitants of a region, i.e., [[vayu]], [[jala]], desha, and ''kala''. These four factors, when not polluted or contaminated, are vital not only for our survival, but for the survival of all life-forms. By nature, air, water, land and seasons are indispensable factors in their progressive order.  

Seasons are the most indispensable ones of all factors, since its vitiation leads to diseases becoming highly virulent, taking epidemic proportions. With regard to communicable diseases in general, an interplay of agents, hosts and the environmental factors lead to a dynamic state of health and disease.

Seasons are the most indispensable ones of all factors, since its vitiation leads to diseases becoming highly virulent, taking epidemic proportions. With regard to communicable diseases in general, an interplay of agents, hosts and the environmental factors lead to a dynamic state of health and disease.

''Adharma karma'' (sinful act) committed during an individual’s present life and the previous life, is responsible for the vitiation of these factors. Intellectual errors (''prajnaparadha'') is the cause for both these types of sins (i.e., sins in the present life as well as in the past).  

''Adharma karma'' (sinful act) committed during an individual’s present life and the previous life, is responsible for the vitiation of these factors. Intellectual errors ([[prajnaparadha]]) is the cause for both these types of sins (i.e., sins in the present life as well as in the past).  

Per ''vedic'' scriptures, large periods of time witness a slow degradation of ''dharma'' (spiritual duties) and ''guna'' (qualities) in the conducts and attributes of living beings. The scriptures divided these periods into four distinct phases, or ''yugas'', with each ''yuga'' witnessing a significant degradation in ''dharma'' and ''guna'' than the preceding one. One such ''guna'', longevity or life-span of individuals, depends upon the strength of both ''daiva'' (predetermined) and ''purushakara'' (human effort of present life). If the individuals of a specific locality might have collectively committed sinful acts like burning villages or other sinful acts etc., in their previous birth, they are likely to die at a time during epidemics. Similarly, persons who committed sinful acts separately in their previous lives gathered in a specific region may also die collectively of a common cause. Atreya opines that the individuals who do not share similarities in death (''mrityu samanyata'') or previous deeds (''karma samanyata'') could be treated with [[Panchakarma]] procedures (five evacuative therapies) and administration of ''rasayana'' measures (rejuvenative procedures) with previously collected drugs, along with ''sadvritta'' (observance of noble conducts) etc. He further recommended administering cold measures to cure diseases caused by hot things and vice versa. The principle of treatment should be administration of antagonistic therapies to their causes (vitiated ''doshas'').  

Per ''vedic'' scriptures, large periods of time witness a slow degradation of ''dharma'' (spiritual duties) and [[guna]] (qualities) in the conducts and attributes of living beings. The scriptures divided these periods into four distinct phases, or ''yugas'', with each ''yuga'' witnessing a significant degradation in ''dharma'' and [[guna]] than the preceding one. One such [[guna]], longevity or life-span of individuals, depends upon the strength of both ''daiva'' (predetermined) and ''purushakara'' (human effort of present life). If the individuals of a specific locality might have collectively committed sinful acts like burning villages or other sinful acts etc., in their previous birth, they are likely to die at a time during epidemics. Similarly, persons who committed sinful acts separately in their previous lives gathered in a specific region may also die collectively of a common cause. Atreya opines that the individuals who do not share similarities in death (''mrityu samanyata'') or previous deeds (''karma samanyata'') could be treated with [[Panchakarma]] procedures (five evacuative therapies) and administration of [[rasayana]] measures (rejuvenative procedures) with previously collected drugs, along with ''sadvritta'' (observance of noble conducts) etc. He further recommended administering cold measures to cure diseases caused by hot things and vice versa. The principle of treatment should be administration of antagonistic therapies to their causes (vitiated [[dosha]]).  

Remedial measures for treating pollution or vitiation of the four environmental factors separately is not suggested, but emphasis is given on the management of individuals affected in an epidemic. Sushruta suggested certain treatment modalities for eliminating the poison from the atmosphere as well as from the patient’s body. [Su.Sa.Kalpa Sthana 6]<ref name=Susruta/> The drums, banners and gateways of the houses should be smeared with the medicament, or ''ksharaagada'' (formulation), that may be beneficial in the management of air pollution.

Remedial measures for treating pollution or vitiation of the four environmental factors separately is not suggested, but emphasis is given on the management of individuals affected in an epidemic. Sushruta suggested certain treatment modalities for eliminating the poison from the atmosphere as well as from the patient’s body. [Su.Sa.Kalpa Sthana 6]<ref name=Susruta/> The drums, banners and gateways of the houses should be smeared with the medicament, or ''ksharaagada'' (formulation), that may be beneficial in the management of air pollution.

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Lord Atreya replied “Agnivesha! Though a community may be dissimilar with respect to the constitution and other characteristics of its individuals, there are other common factors which often get adversely affected, resulting in simultaneous outbreak of diseases having similar symptoms that destroy communities. The common factors which affect mass population are ''vayu'' (air), ''udaka'' (water), ''desha'' (land) and ''kala'' (season). [6]

Lord Atreya replied “Agnivesha! Though a community may be dissimilar with respect to the constitution and other characteristics of its individuals, there are other common factors which often get adversely affected, resulting in simultaneous outbreak of diseases having similar symptoms that destroy communities. The common factors which affect mass population are [[vayu]] (air), [[jala]] (water), ''desha'' (land) and ''kala'' (season). [6]

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=== Characteristics of polluted air ===

=== Characteristics of polluted air ===

The wise man knows that water is more important than air, and land is more important than water and season is yet more important than land by virtue of their degree of indispensability.

The wise man knows that water is more important than air, and land is more important than water and season is yet more important than land by virtue of their degree of indispensability.

Out of aforesaid derangements among the four factors, one should know that it is easier to correct the vitiation of ''vayu, udaka'' and ''desha'', than of ''udaka, desha'' and ''kala''.[10-11]

Out of aforesaid derangements among the four factors, one should know that it is easier to correct the vitiation of [[vayu]], [[jala]] and ''desha'', than of ''udaka, desha'' and ''kala''.[10-11]

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=== General treatment in epidemics ===

=== General treatment in epidemics ===

In spite of vitiation of the four factors ending with vitiation of time (season), one need not suffer from diseases provided they are assured of proper medicaments which are already collected and processed.

In spite of vitiation of the four factors ending with vitiation of time (season), one need not suffer from diseases provided they are assured of proper medicaments which are already collected and processed.

Those who did not engage in identical acts in their prior lives and those who are not destined to die during calamities, for their cure, five elimination therapies (viz., emesis, purgation, enema- ''niruha'' and ''anuvasana'' types and errhines) are considered the best. For them, the proper use of ''rasayana chikitsa'' (rejuvenation treatment) is recommended and maintenance of the body by means of medicinal herbs collected before the onset of epidemics is recommended.

Those who did not engage in identical acts in their prior lives and those who are not destined to die during calamities, for their cure, five elimination therapies (viz., emesis, purgation, enema- ''niruha'' and ''anuvasana'' types and errhines) are considered the best. For them, the proper use of [[rasayana]] chikitsa'' (rejuvenation treatment) is recommended and maintenance of the body by means of medicinal herbs collected before the onset of epidemics is recommended.

Truthfulness, compassion for living beings, charity, sacrifices, worship of god, observance of right conduct, tranquility, prophylactic protection of oneself and seeking one’s own good, residing in a wholesome country, service to those observing ''brahmacharya'' (celibacy) and following it, discussion of religious scriptures, constant association with the righteous, the well disposed and those who are approved by the elders- all this with a view to protecting life has been termed ‘medicine’ to those who are not destined to die in that critical time. [12-18]

Truthfulness, compassion for living beings, charity, sacrifices, worship of god, observance of right conduct, tranquility, prophylactic protection of oneself and seeking one’s own good, residing in a wholesome country, service to those observing ''brahmacharya'' (celibacy) and following it, discussion of religious scriptures, constant association with the righteous, the well disposed and those who are approved by the elders- all this with a view to protecting life has been termed ‘medicine’ to those who are not destined to die in that critical time. [12-18]

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After listening to Lord Atreya, Agnivesha asked once again, ‘Now tell us, Lord! What makes the air etc. vitiated which tends to destroy whole people?’

After listening to Lord Atreya, Agnivesha asked once again, ‘Now tell us, Lord! What makes the air etc. vitiated which tends to destroy whole people?’

Lord Atreya replied that the root cause of vitiation of these factors is adharma (unrighteousness). Sins of the present life or the misdeeds of the past life also are at the root of vitiation of all these factors and the source of this is intellectual error (prajnaparadha).

Lord Atreya replied that the root cause of vitiation of these factors is adharma (unrighteousness). Sins of the present life or the misdeeds of the past life also are at the root of vitiation of all these factors and the source of this is intellectual error ([[prajnaparadha]]).

Thus when the reigning heads of countries, cities, trade guilds etc. govern the people irresponsibly by transgressing the virtuous path, then their officers, sub-ordinates and under- subordinates, people of the city and community and traders deviate from their duties as well and propagate such unrighteous acts further. Their sinful acts perforce causes the righteous acts to disappear. Because of the disappearance of righteous acts, even the Gods desert the people living in such places. This causes seasons to get impaired in these places. There is no rain in time, or never at all, or abnormal rain occurs; the air does not blow properly; the land is afflicted, the water reservoirs dry up, and herbs lose their true properties and suffer deterioration. As a consequence, the people perish as the result of infectious contact or ingestion of polluted food and water.[19-20]

Thus when the reigning heads of countries, cities, trade guilds etc. govern the people irresponsibly by transgressing the virtuous path, then their officers, sub-ordinates and under- subordinates, people of the city and community and traders deviate from their duties as well and propagate such unrighteous acts further. Their sinful acts perforce causes the righteous acts to disappear. Because of the disappearance of righteous acts, even the Gods desert the people living in such places. This causes seasons to get impaired in these places. There is no rain in time, or never at all, or abnormal rain occurs; the air does not blow properly; the land is afflicted, the water reservoirs dry up, and herbs lose their true properties and suffer deterioration. As a consequence, the people perish as the result of infectious contact or ingestion of polluted food and water.[19-20]

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With the onset of the ''tretayuga'', greed gave rise to malice in its wake, malice led to falsehood, and falsehood led to passion, anger, vanity, hatred, cruelty, aggression, fear, grief, anxiety, distress and the like. Symbolically, during ''tretayuga'', one-fourth of ''dharma'' (religious duties) disappeared, resulting in reduction of the life-span of human beings by a quarter. Similarly, there was reduction in the attributes of earth etc., by a quarter. Because of the reduction of these attributes there was diminution by one quarter of the unctuousness, purity, tastes (''rasa''), potency (''veerya''), post digestive effects (''vipaka''), prabhava and qualities of grains.

With the onset of the ''tretayuga'', greed gave rise to malice in its wake, malice led to falsehood, and falsehood led to passion, anger, vanity, hatred, cruelty, aggression, fear, grief, anxiety, distress and the like. Symbolically, during ''tretayuga'', one-fourth of ''dharma'' (religious duties) disappeared, resulting in reduction of the life-span of human beings by a quarter. Similarly, there was reduction in the attributes of earth etc., by a quarter. Because of the reduction of these attributes there was diminution by one quarter of the unctuousness, purity, tastes (''rasa''), potency (''veerya''), post digestive effects (''vipaka''), prabhava and qualities of grains.

In effect, this degradation impacted all aspects of living beings that were described to have existed in the ''satyayuga''. There was an unusual change in the maintenance of equilibrium of tissue elements and there was vitiation of ''agni'' (''pitta'') and ''maruta'' (''vata'') by which, first of all, bodies of living beings got afflicted with diseases viz. ''jwara'' (fever) etc. Therefore the life-span of living beings underwent gradual diminution.  

In effect, this degradation impacted all aspects of living beings that were described to have existed in the ''satyayuga''. There was an unusual change in the maintenance of equilibrium of tissue elements and there was vitiation of [[agni]] ([[pitta]]) and ''maruta'' ([[vata]]) by which, first of all, bodies of living beings got afflicted with diseases viz. [[jwara]] (fever) etc. Therefore the life-span of living beings underwent gradual diminution.  

The concluding verse:

The concluding verse:

On hearing this, Agnivesha asked, “Lord! If this is so, that the lives of men are of un-predetermined duration, then what makes for death in due time and death before time (prematurely)?”

On hearing this, Agnivesha asked, “Lord! If this is so, that the lives of men are of un-predetermined duration, then what makes for death in due time and death before time (prematurely)?”

The Lord Atreya said to him, “Listen, Agnivesha! Just as a vehicle with an axle endowed with all good qualities and driven on a good road gets destroyed only after the expiry of its normal life, similarly the life inside the body of an individual endowed with strong physique and wholesome regimen will come to an end only at the end of its normal span (according to the ''yuga''). This is called ''kalamrityu'' (timely death). The same vehicle along with its axle may subject itself to premature destruction in the event of a heavy load, uneven road, driving in places where there is no road, breakage of the wheel, defects in the vehicle or the driver, separation of the locking hook, lack of grease or a mishap. Similarly, in the event of overstrain, eating in excess of one’s own ''agni'' (digestive power), irregular meals, irregular posture of the body, excessive indulgence in sex, company of evil or wicked, suppression of manifested natural urges, non-suppression of urges which should be controlled, affliction with evil spirits (germs), poison, wind and fire, exposure to injuries and avoidance of food and medicines, or if afflicted with diseases but not treated properly, the life of a human being comes to a premature end. This is called ''akala mrityu'' (premature death). [37-38]

The Lord Atreya said to him, “Listen, Agnivesha! Just as a vehicle with an axle endowed with all good qualities and driven on a good road gets destroyed only after the expiry of its normal life, similarly the life inside the body of an individual endowed with strong physique and wholesome regimen will come to an end only at the end of its normal span (according to the ''yuga''). This is called ''kalamrityu'' (timely death). The same vehicle along with its axle may subject itself to premature destruction in the event of a heavy load, uneven road, driving in places where there is no road, breakage of the wheel, defects in the vehicle or the driver, separation of the locking hook, lack of grease or a mishap. Similarly, in the event of overstrain, eating in excess of one’s own [[agni]](digestive power), irregular meals, irregular posture of the body, excessive indulgence in sex, company of evil or wicked, suppression of manifested natural urges, non-suppression of urges which should be controlled, affliction with evil spirits (germs), poison, wind and fire, exposure to injuries and avoidance of food and medicines, or if afflicted with diseases but not treated properly, the life of a human being comes to a premature end. This is called ''akala mrityu'' (premature death). [37-38]

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=== The role of hot water in ''jwara'' ===

=== The role of hot water in ''jwara'' ===