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<p style="text-align:justify;">The word aupasargika means contagious. The diseases that spread from one person or organism to another person or organism are ‘aupasargika roga’. These types of disease can spread through same or the other pathogenic factors (microbes) like protozoa, yeast, bacteria, virus etc. Ayurveda classics have mentioned concept of epidemic/pandemic in context of janapadodhvamsa (community destruction). Air pollution, water pollution, climate changes and environmental factors are responsible for the spread of diseases on large scale resulting in epidemic/pandemic. Causes of vitiation of air, water, climate and place along with their characteristics are described in context of janpadodhwansa. The causes of contagious diseases are also described in ancient classical texts at various places. Technological advances in medical science have enabled to know precise micro-organisms responsible for causing and spreading contagious diseases. This chapter deals with the diagnosis and principles of management of contagious diseases described in ayurveda and its contemporary practices. </p>

<p style="text-align:justify;">The word aupasargika means contagious. The [[Vyadhi|diseases]] that spread from one person or organism to another person or organism are ‘aupasargika [[Vyadhi|roga]]’. These types of diseases can spread through the same or the other pathogenic factors (microbes) like protozoa, yeast, bacteria, virus etc. [[Ayurveda]] classics have mentioned concept of epidemic/pandemic in context of [[janapadodhvansa]] (community destruction). Air pollution, water pollution, climate changes and environmental factors are responsible for the spread of diseases on large scale resulting in epidemics/pandemic. Causes of vitiation of air, water, climate and place along with their characteristics are described in context of [[janapadodhvansa]]. The causes of contagious diseases are also described in ancient classical texts at various places. Technological advances in medical science have enabled us to know precise micro-organisms responsible for causing and spreading contagious diseases. This chapter deals with the diagnosis and principles of management of contagious diseases described in [[ayurveda]] and its contemporary practices. </p>

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== Etymology ==

==Etymology ==

<ol style="text-align:justify;"><li>The word Aupasargika is derived from ‘upasarga’ meaning (औपसर्गिक)- superior to adversity, able to cope with calamity [gana] [Pāṇini 5-1, 101] </li>

<ol style="text-align:justify;"><li>The word Aupasargika is derived from ‘upasarga’ meaning (औपसर्गिक)- superior to adversity, able to cope with calamity [gana] [Pāṇini 5-1, 101] </li>

<li>superinduced, produced in addition to (or out of another disease), [Suśruta]</li>

<li>superinduced, produced in addition to (or out of another disease), [Suśruta]</li>

<li>infectious (as a disease), [Suśrutai, 271, 13]</li></ol>

<li>infectious (as a disease), [Suśrutai, 271, 13]</li></ol>

== Synonyms ==

==Synonyms==

* Sankramaka vyadhi (contagious disease)

*Sankramaka vyadhi (contagious disease)

* samsargaja vyadhi (infectious diseases)

*samsargaja vyadhi (infectious diseases)

== Difference in infectious disease and contagious disease ==

== Difference in infectious disease and contagious disease==

A clinically manifested disease of man caused by a micro-organism is an infectious disease. The disease that spreads from one person to another person is a contagious disease. All infectious diseases are not contagious.  

A clinically manifested disease of man caused by a micro-organism is an infectious disease. The disease that spreads from one person to another person is a contagious disease. All infectious diseases are not contagious.  

== Mode of transmission ==

==Mode of transmission==

Sushruta observed the modes of transmission of contagious diseases and listed them as follows. [Su.Sa.Nidansthan5/33-34]

Sushruta observed the modes of transmission of contagious diseases and listed them as follows. [Su.Sa.Nidansthan5/33-34]

* Close physical contact (prasangat)  

*Close physical contact (prasangat)

* Touching the affected person (gatra samsparshat)

*Touching the affected person (gatra samsparshat)

* Droplets exhaled in air (nishwasat)

*Droplets exhaled in air (nishwasat)

* Sharing bed with affected person (saha shayya)

*Sharing bed with affected person (saha shayya)

* Eating together or sharing food with affected person (sahabhojanat).

*Eating together or sharing food with affected person (sahabhojanat).

* Sitting together / closely with the affected person (saha aasanat).

*Sitting together / closely with the affected person (saha aasanat).

* Using clothes, ornaments etc. of affected person (vastra mala anulepanat).

*Using clothes, ornaments etc. of affected person (vastra mala anulepanat).

There are seven types of diseases as per acharya Sushruta. [Su.Sa. Sutra Sthana 24/4 Vyadhisamuddeshiya] These are  

There are seven types of diseases as per acharya Sushruta. [Su.Sa. Sutra Sthana 24/4 Vyadhisamuddeshiya] These are  

# Adibala pravrutta (hereditary diseases)

#Adibala pravrutta (hereditary diseases)

# Janmabala pravrutta (congenital diseases)

#Janmabala pravrutta (congenital diseases)

# Doshabala pravrutta (dosha dominant diseases)

# Doshabala pravrutta (dosha dominant diseases)

# Sanghatabala pravrutta (accidental bites, attack of animals)

#Sanghatabala pravrutta (accidental bites, attack of animals)

# Kaala bala pravrutta (time/age/season related based diseases)

#Kaala bala pravrutta (time/age/season related based diseases)

# Daiva bala pravrutta (diseases caused due to previous deeds etc.)

#Daiva bala pravrutta (diseases caused due to previous deeds etc.)

# Swabhava bala pravrutta (diseases occurs due to natural processes like ageing, death) [Su.Sa.Sutra Sthana 24/4]

# Swabhava bala pravrutta (diseases occurs due to natural processes like ageing, death) [Su.Sa.Sutra Sthana 24/4]

Daiva bala pravrutta diseases (previous deeds)are classified as [Su.Sa.Sutrasthan24/7]

Daiva bala pravrutta diseases (previous deeds)are classified as [Su.Sa.Sutrasthan24/7]

# Contagious or communicable (aupasargika roga)

# Contagious or communicable (aupasargika roga)

# Accidental (akasmik)

#Accidental (akasmik)

== List of diseases ==

==List of diseases ==

Ayurveda texts have listed the diseases that can spread through above means as below:

Ayurveda texts have listed the diseases that can spread through above means as below:

* Kushtha (~skin diseases)

*Kushtha (~skin diseases)

* Jwara (~fever)

*Jwara (~fever)

* Netrabhishyanada (~conjunctivitis)

*Netrabhishyanada (~conjunctivitis)

* Shosha (~emaciation/tuberculosis)

*Shosha (~emaciation/tuberculosis)

* Visuchika (~cholera)

*Visuchika (~cholera)

* Shleshmak jwara with pratishyaya (fever with rhinitis)

*Shleshmak jwara with pratishyaya (fever with rhinitis)

* Upadamsha (~chancroid/soft chancre)

* Upadamsha (~chancroid/soft chancre)

* Hepatitis A, B, C, D

*Hepatitis A, B, C, D

* Influenza

*Influenza

* Masurika (chickenpox)  

*Masurika (chickenpox)

* Romantika (measles)

* Romantika (measles)

* Granthi (cysts)

* Granthi (cysts)

* Visarpa (erysipelas)  

*Visarpa (erysipelas)

* Kandu (pruritus)  

*Kandu (pruritus)

=== Bhavamishra described following Aupsargika diseases: ===

===Bhavamishra described following Aupsargika diseases:===

* Kandu (pruritus)

*Kandu (pruritus)

* Kushtha (skin diseases)  

*Kushtha (skin diseases)

* Upadansha (sexually transmitted disease like chancroid/soft chancre)  

*Upadansha (sexually transmitted disease like chancroid/soft chancre)

* Bhuta-unmada (psychosis due to infection of micro-organisms)

*Bhuta-unmada (psychosis due to infection of micro-organisms)

* Jwara (fever)

*Jwara (fever)

=== Dalhana described following aupasargika diseases: ===

===Dalhana described following aupasargika diseases: ===

Shwasa (respiratory disorder), kasa (cough) and pratishyaya (allergic rhinitis) diseases can spread through droplet infection. Jwara (fever) and masurika can spread through skin contact.

Shwasa (respiratory disorder), kasa (cough) and pratishyaya (allergic rhinitis) diseases can spread through droplet infection. Jwara (fever) and masurika can spread through skin contact.

== Causes ==

==Causes==

<ul style="text-align:justify;"><li>The causes of abovementioned diseases are described in the respective chapters. However, the contagious nature of the diseases can affect other person susceptible for similar diseases.  </li>

<ul style="text-align:justify;"><li>The causes of abovementioned diseases are described in the respective chapters. However, the contagious nature of the diseases can affect other person susceptible for similar diseases.  </li>

<li>Ayurveda believe in seed and soil theory, where seeds are microorganisms like bacteria, virus etc. and soil is body. When the soil is healthy, then no disease can prevail in the body. But if the seeds are more potent, they can produce a disease. Therefore, the occurrence of diseases depend on interaction of dosha, dushya, and causes. If the inherent immunity (vyadhikshamatva) is superior, then the affecting micro-organisms cannot multiply and cause diseases. However, if the immunity is poor, then the micro-organisms can lead to infectious diseases. The transmission of microbes from one person to other depends on nature of microbe and availability of its favourable transmission mode like air, soil, water etc. </li>

<li>Ayurveda believe in seed and soil theory, where seeds are microorganisms like bacteria, virus etc. and soil is body. When the soil is healthy, then no disease can prevail in the body. But if the seeds are more potent, they can produce a disease. Therefore, the occurrence of diseases depend on interaction of dosha, dushya, and causes. If the inherent immunity (vyadhikshamatva) is superior, then the affecting micro-organisms cannot multiply and cause diseases. However, if the immunity is poor, then the micro-organisms can lead to infectious diseases. The transmission of microbes from one person to other depends on nature of microbe and availability of its favourable transmission mode like air, soil, water etc. </li>

<li>As per contemporary medical literature, communicable diseases are caused by viruses or bacteria. These micro-organisms are transmitted to one another through contact with contaminated surfaces, bodily fluids, blood products, insect bites, or through the air. The modes of transmission are described by Sushruta as mentioned earlier.</li></ul>

<li>As per contemporary medical literature, communicable diseases are caused by viruses or bacteria. These micro-organisms are transmitted to one another through contact with contaminated surfaces, bodily fluids, blood products, insect bites, or through the air. The modes of transmission are described by Sushruta as mentioned earlier.</li></ul>

== Role of aupsargika roga in current era ==

==Role of aupsargika roga in current era==

<p style="text-align:justify;">With every passing era, mankind has faced healthcare challenges in the form of pandemics like COVID-19, epidemics like cholera, plague etc. These are all aupasargika in nature. Understanding aupsargika roga not only helps to prevent the diseases at individual level, but also helps to prevent epidemics or pandemics. </p>

<p style="text-align:justify;">With every passing era, mankind has faced healthcare challenges in the form of pandemics like COVID-19, epidemics like cholera, plague etc. These are all aupasargika in nature. Understanding aupsargika roga not only helps to prevent the diseases at individual level, but also helps to prevent epidemics or pandemics. </p>

== Root cause for epidemics (janapadodhawansa)- ==

==Root cause for epidemics (janapadodhawansa)-==

<p style="text-align:justify;">Root cause for vitiation of air etc. factors is 'adharma' or misdeeds performed by intellectual errors (prajnaparadha). Sinful acts may be in the form of wars, demons, germs & curse.  In the present day, sinful act can include different activities like antinational elements indulging in bomb blast, crime, deforestation, not obeying government rules in the industries, discharge of untreated polluted water in to the river, automobile pollutions etc., which produce air pollution. Disposal of waste water in an improper method on land leads to pollution of soil. The basic cause of such act is intellectual errors (prajnaparadha), due to rajas & tamas predominance resulting in greed, selfishness, tendency to harm people, jealousy & anger. All these factors not only influence the individual, but also the society leading to janapadodhwansa.</p>

<p style="text-align:justify;">Root cause for vitiation of air etc. factors is 'adharma' or misdeeds performed by intellectual errors (prajnaparadha). Sinful acts may be in the form of wars, demons, germs & curse.  In the present day, sinful act can include different activities like antinational elements indulging in bomb blast, crime, deforestation, not obeying government rules in the industries, discharge of untreated polluted water in to the river, automobile pollutions etc., which produce air pollution. Disposal of waste water in an improper method on land leads to pollution of soil. The basic cause of such act is intellectual errors (prajnaparadha), due to rajas & tamas predominance resulting in greed, selfishness, tendency to harm people, jealousy & anger. All these factors not only influence the individual, but also the society leading to janapadodhwansa.</p>

== Preventive aspects ==

==Preventive aspects==

<p style="text-align:justify;">Ayurveda durably gives priority to preservation of health of healthy person. Immunity plays a major role in occurrence and non-occurrence of any disease especially in such type of infectious disease. Ayurveda believe in ‘sahaja bala’ (inherent immunity) of person. If that is reduced, then thepossibility of getting infection is more. So, Ayurveda recommends a comprehensive regimen for safeguarding health and increasing vyadhikshamatva (immunity) as a code of the health conduct viz ‘swasthavritta’. It includes following practices: [Cha.Sa.Sutrasthan 7/53-60][Cha.Sa.Vimansthan3/13-17]</p>

<p style="text-align:justify;">Ayurveda durably gives priority to preservation of health of healthy person. Immunity plays a major role in occurrence and non-occurrence of any disease especially in such type of infectious disease. Ayurveda believe in ‘sahaja bala’ (inherent immunity) of person. If that is reduced, then thepossibility of getting infection is more. So, Ayurveda recommends a comprehensive regimen for safeguarding health and increasing vyadhikshamatva (immunity) as a code of the health conduct viz ‘swasthavritta’. It includes following practices: [Cha.Sa.Sutrasthan 7/53-60][Cha.Sa.Vimansthan3/13-17]</p>

* Dinacharya (daily code of health conduct)

*Dinacharya (daily code of health conduct)

* Ritucharya (conduct in relation to various seasons)

*Ritucharya (conduct in relation to various seasons)

* Sadvritta (details about life style, diet,

*Sadvritta (details about life style, diet,

exercise, personal and social hygiene)

exercise, personal and social hygiene)

* Avoiding prajnaparadha (intellectual errors)  

* Avoiding prajnaparadha (intellectual errors)

* Controlling senses (indriyopashama)

*Controlling senses (indriyopashama)

* Memorizing the health protocols and following it  

*Memorizing the health protocols and following it

* Shodhana (suitable purification therapies as per season and constitution).

*Shodhana (suitable purification therapies as per season and constitution).

* Following advices given by authorities and elder persons  

*Following advices given by authorities and elder persons

* Ahara vidhi (dietary guidelines)  [Cha.Sa. Sutra Sthana 7/53-54]

*Ahara vidhi (dietary guidelines)  [Cha.Sa. Sutra Sthana 7/53-54]

These all-precautionary measures not only aid to increasing immunity, but also resist the mode of transmission of infectious agents like bacteria, viruses and fungi. The preventive measures as advised in janapadodhwansa shall also be followed.  

These all-precautionary measures not only aid to increasing immunity, but also resist the mode of transmission of infectious agents like bacteria, viruses and fungi. The preventive measures as advised in janapadodhwansa shall also be followed.  

== Treatment measures ==

== Treatment measures==

Krimi is an organism that invades human body. It is generally referred as worms and micro-organisms. The treatment protocol for krimi is as follow  [Cha.Sa.Vimana Sthana 7/14]

Krimi is an organism that invades human body. It is generally referred as worms and micro-organisms. The treatment protocol for krimi is as follow  [Cha.Sa.Vimana Sthana 7/14]

'''Apkarshana: '''Removing krimi manually or with techniques or therapeutically by purification procedures   

'''Apkarshana: '''Removing krimi manually or with techniques or therapeutically by purification procedures   

'''Nidana anupsevana: '''The specific dietary causes are avoided.  

'''Nidana anupsevana: '''The specific dietary causes are avoided.  

== Protocol for prevention of spread of infection ==

==Protocol for prevention of spread of infection==

* Maintaining hygiene to prevent growth of microorganism  

*Maintaining hygiene to prevent growth of microorganism

* Avoiding direct contact with infected individual  

*Avoiding direct contact with infected individual

* Safe handling of patient care  

*Safe handling of patient care

* Controlling spread of micro-organisms in environment  

*Controlling spread of micro-organisms in environment

== Effect of Ayurveda treatments in management of COVID-19 ==

==Effect of Ayurveda treatments in management of COVID-19==

<p style="text-align:justify;">New disease like COVID19 is one of recently known aupasargika roga (contagious or infectious diseases). The studies on effect of Ayurveda formulations and therapies in management of COVID-19 are supportive to the protocol of management of aupasargika roga. Few important studies related with the ayurvedic management of COVID19 are highlighted as follows: </p>

<p style="text-align:justify;">New disease like COVID19 is one of recently known aupasargika roga (contagious or infectious diseases). The studies on effect of Ayurveda formulations and therapies in management of COVID-19 are supportive to the protocol of management of aupasargika roga. Few important studies related with the ayurvedic management of COVID19 are highlighted as follows: </p>

<ol style="text-align:justify;"><li>In a case report, P.L.T Girija et al<ref name="ref1">Girija P.L.T, Sivan N. Ayurvedic treatment of COVID-19: A case report.Journal of Ayurveda and Integrative Medicine,2022,13(1):100329.</ref> noticed that the COVID-19 patient’s condition did not deteriorate when ayurvedic treatment was taken. Despite the patient having severe cough and fever more than 39.1°C, the patient’s condition did not worsen and develop breathlessness. Median time for onset of symptoms to recovery in mild and severe cases was 2 and 3–6 weeks, respectively. Furthermore, time interval between onset and developing severe symptoms such as hypoxia was one week. This patient had recovered in 7 days. Hence, it can be said that the duration of the disease was presumably shorter, because of the ayurvedic medicines. The regulated diet played an important supportive role in the cure. The diet advised was soup made of mung dal and cooked parboiled rice which is easy to digest (laghu) and stimulated the digestive power (agni deepanam) and it nourished the patient. </li>

<ol style="text-align:justify;"><li>In a case report, P.L.T Girija et al<ref name="ref1">Girija P.L.T, Sivan N. Ayurvedic treatment of COVID-19: A case report.Journal of Ayurveda and Integrative Medicine,2022,13(1):100329.</ref> noticed that the COVID-19 patient’s condition did not deteriorate when ayurvedic treatment was taken. Despite the patient having severe cough and fever more than 39.1°C, the patient’s condition did not worsen and develop breathlessness. Median time for onset of symptoms to recovery in mild and severe cases was 2 and 3–6 weeks, respectively. Furthermore, time interval between onset and developing severe symptoms such as hypoxia was one week. This patient had recovered in 7 days. Hence, it can be said that the duration of the disease was presumably shorter, because of the ayurvedic medicines. The regulated diet played an important supportive role in the cure. The diet advised was soup made of mung dal and cooked parboiled rice which is easy to digest (laghu) and stimulated the digestive power (agni deepanam) and it nourished the patient. </li>

<li>Priya Shree<ref name="ref15">Priya S, Priyanka M,Chandrabose S, Sanjeev K.S, Radha C,Neha G. Targeting COVID-19 (SARS-CoV-2) main protease through active phytochemicals of ayurvedic medicinal plants – Withaniasomnifera (Ashwagandha), Tinospora cordifolia (Giloy) and Ocimum sanctum (Tulsi) – a molecular docking study.Journal of Biomolecular Structure and Dynamics, 2022; 40(1):190-203.</ref> el al. concluded that active phytoconstituents of Ayurvedic medicinal plants Withania somnifera (Ashwagandha), Tinospora cordifolia (Giloy) and Ocimum sanctum (Tulasi) predicted to significantly hinder main protease (M^pro or 3Cl^pro) of SARS-CoV-2.Through molecular docking and molecular dynamic simulation study, Withanoside V, Somniferine, Tinocordiside, Vicenin, Ursolic acid and Isorientin 4′-O-glucoside 2″-O-p-hydroxybenzoagte were anticipated to impede the activity of SARS-CoV-2 M^pro.</li></ol>

<li>Priya Shree<ref name="ref15">Priya S, Priyanka M,Chandrabose S, Sanjeev K.S, Radha C,Neha G. Targeting COVID-19 (SARS-CoV-2) main protease through active phytochemicals of ayurvedic medicinal plants – Withaniasomnifera (Ashwagandha), Tinospora cordifolia (Giloy) and Ocimum sanctum (Tulsi) – a molecular docking study.Journal of Biomolecular Structure and Dynamics, 2022; 40(1):190-203.</ref> el al. concluded that active phytoconstituents of Ayurvedic medicinal plants Withania somnifera (Ashwagandha), Tinospora cordifolia (Giloy) and Ocimum sanctum (Tulasi) predicted to significantly hinder main protease (M^pro or 3Cl^pro) of SARS-CoV-2.Through molecular docking and molecular dynamic simulation study, Withanoside V, Somniferine, Tinocordiside, Vicenin, Ursolic acid and Isorientin 4′-O-glucoside 2″-O-p-hydroxybenzoagte were anticipated to impede the activity of SARS-CoV-2 M^pro.</li></ol>

== Conclusion ==

==Conclusion==

<p style="text-align:justify;">From the above literature and research studies, it can be concluded that aupasargika roga (contagious diseases) are well described in the ayurvedic literature and the incidence has increased now. As ayurveda believe in seed and soil theory, where seeds are microorganisms like bacteria, virus etc and soil is body. So if soil is intact then no disease can prevail. In Harrison's text book of medicine, it is described that no disease can prevail in the body until or unless the body is prepared for that. From the experience of COVID19 pandemic, it can be understood that the immunity of the person is most important. If the person is having good immunity, the diseases like COVID19 may not be able to produce any harm to the patient. Therefore, just by following the proper diet, life style pattern, devoid of stress, greed, jealousy etc. along with dinacharya and ritucharya, one can maintain a healthy body and mind and the disease incidence will be negligible. </p>

<p style="text-align:justify;">From the above literature and research studies, it can be concluded that aupasargika roga (contagious diseases) are well described in the ayurvedic literature and the incidence has increased now. As ayurveda believe in seed and soil theory, where seeds are microorganisms like bacteria, virus etc and soil is body. So if soil is intact then no disease can prevail. In Harrison's text book of medicine, it is described that no disease can prevail in the body until or unless the body is prepared for that. From the experience of COVID19 pandemic, it can be understood that the immunity of the person is most important. If the person is having good immunity, the diseases like COVID19 may not be able to produce any harm to the patient. Therefore, just by following the proper diet, life style pattern, devoid of stress, greed, jealousy etc. along with dinacharya and ritucharya, one can maintain a healthy body and mind and the disease incidence will be negligible. </p>

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== References ==

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