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Janapadodhvansa (view source)

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Acharya Sushruta states vyapanna [[Ritu|ritu]] (unfavourable seasons) as the primary cause of janapadodhvansa or maraca. Seasonal variations whether gradual or transient lead to disturbance in equilibrium of doshas, thus affecting the [[Health|health]] of population. (Su. Sa. [[Sutra Sthana|Sutra Sthana]] 6/21)

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Acharya Sushruta states vyapanna [[Ritu|ritu]] (unfavourable seasons) as the primary cause of janapadodhvansa or maraca. Seasonal variations whether gradual or transient lead to disturbance in equilibrium of [[Dosha|doshas]], thus affecting the [[Health|health]] of population. (Su. Sa. [[Sutra Sthana|Sutra Sthana]] 6/21)

== Adharma (inappropriate bahaviour) as a cause ==

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== Management of janapadodhvansa (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/13-18) ==

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Acharya Charaka mentions the need of collection of medicinal herbs and commodities which are important for supporting the [[Ayu|life]] in emergencies or epidemics beforehand, as there can be scarcity of the even most basic [[Ayu|life]] needs during such period. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/4)This denotes the basis of disaster management and organisation of healthcare facilities during epidemics. The hospitals should be well prepared with all the emergency and required facilities to combat the [[Health|health]] consequences of disasters.<ref name="ref28">Hospital Preparedness for Epidemics [Internet]. [cited 2020 Apr 9]. Available from: https://www.who.int/publications-detail/hospital-preparedness-for-epidemics</ref> The principal line of treatment in the management of [[Vyadhi|diseases]] like [[Jwara|jwara]] is pachana (medications enhancing digestion), vamana (therapeutic emesis) and apatarpana (depleting procedures). (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/40) Ushnodaka (warm water) helps in achieving all the above criteria. It is also indicated for the treatment of [[Jwara|jwara]] as it pacifies [[Vata dosha|vata]] and kapha dosha. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/40) It facilitates digestion and relieves anorexia due to its deepana (appetizing), pachana (digestion) properties. It satiatestrishna (thirst), when consumed even in small quantities. Its consumption is especially indicated in management of conditions like [[Kasa Chikitsa|kasa (cough)]], peenasa (sinusitis), nava [[Jwara|jwara]] (pyrexia), [[Shwasa|shwasa]] (breathing abnormality), etc. which represent majority of infectious [[Vyadhi|diseases]].(Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 22/58) The generalized principles for management of janapadodhvansa include the measures for the promotion, preservation and correction of both physical and mental [[Health|health]]. The panchakarma is the main line of treatment in these conditions. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/13) Vamana is important for the radical removal of vitiated dosha especially the kapha dosha and helps in pacifying the [[Jwara|jwara]] and nausea (hrillasa) related conditions associated with the infection. (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 3/146) Virechana also helps to evacuate the vitiated dosha through the faeces and corrects the agni vitiation. (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 3/169) Basti controls the vitiated [[Vata dosha|vata]] and helps in excretion of the toxins and faecal matter from the bowel region. (Cha. Sa. Siddhi Sthana 1/40) Due to nasya or nasal instillation invading pathogens get adsorbed on the surface restricting their growth and further progressiom. Nasya is thus particularly useful in the treatment and prevention of respiratory tract infections. Snehana (internal administration of ghee or oil) in form of go-ghrita (ghee). [[Jwara|Jwara]] involves the obstruction of swedavaha strotas ( body channels carrying sweat) hence it will help to expel the toxins by inducing the process of swedana. (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 3/130) Deepana pachana treatments play an important role at every step in management as maintenance of agni function is of prime importance in prevention of any [[Vyadhi|disease]]. Dhoomapana is a treatment where the particulate matter in dhooma (medicated smoke) has anti-microbial activity and maintains integrity of respiratory tract. It is thus indicated in many respiratory conditions (Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 5/27-32).Gandusha (Oil pulling),kavala (gargling), dantapavana (brushing or cleaning of teeth) act as mechanical barriers by avoiding the entry of pathogens through the buccal cavity.Sharira parimarjana (cleaning of body surface) and snana (bathing) measures contribute to cleansing of the body surfaces and also includes hasta,pada and mukha prakshalana i.e. hand and feet sanitization to prevent the spread of [[Vyadhi|disease]]. (Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 5/93-94)

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Acharya Charaka mentions the need of collection of medicinal herbs and commodities which are important for supporting the [[Ayu|life]] in emergencies or epidemics beforehand, as there can be scarcity of the even most basic [[Ayu|life]] needs during such period. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/4) This denotes the basis of disaster management and organisation of healthcare facilities during epidemics. The hospitals should be well prepared with all the emergency and required facilities to combat the [[Health|health]] consequences of disasters.<ref name="ref28">Hospital Preparedness for Epidemics [Internet]. [cited 2020 Apr 9]. Available from: https://www.who.int/publications-detail/hospital-preparedness-for-epidemics</ref> The principal line of treatment in the management of [[Vyadhi|diseases]] like [[Jwara|jwara]] is [[Pachana|pachana]] (medications enhancing digestion), [[Vamana|vamana]] (therapeutic emesis) and [[Apatarpana|apatarpana]] (depleting procedures). (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/40) Ushnodaka (warm water) helps in achieving all the above criteria. It is also indicated for the treatment of [[Jwara|jwara]] as it pacifies [[Vata dosha|vata]] and [[Kapha dosha|kapha dosha]]. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/40) It facilitates digestion and relieves anorexia due to its [[Deepana|deepana]] (appetizing), [[Pachana|pachana (digestion)]] properties. It satiatestrishna (thirst), when consumed even in small quantities. Its consumption is especially indicated in management of conditions like [[Kasa Chikitsa|kasa (cough)]], peenasa (sinusitis), nava [[Jwara|jwara]] (pyrexia), [[Shwasa|shwasa]] (breathing abnormality), etc. which represent majority of infectious [[Vyadhi|diseases]].(Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 22/58) The generalized principles for management of janapadodhvansa include the measures for the promotion, preservation and correction of both physical and mental [[Health|health]]. The [[Panchakarma|panchakarma]] is the main line of treatment in these conditions. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/13) [[Vamana|Vamana]] is important for the radical removal of vitiated [[Dosha|dosha]] especially the [[Kapha dosha|kapha dosha]] and helps in pacifying the [[Jwara|jwara]] and nausea (hrillasa) related conditions associated with the infection. (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 3/146) [[Virechana|Virechana]] also helps to evacuate the vitiated [[Dosha|dosha]] through the faeces and corrects the [[Agni|agni]] vitiation. (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 3/169) [[Basti|Basti]] controls the vitiated [[Vata dosha|vata]] and helps in excretion of the toxins and faecal matter from the bowel region. (Cha. Sa. [[Siddhi Sthana|Siddhi Sthana]] 1/40) Due to [[Nasya|nasya]] or nasal instillation invading pathogens get adsorbed on the surface restricting their growth and further progressiom. [[Nasya|Nasya]] is thus particularly useful in the treatment and prevention of respiratory tract infections. [[Snehana (unction therapy)|Snehana]] (internal administration of [[Ghee|ghee]] or oil) in form of go-ghrita ([[Ghee|ghee]]). [[Jwara|Jwara]] involves the obstruction of swedavaha strotas (body channels carrying sweat) hence it will help to expel the toxins by inducing the process of [[Swedana|swedana]]. (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 3/130) [[Deepana|Deepana]] [[Pachana|pachana]] treatments play an important role at every step in management as maintenance of [[Agni|agni]] function is of prime importance in prevention of any [[Vyadhi|disease]]. [[Dhumapana|Dhoomapana]] is a treatment where the particulate matter in dhooma (medicated smoke) has anti-microbial activity and maintains integrity of respiratory tract. It is thus indicated in many respiratory conditions (Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 5/27-32). [[Gandusha|Gandusha]] (Oil pulling), [[Kavala|kavala]] (gargling), dantapavana (brushing or cleaning of teeth) act as mechanical barriers by avoiding the entry of pathogens through the buccal cavity. [[Sharira|Sharira]] parimarjana (cleaning of body surface) and [[Snana|snana (bathing)]] measures contribute to cleansing of the body surfaces and also includes hasta, pada and mukha prakshalana i.e. hand and feet sanitization to prevent the spread of [[Vyadhi|disease]]. (Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 5/93-94)

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The [[Rasayana Adhyaya|rasayana chikitsa]] forms the backbone of treatment of janapadodhvansa as it is pivotal in enhancing the immune response to pathogenic external and internal invasion and stress. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/13)Different [[Rasayana|rasayana]] acting on pranavaha, rasavaha strotas, annavaha strotas depending on the dosha and site involvement can thus be implemented for management of janapadodhvansa [[Vyadhi|vyadhi]]. Use of various [[Rasayana|rasayana]] like Chyavanaprasha [[Rasayana|rasayana]] (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 1/1/62-74), Bramha [[Rasayana|rasayana]] (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 1/1/41-57), Amalaki [[Rasayana|rasayana]] (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 1/2/9-14) etc. are popular in clinical scenario for of maintenance of [[Health|health]] during pandemic conditions. Other non-pharmacological and psychotherapy based approaches like [[Sadvritta|sadvritta]] palana (following proper code of conduct) and behavioural attributes like satyabhashana (honesty), bhootadaya (compassion), bali (sacrifice), devata archana (devotion), daana (charity), vriddhopaseva (showing care and empathy towards the elderly) are mentioned to facilitate the social and mental [[Health|health]]. Providing support and care to people and families affected with pandemics is of vital importance to balance the psychological components of [[Health|health]] especially during the pandemic like conditions. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/15-16) [[Sadvritta|Sadvritta]] emphasizes on the spread and containment of the sansargajanya vyadhi (infectious [[Vyadhi|diseases]]) and their mode of transmission. (Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 8/18) The [[Sadvritta|sadvritta]] focuses on various domains like physical [[Health|health]], social behaviour, psychological state, hygiene, food etiquettes thus providing holistic care. The treatment and preventive aspects of epidemics in purview of ayurveda can be summarized in the following table-

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The [[Rasayana Adhyaya|rasayana chikitsa]] forms the backbone of treatment of janapadodhvansa as it is pivotal in enhancing the immune response to pathogenic external and internal invasion and stress. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/13) Different [[Rasayana|rasayana]] acting on pranavaha, rasavaha strotas, annavaha strotas depending on the [[Dosha|dosha]] and site involvement can thus be implemented for management of janapadodhvansa [[Vyadhi|vyadhi]]. Use of various [[Rasayana|rasayana]] like Chyavanaprasha [[Rasayana|rasayana]] (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 1/1/62-74), Bramha [[Rasayana|rasayana]] (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 1/1/41-57), [[Amalaki|Amalaki]] [[Rasayana|rasayana]] (Cha. Sa. [[Chikitsa Sthana|Chikitsa Sthana]] 1/2/9-14) etc. are popular in clinical scenario for of maintenance of [[Health|health]] during pandemic conditions. Other non-pharmacological and psychotherapy based approaches like [[Sadvritta|sadvritta]] palana (following proper code of conduct) and behavioural attributes like satyabhashana (honesty), bhootadaya (compassion), bali (sacrifice), devata archana (devotion), daana (charity), vriddhopaseva (showing care and empathy towards the elderly) are mentioned to facilitate the social and mental [[Health|health]]. Providing support and care to people and families affected with pandemics is of vital importance to balance the psychological components of [[Health|health]] especially during the pandemic like conditions. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/15-16) [[Sadvritta|Sadvritta]] emphasizes on the spread and containment of the sansargajanya vyadhi (infectious [[Vyadhi|diseases]]) and their mode of transmission. (Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 8/18) The [[Sadvritta|sadvritta]] focuses on various domains like physical [[Health|health]], social behaviour, psychological state, hygiene, food etiquettes thus providing holistic care. The treatment and preventive aspects of epidemics in purview of [[Ayurveda|ayurveda]] can be summarized in the following table-

{| class="wikitable" style="text-align:justify;"

! style="text-align:left;" colspan="2"| Other measures to ensure the promotion of [[Health|health]]

|-

−

! style="text-align:left;" colspan="2"| Promotion of ~~mentalandsocial~~ [[Health|health]]

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! style="text-align:left;" colspan="2"| Promotion of mental and social [[Health|health]]

|-

| Behavioural attributes

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* [[Sadvritta|Sadvritta]] is the righteous code of conduct representing different aspects of hygiene, social conduct, morals and behaviour.

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* These measures include regular cleansing and trimming of nails (nakhakartana), hygiene and regular cleansing of external orifices (malayana shodhana), daily bath (snana), use of fragrances (gandhopasevana) in order to arrest the foul odour, to cover ones face while experiencing sneeze, laughter or yawn and avoiding touching of face and nasal area.(Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 8/18-19)

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* These measures include regular cleansing and trimming of nails (nakhakartana), hygiene and regular cleansing of external orifices (malayana [[Shodhana|shodhana]]), daily [[Snana|bath (snana)]], use of fragrances (gandhopasevana) in order to arrest the foul odour, to cover ones face while experiencing sneeze, laughter or yawn and avoiding touching of face and nasal area.(Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 8/18-19)

|-

| Shivanam upasevanaam (using means of protection)

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* These can include the mechanical, chemical and remedial measures.

* For instance, to arrest the spread of novel corona virus, WHO has suggested measures like the usage of protective material like PPE kits which include gloves, surgical face masks, goggles, face shield, and gowns etc. and routine cleansing and disinfection of environmental and other frequently touched surfaces including hand sanitization.<ref name="ref30">Rational use of personal protective equipment for coronavirus disease (COVID-19) and considerations during severe shortages [Internet]. [cited 2020 Apr 10]. Available from: https://www.who.int/publications-detail/rational-use-of-personal-protective

−

equipment-for-coronavirus-~~[[Vyadhi|~~disease]]-(covid-19)-and-considerations-during-severe-shortages</ref>

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equipment-for-coronavirus-disease-(covid-19)-and-considerations-during-severe-shortages</ref>

|-

−

| Bramhacharya palana (Following safe sexual behaviour)

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| [[Brahmacharya|Bramhacharya]] palana (Following safe sexual behaviour)

|

* Sexually transmitting diseases (STD) spread through sexual contact and can affect healthy individuals unaware of the spread of such [[Vyadhi|diseases]]. These can subject a disastrous impact on the [[Health|health]] of women and infant.<ref name="ref31">Sexually Transmitted Diseases - Information from CDC [Internet]. [cited 2022 Jan 23]. Available from: https://www.cdc.gov/std/default.html</ref>

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* Epidemics result in quarantine and isolation of families thus reducing the social contact and depleting the mental [[Health|health]].<ref name="ref33">Hwang TJ, Rabheru K, Peisah C, Reichman W, Ikeda M. Loneliness and social isolation during the COVID-19 pandemic. Int Psychogeriatr. 2020;32(10):1217-1220. doi:10.1017/S1041610220000988</ref>

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* Recreational measures are hence important to avoid panic and maintain the mental [[Health|health]] during the epidemics. WHO also suggests in the same context as self- care, using coping strategies such as ensuring sufficient rest during work or between shifts,consumption of sufficient and healthy food, regularly performing physical activity, maintaining the social and mental wellbeing by staying in contact with family and friends. <ref name="ref34">Mental health (COVID-19) [Internet]. Public Health Sudbury & Districts. [cited 2020 Apr 10]. Available from: https://www.phsd.ca/health-topics-programs/diseases-infections/coronavirus/mental-health-covid-19</ref>

+

* Recreational measures are hence important to avoid panic and maintain the mental [[Health|health]] during the epidemics. WHO also suggests in the same context as self- care, using coping strategies such as ensuring sufficient rest during work or between shifts, consumption of sufficient and healthy food, regularly performing physical activity, maintaining the social and mental wellbeing by staying in contact with family and friends. <ref name="ref34">Mental health (COVID-19) [Internet]. Public Health Sudbury & Districts. [cited 2020 Apr 10]. Available from: https://www.phsd.ca/health-topics-programs/diseases-infections/coronavirus/mental-health-covid-19</ref>

|-

! colspan="2"| Measures according to Sushruta Samhita

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| Shanti Karma

|

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* This includes the spiritual and religious measures for the protection from rakshogana (antimicrobial)and negative afflictions.

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* This includes the spiritual and religious measures for the protection from rakshogana (antimicrobial) and negative afflictions.

|-

| Prayaschitta

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== Summary ==

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The concept of janapadodhvansa is a testimony of the contribution of [[Ayurveda|Ayurveda]] in the field of epidemiology and public [[Health|health]]. The description of the major etiological factors like sadharana [[Hetu|hetu]] (common spreading causes), adharma (not following code of conduct) and vyapanna [[Ritu|ritu]] (unfavourable climatic conditions) shall be considerd while dealing with the epidemics or pandemics. Preservation of [[Health|health]] through [[Ayurveda|ayurveda]] measures like panchakarma (five purification therapies), [[Rasayana|rasayana]] (rejuvenation therapies), [[Sadvritta|sadvritta]] (good code of conduct) are best measures for protection against pandemics. The treatments to promote good digestion and metabolism (deepana pachana) and [[Vyadhi|disease]] specific therapies for [[Jwara|jwara]] are important in case of occurance. Hygiene of external pathways like oral hygiene, nasal mucosal protection, bath, medicated smoking are measures to prevent microbial invasion and their growh in body. Thus the treatment of janapadodhvansa is a comprehensive protocol for personal and social [[Health|health]].

+

The concept of janapadodhvansa is a testimony of the contribution of [[Ayurveda|Ayurveda]] in the field of epidemiology and public [[Health|health]]. The description of the major etiological factors like sadharana [[Hetu|hetu]] (common spreading causes), adharma (not following code of conduct) and vyapanna [[Ritu|ritu]] (unfavourable climatic conditions) shall be considerd while dealing with the epidemics or pandemics. Preservation of [[Health|health]] through [[Ayurveda|ayurveda]] measures like [[Panchakarma|panchakarma]] (five purification therapies), [[Rasayana|rasayana]] (rejuvenation therapies), [[Sadvritta|sadvritta]] (good code of conduct) are best measures for protection against pandemics. The treatments to promote good digestion and metabolism ([[Deepana|deepana]] [[Pachana|pachana]]) and [[Vyadhi|disease]] specific therapies for [[Jwara|jwara]] are important in case of occurance. Hygiene of external pathways like oral hygiene, nasal mucosal protection, bath, medicated smoking are measures to prevent microbial invasion and their growh in body. Thus the treatment of janapadodhvansa is a comprehensive protocol for personal and social [[Health|health]].

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