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Janapadodhvansa (view source)

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== Causes of janapadodhvansa ==

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Two types of causes of origin of [[Vyadhi|diseases]] ([[Vyadhi|vyadhi]]-utpatti hetu) are described. Common aetiological factors (sadharana hetu) can produce [[Vyadhi|diseases]] in almost all the beings (bahujana sadharana).Specific etiological factors (asadharana hetu) are personalized and differ from individual to individual. (Chakrapani on Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/3)Janapadodhvansa chapter deals with the common causes of [[Vyadhi|disease]] occurrence in large community. The four main environmental factors like [[Vata dosha|vata]] (vitiated air or atmospheric factors), [[Jala mahabhuta|jala]] (vitiated water), [[Desha|desha]] (geographical factors or those related to vitiated land and soil resources), kaala (seasonal and climatic conditions) are focused to cause epidemic situations. (Cha. Sa [[Vimana Sthana|Vimana Sthana]] 3/6). These can be summarized as given in the table below: (Table No. 1 – Entity causative of janapadodhvansa and its interpretation in present context)

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Two types of causes of origin of [[Vyadhi|diseases]] ([[Vyadhi|vyadhi]]-utpatti [[Hetu|hetu]]) are described. Common aetiological factors (sadharana [[Hetu|hetu]]) can produce [[Vyadhi|diseases]] in almost all the beings (bahujana sadharana).Specific etiological factors (asadharana [[Hetu|hetu]]) are personalized and differ from individual to individual. (Chakrapani on Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/3)Janapadodhvansa chapter deals with the common causes of [[Vyadhi|disease]] occurrence in large community. The four main environmental factors like [[Vata dosha|vata]] (vitiated air or atmospheric factors), [[Jala mahabhuta|jala]] (vitiated water), [[Desha|desha]] (geographical factors or those related to vitiated land and soil resources), kaala (seasonal and climatic conditions) are focused to cause epidemic situations. (Cha. Sa [[Vimana Sthana|Vimana Sthana]] 3/6). These can be summarized as given in the table below: (Table No. 1 – Entity causative of janapadodhvansa and its interpretation in present context)

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

! Entity

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| Upaksheena jalashaya – drying up of water resources- indication of drought

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| Drought is a prolonged dry period in the natural climate cycle. This slow-onset disaster is ~~characterizedby~~ lack of precipitation, resulting in a water shortage.<ref name="ref13">Drought [Internet]. [cited 2022 Jan 21]. Available from: https://www.who.int/westernpacific/health-topics/drought</ref>

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| Drought is a prolonged dry period in the natural climate cycle. This slow-onset disaster is characterized by lack of precipitation, resulting in a water shortage.<ref name="ref13">Drought [Internet]. [cited 2022 Jan 21]. Available from: https://www.who.int/westernpacific/health-topics/drought</ref>

|-

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| Apreetikara aapada guna –Water sources having questionable palatability and quality.

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| Apreetikara aapada [[Guna|guna]] –Water sources having questionable palatability and quality.

| The water quality is affected by pollutants and particulate matter rendering it undesirable taste, odour, colour and consistency. If the drinking water is not of optimum quality, it threatens the overall [[Health|health]] of community.<ref name="ref14">Common Perceptible Water Quality Issues [Internet]. [cited 2020 Apr 5]. Available from: https://www.wqa.org/learn-about-water/perceptible-issues</ref>

|- style="vertical-align:top;"

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| Disruption of social conduct and behaviour. These factors determine the effect on the social, behavioural determinants of health.<ref name="ref18">Social determinants of health [Internet]. [cited 2021 Jul 21]. Available from: https://www.who.int/westernpacific/health-topics/social-determinants-of-health</ref>

|-

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| Pratata ulka pata - area more prone to occurrence of natural calamities like meteors etc. Bhumikampa – occurrence of earthquakes.

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| Pratata ulka pata - area more prone to occurrence of natural calamities like meteors etc. Bhumikampa – occurrence of earthquakes.

| This refers to susceptibility of region for the occurrence of natural calamities.<ref name="ref19">Definition of NATURAL DISASTER [Internet]. [cited 2022 Jan 23]. Available from: https://www.merriam-webster.com/dictionary/natural+disaster</ref> These are a sudden events in nature that usually results in serious morbidity and mortality. floods ,earthquakes, tornados etc.

|- style="vertical-align:top;"

| Kaala

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| Yatha ritu -viparita lakshana – excessive seasonal variations. yatha ritu- hina linga, ati linga

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| Kaala factor is the seasonal occurrence of [[Vyadhi|diseases]]. These also indicate the [[Vyadhi|disease]] conditions arising from the disrupted climate.<ref name="ref20">Grassly NC, Fraser C. Seasonal infectious disease epidemiology. Proc Biol Sci. 2006 Oct 7;273(1600):2541–50.</ref>

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|}

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Acharya Sushruta states vyapanna 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 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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Adharma (inappropriate behaviour) is another cause of janapadodhvansa can be described as not abiding to one’s prescribed duties and responsibilities. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/24) This can be associated with the human conduct and behaviour responsible for the occurrence of [[Vyadhi|diseases]]. This reflects on the social determinants of [[Health|health]]. The researches have proved that human behaviour is equally responsible in occurrence of epidemics as it results in excessive exploitation of natural resources, increase in pollution, increase in incidence of warfare, decreased social harmony, disturbance of ecosystems and deterioration of universal [[Health|health]].<ref name="ref21">Funk S, Salathé M, Jansen VAA. Modelling the influence of human behaviour on the spread of infectious diseases: a review. J R Soc Interface. 2010 Sep 6;7(50):1247–56.</ref> Pragyaparadha (intellectual errors), shashtraprabhava (warfare), rakshogana (infectious conditions) and abhishapa (inappropriate social behaviour) are social, behavioral determinants of [[Health|health]]. These can be termed as host specific factors for [[Vyadhi|disease]] occurrence. Adharma as a hetu of janapadodhvansa can be illustrated in the table as given below (Table No. 2-Hetu of janapadodhvansa in purview of adharma)

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Adharma (inappropriate behaviour) is another cause of janapadodhvansa can be described as not abiding to one’s prescribed duties and responsibilities. (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3/24) This can be associated with the human conduct and behaviour responsible for the occurrence of [[Vyadhi|diseases]]. This reflects on the social determinants of [[Health|health]]. The researches have proved that human behaviour is equally responsible in occurrence of epidemics as it results in excessive exploitation of natural resources, increase in pollution, increase in incidence of warfare, decreased social harmony, disturbance of ecosystems and deterioration of universal [[Health|health]].<ref name="ref21">Funk S, Salathé M, Jansen VAA. Modelling the influence of human behaviour on the spread of infectious diseases: a review. J R Soc Interface. 2010 Sep 6;7(50):1247–56.</ref> [[Prajnaparadha|Pragyaparadha]] (intellectual errors), shashtraprabhava (warfare), rakshogana (infectious conditions) and abhishapa (inappropriate social behaviour) are social, behavioral determinants of [[Health|health]]. These can be termed as host specific factors for [[Vyadhi|disease]] occurrence. Adharma as a [[Hetu|hetu]] of janapadodhvansa can be illustrated in the table as given below (Table No. 2 - [[Hetu|Hetu]] of janapadodhvansa in purview of adharma)

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

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!colspan="2"| Hetu of janapadodhvansa in purview of adharma

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!colspan="2"| [[Hetu|Hetu]] of janapadodhvansa in purview of adharma

|-

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| Prajnaparadha

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| [[Prajnaparadha|Prajnaparadha]]

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| Prajnaparadha is intellectual mistake or knowingly performing sinful or inappropriate actions. (Cha. Sa. Shareera Sthana 1/102)This can be compared with the imbalance in public [[Health|health]] and lack of healthcare management systems, lack of personal hygiene and lack of awareness regarding preservation of [[Health|health]] which affects the [[Health|health]] of community.<ref name="ref22">Organisation mondiale de la santé. Managing epidemics: key facts about major deadly diseases. 2018.</ref>

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| [[Prajnaparadha|Prajnaparadha]] is intellectual mistake or knowingly performing sinful or inappropriate actions. (Cha. Sa. [[Sharira Sthana|Shareera Sthana]] 1/102) This can be compared with the imbalance in public [[Health|health]] and lack of healthcare management systems, lack of personal hygiene and lack of awareness regarding preservation of [[Health|health]] which affects the [[Health|health]] of community.<ref name="ref22">Organisation mondiale de la santé. Managing epidemics: key facts about major deadly diseases. 2018.</ref>

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| Shashtraprabhava

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| Abhishapa

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| These refer to the compromised social and community manners and etiquette guidelines thus decreasing public [[Health|health]] i.e. absence of sadvritta palana (code of conduct).<ref name="ref25">Dempsey RC, McAlaney J, Bewick BM. A Critical Appraisal of the Social Norms Approach as an Interventional Strategy for Health-Related Behavior and Attitude Change. Frontiers in Psychology [Internet]. 2018 [cited 2022 Jan 23];9. Available from: https://www.frontiersin.org/article/10.3389/fpsyg.2018.02180</ref>

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| These refer to the compromised social and community manners and etiquette guidelines thus decreasing public [[Health|health]] i.e. absence of [[Sadvritta|sadvritta]] palana (code of conduct).<ref name="ref25">Dempsey RC, McAlaney J, Bewick BM. A Critical Appraisal of the Social Norms Approach as an Interventional Strategy for Health-Related Behavior and Attitude Change. Frontiers in Psychology [Internet]. 2018 [cited 2022 Jan 23];9. Available from: https://www.frontiersin.org/article/10.3389/fpsyg.2018.02180</ref>

|-

|}

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'''Thus the three ~~majoretiological~~ causes of Janapadodhwans can be featured in the figure as given below- (Figure No. 1 – Major Hetu of Janapadodhvansa)'''

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'''Thus the three major etiological causes of Janapadodhwans can be featured in the figure as given below- (Figure No. 1 – Major [[Hetu|Hetu]] of Janapadodhvansa)'''

[[File:Major Hetu of Janapadodhvansa.jpg|center|Figure No. 1 – Major Hetu of Janapadodhvansa]]

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== Jwara (fever) as a prime linga (~representative symptom) of janapadodhvansajanya [[Vyadhi|vyadhi]] ==

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== [[Jwara|Jwara (fever)]] as a prime [[Linga|linga]] (~representative symptom) of janapadodhvansajanya [[Vyadhi|vyadhi]] ==

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Jwara is characterized as a condition affecting both physical and mental wellbeing. It is the chief disorder amongst all other [[Vyadhi|diseases]] affecting every living being at the time of birth and death. (Cha. Sa. Nidana Sthana 1/35) Most of the epidemics related to infectious [[Vyadhi|diseases]] are types of influenza or are almost always associated with fever.<ref name="ref26">Microbial Threats I of M (US) F on. Infectious Disease Emergence: Past, Present, and Future [Internet]. Microbial Evolution and Co-Adaptation: A Tribute to the Life and Scientific Legacies of Joshua Lederberg: Workshop Summary. National Academies Press (US); 2009 [cited 2020 Apr 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK45714/</ref> Outbreak of Spanish Flu, dengue fever, swine flu, bird flu, typhoid, cholera, and even the present day COVID-19 are examples of jwara that resulted in some or the other form of janapadodhvansa.<ref name="ref27">Baker RE, Mahmud AS, Miller IF, et al. Infectious disease in an era of global change. Nat Rev Microbiol. 2022;20(4):193-205. doi:10.1038/s41579-021-00639-z</ref> Sushruta (Su. Sa. [[Sutra Sthana|Sutra Sthana]] 6/21) on the other hand has also explained few other manifestations of maraka like kasa (cough, bronchitis, lower respiratory tract infections), shwasa (respiratory infections, pneumonia), vamathu (gastric disturbance, nausea), pratishyaya (rhinitis, coryza or upper respiratory tract infections), shiroruja (headache)besides jwara. These are also commonly observed infectious [[Vyadhi|diseases]] posing havoc in the community. Similarly, Sushruta mentions that the infection can also spread through surface contact with things like beddings, blankets, seating arrangement, vehicles, jewellery and accessories. (Su. Sa. [[Sutra Sthana|Sutra Sthana]] 6/21)

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[[Jwara|Jwara]] is characterized as a condition affecting both physical and mental wellbeing. It is the chief disorder amongst all other [[Vyadhi|diseases]] affecting every living being at the time of birth and death. (Cha. Sa. [[Nidana Sthana|Nidana Sthana]] 1/35) Most of the epidemics related to infectious [[Vyadhi|diseases]] are types of influenza or are almost always associated with fever.<ref name="ref26">Microbial Threats I of M (US) F on. Infectious Disease Emergence: Past, Present, and Future [Internet]. Microbial Evolution and Co-Adaptation: A Tribute to the Life and Scientific Legacies of Joshua Lederberg: Workshop Summary. National Academies Press (US); 2009 [cited 2020 Apr 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK45714/</ref> Outbreak of Spanish Flu, dengue fever, swine flu, bird flu, typhoid, cholera, and even the present day COVID-19 are examples of [[Jwara|jwara]] that resulted in some or the other form of janapadodhvansa.<ref name="ref27">Baker RE, Mahmud AS, Miller IF, et al. Infectious disease in an era of global change. Nat Rev Microbiol. 2022;20(4):193-205. doi:10.1038/s41579-021-00639-z</ref> Sushruta (Su. Sa. [[Sutra Sthana|Sutra Sthana]] 6/21) on the other hand has also explained few other manifestations of maraka like [[Kasa Chikitsa|kasa]] (cough, bronchitis, lower respiratory tract infections), [[Shwasa|shwasa]] (respiratory infections, pneumonia), vamathu (gastric disturbance, nausea), pratishyaya (rhinitis, coryza or upper respiratory tract infections), shiroruja (headache) besides [[Jwara|jwara]]. These are also commonly observed infectious [[Vyadhi|diseases]] posing havoc in the community. Similarly, Sushruta mentions that the infection can also spread through surface contact with things like beddings, blankets, seating arrangement, vehicles, jewellery and accessories. (Su. Sa. [[Sutra Sthana|Sutra Sthana]] 6/21)

== 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 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 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 (cough), peenasa (sinusitis), nava jwara (pyrexia), 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 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 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 (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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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 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 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 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-

+

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-

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

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

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* Mental and social [[Health|health]] is as important as the physical [[Health|health]] as epidemics result in massive disruption of all aspects of [[Health|health]].<ref name="ref29">Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. J Health Soc Behav. 2010;51 Suppl(Suppl):S54-S66. doi:10.1177/0022146510383501</ref>

|-

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| Practice of sadvritta

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| Practice of [[Sadvritta|sadvritta]]

|

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

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

* 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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== Recent research work done with regard to janapadodhvansa ==

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As mentioned earlier the pandemics have been a pressing problems since centuries altogether. The published data suggests that there have three pandemics of plague (since 5th century AD) , 7 pandemics of cholera(17th century AD), Influenza related pandemics (17th century AD) like Russian Flu, Spanish Flu, Swine Flu, SARS (Severe Acute Respiratory Syndrome), MERS (Middle East Respiratory Syndrome) in the past and Covid 19 (21st century) being the most recent.<ref name="ref60">Piret J and Boivin G (2021) Pandemics Throughout History. Front. Microbiol. 11:631736. doi: 10.3389/fmicb.2020.631736</ref> The data from WHO sugggets that Covid 19 is still prevalent in most of the parts of the world and as of 9 April 2023 more than 762 million confirmed cases and over 6.8 million deaths have been reported globally.<ref name="ref61">Weekly epidemiological update on COVID-19 - 13 April 2023 [Internet]. [cited 2023 May 5]. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---13-april-2023</ref> The outbreak of COVID-19 pandemic attracted the attention of [[Ayurveda|ayurveda]] fraternity towards the concept of Janapadodhvansa and its importance in preservation of [[Health|health]] of entire community. Significant research work was thus carried out in this purview keeping janapadodhvansa in mind. Few such works are mentioned are mentioned belowHowever epidemiological assessment of various Hetu and Lakshana should be done accordingly

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As mentioned earlier the pandemics have been a pressing problems since centuries altogether. The published data suggests that there have three pandemics of plague (since 5th century AD) , 7 pandemics of cholera(17th century AD), Influenza related pandemics (17th century AD) like Russian Flu, Spanish Flu, Swine Flu, SARS (Severe Acute Respiratory Syndrome), MERS (Middle East Respiratory Syndrome) in the past and Covid 19 (21st century) being the most recent.<ref name="ref60">Piret J and Boivin G (2021) Pandemics Throughout History. Front. Microbiol. 11:631736. doi: 10.3389/fmicb.2020.631736</ref> The data from WHO sugggets that Covid 19 is still prevalent in most of the parts of the world and as of 9 April 2023 more than 762 million confirmed cases and over 6.8 million deaths have been reported globally.<ref name="ref61">Weekly epidemiological update on COVID-19 - 13 April 2023 [Internet]. [cited 2023 May 5]. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-on-covid-19---13-april-2023</ref> The outbreak of COVID-19 pandemic attracted the attention of [[Ayurveda|ayurveda]] fraternity towards the concept of Janapadodhvansa and its importance in preservation of [[Health|health]] of entire community. Significant research work was thus carried out in this purview keeping janapadodhvansa in mind. Few such works are mentioned are mentioned belowHowever epidemiological assessment of various [[Hetu|Hetu]] and Lakshana should be done accordingly

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<ol style='text-align:justify;'><li>In the review article entitled “Scientific aspects of Janapadodhvansa [[Vyadhi|Vyadhi]] (epidemic disorders) according to [[Ayurveda|Ayurveda]] in the context to ~~Jwara—An~~ epidemiological and Trisutra-based approach” authors have tried to throw light upon the scientific aspects of janapadodhvansa [[Vyadhi|vyadhi]] in light of epidemiology by correlating the epidemiological triad with trisutra i.e. epidemiological triad i.e. Host, agent and environment.<ref name="ref62">Joglekar AA, Vyas MK, Bhojani MK. Scientific aspects of Janapadodhwansa Vyadhi (epidemic disorders) according to Ayurveda in the context to Jwara—An epidemiological and Trisutra-based approach. J Indian Sys Medicine [serial online] 2022 [cited 2023 Apr 23];10:176-85. Available from: https://www.joinsysmed.com/text.asp?2022/10/3/176/357681</ref></li>

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<ol style='text-align:justify;'><li>In the review article entitled “Scientific aspects of Janapadodhvansa [[Vyadhi|Vyadhi]] (epidemic disorders) according to [[Ayurveda|Ayurveda]] in the context to [[Jwara|Jwara]]—An epidemiological and Trisutra-based approach” authors have tried to throw light upon the scientific aspects of janapadodhvansa [[Vyadhi|vyadhi]] in light of epidemiology by correlating the epidemiological triad with trisutra i.e. epidemiological triad i.e. Host, agent and environment.<ref name="ref62">Joglekar AA, Vyas MK, Bhojani MK. Scientific aspects of Janapadodhwansa Vyadhi (epidemic disorders) according to Ayurveda in the context to Jwara—An epidemiological and Trisutra-based approach. J Indian Sys Medicine [serial online] 2022 [cited 2023 Apr 23];10:176-85. Available from: https://www.joinsysmed.com/text.asp?2022/10/3/176/357681</ref></li>

<li>Review article entitled “Conceptual study on Janapadodhvansa Roga and its treatment” focuses on the major causes of janapadodhvansa and purification of impure soil, water and air mentioned according to [[Ayurveda|Ayurveda]].<ref name="ref63">Anuradha G. Patil, Hemlata Krishnarao Belorkar, Conceptual study on Janapadodhvansa Roga and its treatment. J Ayu Int Med Sci. 2022;7(1):275-278.

Available From- https://jaims.in/jaims/article/view/1702

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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 (common spreading causes), adharma (not following code of conduct) and vyapanna 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 (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 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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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]].

== Related Chapters ==

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Janapadodhvansaniya Vimana (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3), Ritucharya Adhyaya (Su. Sa. [[Sutra Sthana|Sutrasthana]] 6)

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Janapadodhvansaniya Vimana (Cha. Sa. [[Vimana Sthana|Vimana Sthana]] 3), [[Ritucharya|Ritucharya]] Adhyaya (Su. Sa. [[Sutra Sthana|Sutrasthana]] 6)

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