Changes

<p style='text-align:justify;'>[[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> <br/>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. <br/>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)</p>

<p style='text-align:justify;'>[[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> <br/>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. <br/>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)</p>

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

== Management of janapadodhvansa ==

<p style='text-align:justify;'>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> <br/>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) <br/>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]]. <br/>[[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)

<p style='text-align:justify;'>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]] 3/4,13-18] This denotes the basis of disaster management and organization 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> <br/>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 satiates thirst(trishna), 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] <br/>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 fecal 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 progression. [[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]]. <br/>[[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]

<br/>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. <br/>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) <br/>[[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. <br/>The treatment and preventive aspects of epidemics in purview of [[Ayurveda|ayurveda]] can be summarized in the following table-</p>

<br/>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. <br/>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] <br/>[[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. <br/>The treatment and preventive aspects of epidemics in purview of [[Ayurveda|ayurveda]] can be summarized in the following table-</p>

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

{| 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"| Other measures to ensure the promotion of [[Health|health]]

|  

|  

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

* [[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|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)

* 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 <br/>(using means of protection)

| Shivanam upasevanaam <br/>(using means of protection)

| Prayaschitta

| Prayaschitta

|  

|  

* As the adharma is considered to be important aspect in causation of janapadodhvansa, the papakarma(..)can be alleviated through some form of prayaschitta or good deeds

* As the adharma is considered to be important aspect in causation of janapadodhvansa, the papa karma(evil deeds)can be alleviated through some form of prayaschitta or good deeds

|-

|-

| Japa (meditation), <br/>homa (sacred offering to fire), <br/>Ijya (sacred offerings)

| Japa (muttering a prayer/chanting repeatedly), <br/>homa (sacred offering to fire), <br/>Ijya (sacred offerings)

|  

|  

* This again includes performing the religious deeds and offerings to sacred fire which help to curb the negativity in the atmosphere and [[Manas|mind]].<ref name="ref35"> Nair RR. Agnihotra Yajna: A Prototype of South Asian Traditional Medical Knowledge. Journal of Acupuncture and Meridian Studies [Internet]. 2017 Apr 1 [cited 2023 Apr 23];10(2):143–50. Available from: https://www.sciencedirect.com/science/article/pii/S2005290116301728</ref>  

* This again includes performing the religious deeds and offerings to sacred fire which help to curb the negativity in the atmosphere and [[Manas|mind]].<ref name="ref35"> Nair RR. Agnihotra Yajna: A Prototype of South Asian Traditional Medical Knowledge. Journal of Acupuncture and Meridian Studies [Internet]. 2017 Apr 1 [cited 2023 Apr 23];10(2):143–50. Available from: https://www.sciencedirect.com/science/article/pii/S2005290116301728</ref>