Review Article |
Open Access |
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Nishant Shukla |
Gujarat Ayurved University, Jamnagar, India |
*Corresponding author: |
Nishant Shukla
Lecturer, SYN, SGAM
Gujarat Ayurved University
Jamnagar, India
E-mail: nishantvd@rediffmail.com |
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Received April 10, 2012; Published June 22, 2012 |
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Citation: Shukla N (2012) Ayurvedic Approach to Communicable Disease – An Overview. 1: 122. doi:10.4172/scientificreports.122 |
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Copyright: © 2012 Shukla N. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
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Abstract |
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It is believed in society that communicable diseases are managed only by modern medicines, though this is not completely true. Advances in antibiotics decreased toxicity, and many complications, but usually have adverse drug reactions. Management of these diseases is not only important but their prevention is also of concern. |
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Ayurved do believes in microorganisms and their role in disease, but emphasized more on body’s response and occurrence of disease occurs only if the Bala is reduced. |
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Susruta describes the communication through contacts; Charaka describes communication of disease via other factors like air, water, etc. Combating these diseases is to be done at various levels i.e. stopping the progression, building immunity against disease using various means and treating them. |
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Details regarding the management including prophylactics are described in Ayurvedic texts that will be incorporated in full paper. |
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Keywords |
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Infectious disease; Contagious disease; Vaccine |
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Introduction |
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Communicable disease is amongst the important group of human diseases coming into contact. These diseases have specific etiological cause usually a microorganism. These microbial agents are usually specific in nature, lodge in particular tissues, and grow with the help of human biological system, finally precipitate as disease as a result of toxins (endotoxins or exotoxins). Development in investigative techniques increased knowledge of these infective organism, and also means for combating against them. Knowing behavior of these organisms it is easier to know the route of spreading and thus control measure of their communication can be made with ease. Ayurveda too described these agents, method of spread, methods of controlling and also curative measure of these diseases. |
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Communicable disease are classified into two categories viz. 1 ) Contagious disease – spreading of these disease is usually by direct contact & the other group is 2 ) Infectious diseases – spreading of these is usually by physical, chemical and biological pathway including vector. Infectious diseases do not require direct contact of healthy person to diseased one, but patient may spread disease through many ways. |
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It is important to stop the progression of disease at earliest possible stage [1]. Stopping the progression of the disease in case of communicable disease is the most ideal stage of controlling the disease, moreover increasing immunity by various means against these ailments are also required. Increasing immunity ensures, that even with the exposure of the disease producing pathogens, disease is not going to be manifested. Ayurved describes general guidelines of leaving healthy [2], but specific measure needs to be discovered from the Ayurvedic treatises. Acharya Susruta describes in Alarka Visha (rabies or hydrophobia) that, if the symptoms of the disease are produced diseased person survives but if the symptoms produces on its own there is no cure and death is certain. Concept of vaccine is narrated in the presented example; it is required to search for others also. |
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Ayurvedic Concept of Disease |
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Disease is state of altered or vitiated state of Doshas. Alteration in these body elements occurs due to various internal and external factors. External factors directly lead to manifestation of disease followed by involvement of Doshas. Thus the etiological factors of the disease may be in relation to food, routine, external factors like air, water, trauma or microbes, disease occurs only after Doshic vitiation. Thus even in microbial diseases too Doshas are important for occurrence of disease and its management. In view of this it seems that though Scholars of Ayurved knew the role of microbial agents in occurrence of disease but emphasized more on Doshas only. |
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Susruta in Kustha (group of skin disease) describes that the diseases like Kustha (skin disease), Jwara (pyrexia or fever), Shosha (kock’s or tuberculosis) etc are contagious and spreads or occurring direct contact or by use of contaminated objects [3]. Prasnaga all forms contacts, Gatra Sansparsha direct contacts, eating together, sleeping together (including sexual contact), sharing and using of others cloths, ornaments, ointments, etc leads to diseases like Kustha, Jwara, Shosha, Netrabhishyanda (conjunctivitis), and in this manner the disease spread from person to person. This describes Aupsargic disease i.e. contagious disease or spread of disease through contacts. Charaka Samhita describes role of Vayu (air), Udak (Water), Desha (soil & area), Kala (Time) are the factors responsible for Janapadodhwansha – epidemics. Charka’s description is more of the infectious disease, and narrates contamination of physical, chemical & biological factors in occurrence of disease [4]. |
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These two are the examples of what Ayurveda believes about the infectious disease and epidemics. This is described to justify that, role of microorganism and knowledge of epidemics was known in Ayurveda and not the only the contribution of western world. Charaka Samhita in describing the Vishama Jwara (a variety of Tridoshaja Jwara – most common variant of Visham Jwara is Malaria), describes that depending on localization and involvement of Dhatus (Body Tissues) fever (temperature) rises after a particular interval only. More over it is advocated that body’s immunity system is of more importance than the infective organisms. It is mentioned that Bij (seeds) socked in Bhoomi (land) flourishes only in correct time (atmosphere), and Doshas vitiates (microorganism ought to vitiate Doshas) Dhatus if Dhatus Bala (immunity) depleted and in correct time [5]. |
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Above description is quite clear that the body’s specific and nonspecific immunity plays major role in occurrence and non-occurrence of disease. Charaka describes in details the role of amalgamation of causative factors, Doshas and Dushyas in occurrence and nonoccurrence of disease. If these factors amalgamate by massive exposure or indulgence of etiological factors (massive microbial load), during very short period and depleted strength of Dhatus leads to occurrence of disease with gigantic presentation of disease and symptom. If the case occurs disease even if produced will be with mild to mildest form only or mere induce an immune response in body thus no disease occurs [6]. Amalgamations of these three components are even described in Jwara by Achrya Charaka with specific role of debilitative strength of body [7]. Acharya Charaka scholarly describes in Jwara (Fever – the most common presenting clinical manifestation of any type of inflammatory process in body) that inflammatory process due to pathogen occurs only when body’s defense mechanism is compromised or in other words, disease occurs only in immno-compromised subjects. |
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Ayurvedic Approach for Pathogenesis of Infectious Diseases |
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No separate description for pathogenesis is described for the pathogenic occurrence of disease. In some diseases like Agantuj Jwara (variety of fever occurring due to external factors), Agantuja Atisara (Diarrhea due to external factors), Ajirna (indigestion), Visuchika (Cholera), etc are fewer disease where immediately disease occurs followed by vitiation of Doshas, which may be correlated with the infectious agents. In rest of the cases, no separate description is available for infectious diseases and they are understood with the reference to general description of disease. |
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Disease origin, progression and development of disease is described in the description in Shat Kriya Kala (here one thing must be clarified that basic motto of Ayurveda is to obtain the state of Dhatu Samya – equilibrium of dhatus [8] and for achieving these objective studies of a through knowledge of Hetu (etiological factors), Linga (clinical presentation) and Aaushadha (Drugs or medicines) [9] for healthy & diseased person for maintenance of health of healthy individual and treating the diseased person to obtain the status of Prakriti Satmya) stages of pathogenesis are referred as the stages of arresting the progression of disease [10] and hence are termed as the stage of treatment. These stages involve vitiating condition of Dosha, Dhatu and Malas. Out of those, first stages involves only Dhatus, followed by them is the stages where Dhatus & Malas and last stage is the stage of differentiation or complications. The first three stages is the time in which lodgment of infective agents, disturbing the status of Doshas. Environmental, diet, life style modifications, indulgence, etc leads to vitiation of the bodily elements. The third stage of pathogenesis is the stage of migration and circulation, which happens by the action of Vayu by the means of Rasa (blood circulation, lymphatics, interstitial fluid, etc) [11] these circulating Doshas settle in places of Lowered vitality [12-14]. This means that, though the knowledge of infective knowledge is not poor to Ayurvedic scholars emphasized more on the status of Doshas or body’s immune system in manifestation of infective diseases also. |
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Ayurvedic Approach of Management of Infective Diseases |
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Ultimate goal of Ayurveda is to ensure complete and comprehensive health and all literature is all about maintenance of the status of equilibrium of body tissues [15]. Ayurved provides three fold comprehensive management modalities for disease [16]. It is believed in Ayurved that infective agents producing bodily disease also effects psyche [17, 18]. Thus even in Infective pathologies too three fold management of Ayurveda has definite role to play. Daivavyapaashrya and Satvavajaya the methods of psycho-spiritual healing practices help in correcting disturbed state of Psyche which in turn help in potentiating body’s immune system. Yukti Vyapaashrya Chikitsa is the considered to be more important as certain specific measure against disease are carried out, including purifications, medications, surgical interventions etc. In Yukti Vyapaashrya Chikitsa Charaka describes unique three fold management for the disease esp. occurring due to any infections. Charaka describes in three different [19] modalities in management of Krimi (micro & macro organisms tend to produce disease) viz. 1) Apakarshana, 2) Prakriti Vighata and 3) Nidaana Parivarjana [20]. |
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1) Apakarshana: is the process of removal of disease producing Krimi out of body using various therapeutic purificatery process like Vaman (Therapeutic emesis), Virechana (Therapeutic purgation), Basti (Enema usually decoction enemas), Shirovirechana (Nasal drops), Rakta Moskha (blood letting) & manual removal of visible macro organisms. These processes are to be done in accordance to the feasibility of these processes i.e. after proper examination of Ama, Pachayamaana and Niram stages. This may be employed depending on clinical presentation of disease, easy removal of Doshas, etc. |
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2) Prakriti Vighata: is a very unique medicament described by Charaka that uses the drugs which stops growth of disease producing microbes by creating an unfavorable condition of growth of these organisms. In Prakriti Vighata drugs having Katu, Tikta, Kashaaya, Kshra (alkali), Ushna (worm material), etc are utilized which decreases Kapha and Malas on which these microorganisms lodges, flourish, grows in increase in numbers, thus leading to disease. Increase in number of microorganism is very important step in infective diseases, as increased number of the microbes will increase toxin load and also uses body physiological mechanism in increasing the number more, thus disease progress and if this chain is blocked at this level, disease even though occurs will be of mild form, requires very less medication, reduces toxicity & complications and early recovery. Thus load on the medical management may be decreased. This is even more useful in infective diseases having long incubation and window period. Even after known infection, this if utilized will help in treating the condition very easily. Scholar has tried the same principal in managing symptoms less patients of HbSAg (Hepatitis B), TORCH, chronic & latent malaria, etc. where most of the other medicament usually having limitation, having the chances of therapeutic adverse drug reactions. Details of the cases are not discussed here as there are very few cases and are under study, moreover the subject of the paper is ayurvedic principles in infective disease thus it is not discussed here. It may be dealt in separate paper. |
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3) Nidaana Parivarjana: is the most efficient method of managing the disease condition. It is considered to be the first and foremost method of management. Stopping the invasion of path gnomic organisms into the body will ceases the chances of getting disease. To understand and effectively using Nidaan Parivarjana, it is required that the knowledge of invasion, factors responsible for the disease must be known, and all necessary steps are to be employed for reducing the chances of contacts so that one is not exposed to disease producing microbes and doesn’t indulge the same. |
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Summery Decision and Conclusion |
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It may be summarized that Ayurved was having adequate knowledge about microorganisms, but emphasized more on body’s response towards them. This is the reason that Ayurvedic Scholars described very little about these microbial agent, where ever necessary they described with most precise details. According to Charaka disease is only due to amalgamation of Dosha and Dhatus and impartation of vitiated qualities of Doshas over Dhatus. This justifies that Body’s immune system plays vital role in production and non-production of diseases. |
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Infective pathologies can be efficiently managed by ayurvedic managements and medicaments also. Though it is evident that most of the herbal formulation fails to prove its efficacy on microbes in experimental studies, but it is observed since ages that they have disease curing action, which is by the action of these herbs or medicine on increasing body’s action against disease. Here it may be clarified that the lack of technologies fails to prove the affectivity of herbal formulations in infective disease, newer advanced technologies in future may prove them effective, but till that time as an Ayurvedist it is required to collect as many clinical evidence to prove ayurvedic medicine effective and safe in managing even infective diseases. |
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