Article Type : Review Article
Authors : Prakash Yoganandam G, Gopal V and Aravinth V
Keywords : Covid-19; WHO; Ayush; Traditional system of medicine
A novel coronavirus, designated as 2019-nCoV, emerged
in Wuhan, China, in the completion of 2019 calendar year. As of January 24,
2020, nearly 830 cases had been identified in nine countries viz China,
Thailand, Japan, South Korea, Singapore, Vietnam, Taiwan, Nepal, and the United
States of America.
Twenty-six
mortalities ensued, mainly in patients who had serious fundamental
co-morbidities. Many details of the appearance of this virus such as its origin
and its ability to spread among humans remain mysterious, increasing number of
cases appear resulted from human to human transmission. 2019-nCoV is the third
coronavirus to emerge in the human population in the past two decades in spite
of the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) outbreak in
2002 and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak
in 2012, an emergence that has put world population and medical organizations
on highly prepared [1].
China immediately reports this issue by informing the
World Health Organization (WHO) and sharing information with the international
community after discovery of the causative agent SARS CoV-2. The WHO responded
promptly by organizing diagnostics development; issuing direction on patient
monitoring, specimen collection, and management; and providing up-to-date info
on the outbreak of COVID-19 [2-3]. Several countries in the world are screening
travellers from Wuhan for fever, aiming to detect 2019-nCoV cases before the
virus banquets further.
Updates from China, Thailand, Korea, and Japan
indicates the disease associated with 2019-nCoV appears to be relatively minor
as related with SARS and MERS. Corona viruses constitute a large family of
viruses that can infect animals including humans, according to world health
organization (WHO). These viruses have been responsible for numerous outbreaks
all over the globe, including the early detected severe acute respiratory
syndrome (SARS) pandemic of 2002-2003 and the Middle East respiratory syndrome
(MERS) outbreak in South Korea in 2015. Most recently, a novel coronavirus
(SARS-CoV-2, also known as Covid-19) elicited an outbreak in China in December
2019, flashing worldwide anxiety. While some corona viruses have caused
shocking epidemics, others cause mild to moderate respiratory infections, like
the common cold, fever, body pain and head ache etc., [4-6].
Dos and don'ts as outlined by Department of
Naturopathy under the ministry of AYUSH
|
What to do |
What
to avoid |
|
Drink plenty of warm
water, lemon or fresh citrus juices with honey or jaggery. |
Avoid cold drinks, preserved juices and aerated drinks and
coffee. |
|
Increase seasonings in
your daily food (Jeera, Turmeric, Ajwain, Cinnamon, cloves, cardamom etc.). |
Avoid refined sugars. |
|
Prepare foods that are
low on oils and fats (Dhalia, Idly, Kichdi). |
Avoid confectionary and bakery products. |
|
Ensure a balanced food
regime. · Have protein rich (Dal Kichdi, boiled legumes) and fiber rich
foods, millets, (vegetable soups). |
Avoid sweets, chocolates, ice creams. |
|
Obligate plenty of
coloured fruits and vegetables. Wash them thoroughly; have boiled vegetables
as curry or sambhar. |
Avoid snacking on oily and junk foods. |
|
Drink alkaline rich
juices. |
Reduce salt intake. |
|
Include Zinc and
Selenium rich foods: Oats spinach, beans, milk, cheese, pumpkin seeds,
cashews etc. |
Reduce the amount of trans- and omega-6 fatty acids in the
diet (vegetable oils). |
|
Drink at least one glass of Yogurt/day (probiotics) to
improve gut flora. |
Food in eateries. |
|
Smoking and alcohol. |
This guideline is to instruct yoga therapy, naturopathy
treatment modalities, nutrition, diet and lifestyle approaches to improve
immunity in our population. The imminent anxiety and stress of isolation due to
Covid-19 disease and lockdown can down regulate immune responses and defences
that can lead them to contract this infection and increase its severity. Though
isolation, hygiene precautions and social distancing are important for
preventing one being infected, anxiety and stress resulting from these also
need to be taken care of Treatment protocols for people with Covid-19 should
address both the physical and psychic needs of the patients and health service
providers.
Acupressure:
Applying manual pressure with the thumb to
certain points in the body is known to confer immunity and improve respiratory
effort. Individuals should be taught to apply intermittent pressure over
acupressure points LI-4, LI11, SP6, TW 5, CV17, ST36(29).
Heliotherapy:
Contact sun and air in the morning and
evening hours is known to reduce stress and confer immunity by improving
Vitamin D metabolism. This will give a change from confines of indoors and has
been shown to be useful in managing flu symptoms. Following a healthy regimen
is very important to boost one's immune response. The following lifestyle
practices have evidence to prevent one from being infected with flu.
Exercise:
Regular exercise of moderate-intensity is
related with an abridged incidence of upper respiratory tract infection. The
recommended means of aerobic exercise is walking, with an optimal frequency of
three to five days a week and an optimal duration of 20 to 30 minutes of
continuous activity.
Sleep:
Snooze and the circadian system apply a
regulatory influence on immune functions. Sleep deprivation can affect immune
function in several ways that lead to enhanced susceptibility to the common
cold and pneumonia with poor sleep efficiency [7].
In the rouse of Covid-19, an
infectious disease caused by a newly discovered coronavirus, entire manhood
across the globe is distress. Up to now, there is no medicine or therapy has
established promising results in either stopping the spread or improving its
diagnosis to prevent this infection. The greatest means of preventing Covid-19
infection are flouting the chain, improving an individual's body immunity,
identifying the infection early and timely medical care.
The Ministry of Ayush, Govt. of India
is dedicated to help the nation with the large resource of time-tested and
proved traditional knowledge practice in this continent for the benefit of
manhood. The Ministry has already circulated a series of measures to improve
individual's natural defence system (immunity) in addition to the personal
hygiene and social distancing. Ayurveda recognized epidemics/pandemics under
the context of Janapadodhvamsa (conditions devastate the human settlements).
Similarly, infectious diseases have been considered under Sankramika rogas.
Contamination of air, water, environment and atmosphere is responsible for the spread
of diseases on such a large scale resulting in Janapadodhvamsa. Causes of
vitiation of air, water, climate and place along with their features have been
enumerated in classics.
Improper disposal of waste,
distribution of polluted water, air pollution, indulgence in unhealthy and
unwholesome activities, failure of judgment and misunderstanding of situation
etc. also result in judicious damage to the health of the society; ultimately
leading to Janapadodhwamsa. Such conditions will manifest in symptoms like
cough, breathlessness, fever etc. In Ayurveda, initial phases of the
manifestation can be comparable to AgantujaVata Kaphaja Jwara. Uncontrolled
conditions further vitiate other Doshaas and other Rasa, Rakta, Mamsadi dushyas
thus entering into Sannipataja condition. This document “Protocol for Ayurveda
Practitioners” is a guideline for the use of registered Ayurveda Practitioners
only. There are four sections covering the whole spectrum of COVID 19 infection
management.
Rasayana
for Children
·Indukanta Ghritam– 5-10
ml in two divided doses with warm milk.
·Aravindasavam– 5-15 ml in
two divided doses with warm water after food.
·Balachaturbhadra Churna -
1-2 gm dose with honey two times a day.
Rasayana
for pregnant and lactating women
· Phala Sarpis*: 10-12 g in
two divided doses with warm water
·Kalyanaka Ghrita*: 10-12g
in two divided doses with warm water
· Ashwagandha Rasayana* -
10-12 g twice daily with warm milk. Soubhagya Shunti Leha* - 10-12 g twice
daily with warm milk in empty stomach
· Daily use of Milk with
Ghee (cup of milk with a teaspoon of ghee)
*Disclaimer -The Rasayana drugs should be consumed
after recovery from the fever and once Agni is stabilized during pregnancy.
Rasayana
for geriatric subjects
·Chayvanaprasha Avaleha -
10 - 12 gm twice daily with warm milk.
· Ashwagandha Avaleha - 10
- 12 gm twice daily with warm milk.
· Brahma Rasayana - 10 - 12
gm twice daily with warm milk.
· Daily use of Milk with
Ghee (cup of milk with a teaspoon of ghee).
· Shilajeet Rasayana
[prepared by giving 7 times Bhavana of all the medicines - Triphala, Musta,
Guduchi (Tinospora Cordifolia), Pippali etc.).
· Khadiradi Rasayana.
· Shatavari Siddha Ghrita.
The following Rasayana Yoga in Vardhamana Krama may
also be advised with strict supervision of attending Physician:
· Vardhamana Pippali
Rasayana [Kasa, Shwasa, Galagraha,
· Vishama Jwara
· VardhamanaGuduchi
Rasayana
· Vardhamana Musta Rasayana
· Vardhamana Triphala
Rasayana
Rasayana
for immune-compromised subjects
·Samshamani Vati 500 mg
tablet, 2 tablet BD after food
· Agastya Haritaki
Rasayana* 10-12 g BD after food
· Chitraka Haritaki
Rasayana* 10-12 g BD after food
· Chayavanaprashavaleha
10-12 g BD after food
· Bramha Rasayana 10-12 g
BD after food
· Swarnamalinivasanta rasa
125 mg BD after food with water
· Guduchi Rasayana
Yoga System of Medicine
Yoga based life style module to improve immune
flexibility in healthy peoples of all age groups.
Forty-Five-minute module: The general
Yoga Protocol of IDY (International Day of Yoga) that was established by a team
of chief Yoga specialists / Yoga Leaders include safe practices to improve
physical, mental, emotional and spiritual health of the peoples.
· Regular practice on empty
stomach is recommended to improve immune resilience. · Twenty and ten minute
segments are acclaimed for children, adults, Young and the elderly peoples to
be repetitive twice a day (morning and evening).
· Apart from CYP; Jalaneti,
Sutraneti and Bhastrika Kriyas are suggested once or twice in a week and Yoga
nidra for 20-30 minutes twice or thrice a week.
· Follow the commendations
as per the medical advice on diet for your condition of diabetes, or heart
ailment etc. and in additional these concepts from yoga that stimulates mental
wellbeing. This comprises wholesome nutritious recently cooked traditional
home-based cooked food with plenty of fresh vegetables and fruits with added
traditional seasonings in reasonable quantities, consumed at regular timings. Abstinence
from substance abuse including tobacco, alcohol and medications to reduce
disease susceptibility in high-risk population. This recommendation based safe
and simple yoga practices as mentioned above that promote heath of the
respiratory, circulatory and the immune systems.
· Habb-e-Surfa (125-250 mg)
· Khamira-e-Banafsha (10-20
gm) (Not suggested for diabetics)
· Laooq-e-Sapistan (10-20
gm) (Not suggested for diabetics)
· Sharbat-e-Sadr (20-40 ml)
(Not suggested for diabetics)
· Habb-e-Bukhar (250-500
mg) • Habb-e-Mubarak (1-2 gm)
· Sharbat-e-Toot Siyah
(20-40 ml) (Not suggested for diabetics)
· Laooq-e-Katan (10-20 gm)
(Not suggested for diabetics)
· Habb-e-Hindi Zeeqi (125-250 mg)
· Kaba Sura Kudineer - 60
ml two times a day after food.
· NilaVembu Kudineer- 60 ml
two times a day after food.
· Visha Sura Kudineer- 60
ml two times a day after food.
· pavala Parpam -100 mg two
times a day with Honey.
· Velli parpam - 50 to 100
mg two times a day with Honey.
(i) “Nilavembu kudineer is a
polyherbal formulation with A. paniculata
as the main constituent that reins all types of fever related to body pain.
Other components include Vetiveria
zizanioides, V. zizanioides, Santalum album, T. cucumerina, C. rotundus,
Zingiber officinale, Piper nigrum, and M. cerviana. All these florae are utilized traditionally in the
management of pyretic, “inflammation, arthralgia, stiffness in the joints,
stomach ulcer, jaundice, and general debility conditions”. Nilavembu kudineer
extensively controls fever through its managing consequences effects on
temperature, inflammation control, body pain, and it also acts in a way to
improve immunity. All the components in this formulation have the bioactive
molecules that show excellent activity against dengue, chikungunya, herpes
simplex virus (HSV), and influenza virus [8].
(ii) Visha sura kudineer (VSK) is a
polyherbal formulation from Siddha literature “Kaaviya Sura Nool”. The
components were Azadirachta indica, Indigofera tinctoria, Z. officinale, Hemidesmus indicus, Aristolochia
bracteata, V. zizanioides, Glycyrrhiza glabra, E. cardamomum, and Santalum
album. Each of the component shows antiviral activity against wide range of
viruses. Aqueous leaf extract of A.
indica offers antiviral activity against vaccinia virus, chikungunya
measles virus, dengue virus type-2, and HSV type-1, it also has immune
stimulant, anticomplement activity. Indigofera
tinctoria shows an inhibitory effect of HIV-1 (III B) and HIV-2. Zingiber officinale has antiviral
activity against the human lung syncytial virus in human respiratory tract cell
lines”. Hemidesmus indicus antiviral
activity was studied against the Ranikhet virus. “A constituent of licorice
root glycyrrhizic acid has antiviral activity by impeding the growth and
cytopathic effect of numerous DNA and RNA viruses, such as vaccinia, HSV-1,
Newcastle disease, and vesicular stomatitis viruses”. It also shows antiviral
activity against flaviviruses, such as dengue, Japanese encephalitis, Yellow
fever, mammalian tick-borne encephalitis, influenza, and hepatitis A, B, C
viruses.34 Sandalwood oil, the essential oil of Santalum album L., indicated antiviral activity against HSV-1 and
HSV-2 [9-10].
Homeopathy, as a healing method, is
based on the Hippocratic Similia Similibus Curentur therapeutic law. The
physician trusts on the completeness of symptoms exposed during the entire
evolution of the contamination, and prescribes an ultra - high diluted successor
solution product which has been proven to heal alike conditions. This is a
great benefit in this mastery while Covid-19 disease is in rapid development,
because the diagnosis of the indicated ultra-high diluted successor solution
product is based on separate symptoms (if these are very characteristic) or on
the totality of symptoms, and not in the pathology. Homeopathy therefore
endorses issuing of public notice for Genus epidemics identified by the
nominated authorities for immunity enhancement and physicians may suggest the
same to the people and as per the Advisory issued by Ministry of Ayush.
Second method is to provide
homoeopathic symptomatic alleviation to affected persons. Homoeopathic
medicines are also useful in the management of communicable ailments like
Influenza like Illness, dengue, acute encephalitis syndrome. Several studies
are also circulated which shows the immune modulatory potential of homoeopathic
medicines in preclinical studies. These medicines can be recommended in a
combined manner or individual depending on the cruelty on a case to case
[11-12].
The medications according to
different stages of ailment are given below:
Mild Disease (Symptomatic
Amelioration and Mitigation Approach): Medicines like Aconite napellus, Arsenicum
album, Bryonia alba, Gelsemium sempervirens, Rhus tox. Eupatorium perfoliatum, Ipecacaucunha, Belladonna, Camphora, may be
used depending upon the symptoms similarities.
Severe disease but not in critical condition: It is
defined by following criteria (Dyspnoea, respiratory frequency 30/min, blood
oxygen saturation (SpO2) 93%, PaO2/FiO2 ratio < 300, and/or lung infiltrates
> 50% within 24 to 48 hours)/) Recommended medications are as adjuvant to
Standard Management strategies in the hospital setting only with the approval
of authorities and inclination of the patient/guardian. The prescription is to
be given only by institutionally qualified practitioner. Medicines like Phosphorus,
Chelidonium, Veratrum Viride, Iodum,
Camphora, Cinchona officinalis,
Lycopodium, Ars. iod., Antim ars., Stannum met, Carbo veg., can be prescribed
on symptomatic indication.
Covid-19 outbreak
and the usage of medicinal plants as herbal ingredients in the formulations for
medicine is highly recommended for the current era of the world. Currently,
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2, formerly known as
2019-nCoV, has fast spread across China and round the world. Thus the current
study helps us to understand the hidden potential of traditional system of
medicines especially those practiced in India.
The author has no
relevant affiliations or financial involvement with a financial interest in or financial with the subject matter or materials discussed in
the manuscript.
There
is no conflict of interest.