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\def\RunningAuthor{Punam Sawarkar and Harsha Deepak Vaidya}
\firstPage{286}
\articleType{Original Article}
\receivedDate{13 Apr 2020}
\acceptedDate{22 May 2020}
\revisedDate{15 May 2020}
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\title{Ayurvedic Remedies for Covid-19 - A Conceptual Study}
\author{Harsha~Deepak~Vaidya\textsuperscript{1}, 
            Punam~Sawarkar\textsuperscript{*}\textsuperscript{2}~\\[5pt]{\textsuperscript{1}Department of Panchakarma, Mahatma Gandhi Ayurved college and hospital and Research Centre, Salod, Wardha, DattaMeghe University of Health sciences, (DMIMSU), Maharashtra, India}~\\{\textsuperscript{2}Department of Panchakarma, Mahatma Gandhi Ayurved college Hospital and Research Centre, Salod, Wardha,DattaMeghe University of Health sciences, (DMIMSU), Maharashtra,  India}}

\begin{abstract}
Novel Corona disease becomes a worldwide crisis. Its outbreak starts from China and now it becomes a pandemic. The aim is to review various Ayurvedic remedies for COVID-19. This was purely a literary study done from various Ayurvedic compendiums. As there is no effective treatment in the form medicine \&vaccines is available for COVID- 19 in contemporary science. But in the ancient medical science \textit{Vatasleshmika Jwara}(fever) can be correlated with COVID-19 as Their symptoms are indistinguishable. Like, the clinical features of COVID- 19 are fever, cough, dyspnea, cold, headache, etc. are relatable to \textit{Santapa, ShushkaKasa, Bhrushamkshav,Pratishya,  Shirograha }which are \textit{Akshan }of \textit{Vatasleshmak Jwar. } Here, treatment can be given according to the \textit{Chikitsa} of \textit{Vatasleshmakjwar on } COVID 19.In current outbreak of Corona; it may prove as a ray of hope for further research.
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Chikitsa(Treatment),\newline COVID-19,\newline Hetu,\newline History of COVID -19,\newline VatasleshmakJwar( fever),\newline Symptoms
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Punam~Sawarkar~\\ Phone:\ 9860667023~\\  Email:\ drsuple.punam@gmail.com
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\section{Introduction}
Corona disease was commenced as an epidemic in china which was not limited up to one nation but now it is a global pandemic. It becomes a novel virus which affects near about 13, 12,387 people worldwide. The world health organization (WHO) office in china had reported the first case of the unknown virus which caused pneumonia in a number of people in Wuhan city on 31 December 2019. Wuhan is the place of China where seafood market is situated and wild animals, including snakes, rabbits, bats, marmots, and birds are traded illegally\unskip~\citep{803998:19206238}. This clinical entity can be correlated with \textit{Vatashleshmaka Jwara} quoted in our Ancient Ayurvedic science. As it is a need of to search some alternative safe medicaments in alternative science to combat with this COVID 19 as there is no standard and effective treatment is not yet find out in contemporary science.

 It is a conceptual study whose main aim is to review various Ayurvedic remedies from different Ayurvedic compendium for airborne infections and COVID 19. This was purely a literary study done from Ayurvedic Classical Texts; Modern Scientific books, Research articles \& e- media from which review data isexplored and analyzed for following interpretations. Here, information regarding the COVID-19 are explain under the topic of history of Corona, Ayurvedic approach toward COVID-19, Etiopathology, Symptoms, Pathophysiology, Treatment.
    
\section{\textbf{OBSERVATION \& RESULTS}}
After overview of literature in Ayurveda \& modern science, information collected regarding various airborne diseases are narrated under following heads

\textbf{History of Corona }

 Now, the corona has become a worldwide problem it came across as a pandemic. It is belonging to the genera coronaviridae virus. Corona was recognized over 50 years ago, it causes symptom in human and animals both but most of the people were not known that corona is the disease until the outbreak \unskip~\citep{803998:19206229}. The first case was found in human in 1965 which were called as 229E and OC43 which manifested with mild symptoms like the common cold, cough. Later on, the researcher understood that cause of serious human infection after the outbreak of SARS (severe acute respiratory syndrome) in 2003 - 2004 in North America it becomes epidemic. However, 1st case MERS ( Middle Eastern respiratory syndrome) found in Saudi Arabia in 2012 \unskip~\citep{803998:19206229}. These two infections caused by corona virus transmitted by bats via cats and mammals.

In 1968, the Journal Nature relayed their findings they reported that these viruses are members of a previously unrecognized group called corona viruses, which was suggested by the virologists. They recollect the appearance characteristic of these viruses after observed in the electron microscope. The virologist had imagined the sun in mind before giving name Corona. They said that "they correlated the characteristic of the virus with solar corona by the 'fringe' of projection on the outside of the virus \unskip~\citep{803998:19206229}.\ensuremath{^{}}


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\caption{\boldmath {Pathophysiology of VatasleshmakJwar}}
\label{f-d94d69989ad8}
\end{figure}
\egroup

\begin{table*}[!htbp]
\caption{\boldmath {Similarities between the appearance and Symptoms of the COVID-19 \& Organisms} }
\label{tw-23cd5360c028}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.1016\linewidth-2\tabcolsep}p{\dimexpr.4484\linewidth-2\tabcolsep}p{\dimexpr.45\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}S.N.  & Organisms explained in Ayurveda literature  & COVID-19-appearance and symptoms \\
\tblmidrule 
1  &
  Sukshma (minuite), Adrushya ( Invisible)  &
  Virus- Microscopic  \\
2  &
  Ashukari (Rapid in action)  &
  Rapid in action \\
3  &
  Jvaraupanna ( Causing fever)  &
  Causing Fever \\
4  &
  Snayudurbala (Causing generalized weakness)  &
  Muscle weakness  \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Similarity between symptoms of COVID-19 \& Vata Shelamaja Jwara} }
\label{tw-3c2646141569}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.11889999999999997\linewidth-2\tabcolsep}p{\dimexpr.5411\linewidth-2\tabcolsep}p{\dimexpr.34\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}S. N.  & Covid-19 Symptoms  & Symptoms of vatakaphajjwar \\
\tblmidrule 
1  &
  Cold, Nasal Congestion  &
  Pratishyaya \\
2  &
  Cough,Sore Throat  &
  Kasa \\
3  &
  Fever  &
  Jvara \\
4  &
  Difficulty In Breathing/Breathlessness  &
  Shvas \\
5  &
  Headache  &
  Shirograha \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Devavaiprashya Chikitsa } }
\label{tw-ef94b6aef126}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.1172\linewidth-2\tabcolsep}p{\dimexpr.54279999999999994\linewidth-2\tabcolsep}p{\dimexpr.34\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}S. N.  & DevavaiprashyaChitiksa  & Details of Chikitsa\\
\tblmidrule 
1.  &
  Homa  &
  -\\
2  &
  Japa  &
  -\\
3  &
  Mantra   &
  Rama Rakshastrotra( given by Kaushik Rishi), Gayatrijwarastrotra, Purushasukta, Vishnu Shastra are very beneficial. \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Treatment advised according to type of symptoms} }
\label{tw-8184331f073e}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.12579999999999998\linewidth-2\tabcolsep}p{\dimexpr.306\linewidth-2\tabcolsep}p{\dimexpr.5682\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}S. N.  & Symptom  & Advised Medications \\
\tblmidrule 
1  &
  Fever- Jwara  &
  MahasudharshanKwath, Mahamrityunjaya Rasa, Suwarnashuthashekhar . \\
2  &
   For Cold {\textendash} Pratishya  &
  - Lakmivilas Rasa. Nashya given of Anutail and Goghrita. \\
3  &
   Cough- Kasa  &
  Shwashkuthar Rasa, ShitopaladiChurnaare given. AjmodaDhumapan \\
4  &
  Malaavrodha  &
  Kwath(Decoction) of Haritaki (Curcuma longa Linn.), Pippali ( Piper longum), Aragvada( Aasia fistula), Kutaki (Picrorhizakurrooa), Mushta (Cyperousrotundus). \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Various formulations useful in Vatakahaja Jwara } }
\label{tw-ce80f3c0fdf6}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.11549999999999997\linewidth-2\tabcolsep}p{\dimexpr.3868000000000001\linewidth-2\tabcolsep}p{\dimexpr.49769999999999996\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}S.N. & Type of formulation & Drugs \\
\tblmidrule 
1 &
  Churana  &
  GuduchiChurna, HaridradiChurna, YastimadhuChurna, SunthiChurna, PushkarmulaChurna, KanthakariChurna, ShitopalatiChurna, GandharvaHaritaki, TantanBhasma \\
2 &
  Kalpa-  &
  Mahamrityunjaya Rasa, Suvarnashutashekhar Rasa, LaxmiVilas Rasa, SanshamaniVati. \\
3 &
  Asav  &
  MahasudharshanKwath, Kankaashawa \\

  ~\newline 1.~4.~\newline  &
  Rasayan-ApunarbhavChikitsa  &
  KushmandAvleha, RashonKsheerpaka, PippaliKsheerpaka, AgashtiHaritakiAvleha. \\

  ~\newline 1.~5.~\newline  &
  Kshaya  &
  HaridradiKashay, KatutrikadiKashyap, AadivasiKashya. \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}
\textbf{Ayurvedic Approachtowards COVID -19}

COVID-19 generally manifests with symptoms such as cold, cough, sore throat, nasal congestion, headache, fever which is similar to the symptoms of  \textit{Vatasleshmak Jwara} i.e \textit{Pratishya}, Kasa, Shirograha, \textit{Jwara} narrated in \textit{Ayurvedic}  compendium. In contemporary science, till date ; it is difficult to treat COVID -19 as there is no standard treatment protocol for it. But recently drugs are generally prescribing to the patient are Hydroxychloroquine (Dose 400mg BD {\textendash} for 1 day followed by 200mg BD for 4 days) in combination with Azithromycin (500 mg OD for 5 days).[16] However, standard medication advised for \textit{Vatasleshmak Jwara} in \textit{Ayurveda,} which may be beneficial for the COVID 19 because \textit{Acharya Charak}had said that unknown or new disease can be treat by the methodology of \textit{AptopdeshPariksha}. He further stated that when there is no narration about treatment protocol of any Disease i.e. \textit{AnuktaVydadhi} then treatment should be prescribed on the basis of nature of disease, involvement of \textit{Dosha ,Dushya}\&\textit{Samprapti} i.e. pathology occurring in such clinical entities. According to this Ayurevdic principle \& as cardinal features of COVID 19 and\textit{ Vatasleshika jwara} are similar in nature, so same treatment protocol should be adopted here. 

Hetu. {\textendash} \textit{Hetu Sewan  (Rogotthan, Abhighat, Bhutabhisanga, Jantu-kitta}  transmission through \textit{Mansahar}- non-veg consumption

\textbf{Etiopathological factors in Ayurveda}

COVID 19 is the virus\textit{( Jantu)} which has originated from the animal-like snake and bats. It is also supported by Ayurveda also by stating that the many \textit{Aoupasargik Rogas} (infectious diseases) have origin from different types of Worm \textit{(krumi)}, Insect \textit{( Kittak)}, Virus\textit{( Jantu).}According to Ayurveda, mainly, there are 4 types of origin Of \textit{Kitta}  and \textit{Jantu}. These are - \textit{Jarayaj}, S\textit{wedaja, Andaj, Udbidaj \unskip~\citep{803998:19206231}}. In Atharva Veda, 80 references can be found with carries the explanation of origin of \textit{krumi, kitta, Jantu \unskip~\citep{803998:19206232}}. According to Sushruta\textit{Acharya}, in 8th \textit{adhya of Kalpasthan} , \textit{kalpakitta,}there are 2 types of \textit{Jantu} and \textit{Kitta.} These are are - \textit{Drushya} (Visible) and \textit{Adrushya} (Invisible) \unskip~\citep{803998:19206234}. Dalhana, the commenter of the \textit{Sushtruta Samhita } said that there are 4 types of the snakes from which the\textit{Jantu} and \textit{Kitta} are originated by the seman, urine, faeces, etc of snake. The \textit{Kitta}and \textit{Janta} originated from the \textit{Darivikar, Mandal, Rajimantha, VaikranjaSarpa}which are causes\textit{Vata, Pitta, Kapha, SannipatajPrakopa respectively \unskip~\citep{803998:19206234,803998:19206244}}.

\textbf{Appearence\& Symptoms of COVID and Organisms explain in Ayurveda literature}

COVID- 19 and Organisms explain in Ayurveda litreature are having the similar appearance and symptoms. Explain in Table~\ref{tw-23cd5360c028}, \unskip~\citep{803998:19206243}.

\textbf{Symptoms (Lakshanaof \textit{VatashleshmaJwar)}}

Characteristics and symptoms causes by these organisms and COVID-19 are compared in Table~\ref{tw-3c2646141569}\unskip~\citep{803998:19206245}.The clinical feature is seen in COVID - 19 are common cold, cough, fever, sore throat, difficulty in breathing which are correlated with \textit{Vatakaphaj}fever are given in Table~\ref{tw-3c2646141569}. \unskip~\citep{803998:19206235}. Symptoms are \textit{Staimitya, Parvbhed, Nidradhikya, Angagaurava, Shiroghrah, Pratishyay, Kasa, Jwar, Swedapravartanam \unskip~\citep{803998:19206235}}. In Prashisthabhav of MadhavNidan, there are 8 types of \textit{Jwara'spanchanidan}. Especially, \textit{Vatashleshmikajwar}which can be compared with the COVID - 19 because of similarities in symptoms. This is also explained in chikitsatatwapradipita which is published by the krushana Gopal Ayurvedic pharmacy in 1935, they have compared \textit{Vatasleshmakjwarlakshan}with modern clinical features which is same as covid 19 \unskip~\citep{803998:19206230}.

\textbf{Path physiology of \textit{VatasleshmakJwara}}

Path physiology of \textit{Vatasleshmak Jwara }is mentioned in Figure~\ref{f-d94d69989ad8},\unskip~\citep{803998:19206233}.\textit{}

\textbf{Treatment approach in Ayurveda}

In Ayurveda, \textit{Acharya Charak } had said that is no shame if the physician is not able to name the disease. Because it is not always possible to give exact name of all type of diseases. When the same \textit{Dosha} get aggravated they may cause numerous illness, which is depending upon the different type \textit{hetu}(etiological factor) and \textit{sthan} (site of manifestation). That's why, the physician should understand the nature of vyadhi (disease) through \textit{Dosha}, the \textit{shathansanshrya}( site of manifestations), \textit{hetu} (etiological factor) after that treatment should initiated. Therefore during diagnosing of a new disease, it is necessary to have the full knowledge about scriptural instruction. With this knowledge one would never fail to treat the disease \unskip~\citep{803998:19206233}. Like, in some diseases which is having unknown etiopathogenesis, in Ayurveda, it can be treated indications in scriptural instruction of Ayurveda textbook e.g. Hypertension.

To understand the new unknown disease \textit{Acharya charak}had given the second methodology to understand an unknown disorder, which is based on \textit{AptopadeshaPariksha. } They are \textit{adhisthan}(location), \textit{vedana}( pain), \textit{samsthana}(clinical feature), \textit{yoni}(site of origin), \textit{atmanam}(cardinal symptom) etc \unskip~\citep{803998:19206233}. 

\textbf{In Ayurveda there are 3 types of the treatment are explained}


  
  \begin{enumerate}
  \item \relax \textit{Devaviprashya}
  \item \relax \textit{Yuktiviprashya}
  \item \relax \textit{Satwavijaya}
  \end{enumerate}
  Basic line of treatment is \textit{NidanParivarjan,} avoid the travelling, \textit{RatriJagaran, Divaswapn, Shweta PadarthaShewan} avoid.

In \textit{Devaviprashya}, this is also a S\textit{ukhsham Chikitsha.} According to \textit{Acharya Charak Mantra Chikitsa}is very beneficial in these conditions this is also accepted by the modern science as a \textit{raga} therapy \unskip~\citep{803998:19206240} , Table~\ref{tw-ef94b6aef126}. 

In \textit{Yuktiviprashya, Aushadi} is given according to the \textit{Dosha, Vikruti, Dushya.} In this condition, treatment is given according to the V\textit{atasleshmakaJawar \unskip~\citep{803998:19206236}} in Tables~\ref{tw-8184331f073e} and~\ref{tw-ce80f3c0fdf6},\textit{\unskip~\citep{803998:19206239,803998:19206243}.}
    
\section{Discussion}
COVID -19 become a pandemic and it is difficult to treat, as there is no standard treatment protocol for it. In contemporary science, there is no effective drugs are available as per currently available data. But for a basic treatment Hydroxychloroquine (Dose 400mg BD {\textendash} for 1day followed by 200mg BD for 4 days) in combination with Azithromycin (500 mg OD for 5 days) are given\unskip~\citep{803998:19206241}.

However, In Ayurveda, the standard medicine protocol is available for \textit{VatashlehmakJwara}which can be related to COVID -19 by its cardinal feature given in Table~\ref{tw-3c2646141569}, \unskip~\citep{803998:19206230}. As \textit{Acharya Charaka} explained in \textit{Charak Samhita} about the \textit{AptopdeshaPariksha,} which is use to treat the unknown and new disease. According to \textit{Aptopdesha} if the cardinal symptoms are similar to that of the new or unknown disease it can be treated with the same treatment protocal which is given for the identified disease \unskip~\citep{803998:19206242,803998:19206237}.

While treating airborne infections such as COVID-19, etiopathological factors of \textit{VatasleshmakJwar, Chikitsa} in Ayurveda as well as Atharvaveda should be kept in mind. These causative factors are quite similar as told by contemporary science. This is very well supported by Ayurveda by stating that \textit{Aoupasargik Rogas} (infectious diseases) haveing an origin from different types of Worm (\textit{Krumi}), Insect ( \textit{Kittak}), Virus( \textit{Jantu}) which are four types in nature.It is again established by this science with narration of quite similarities between the appearance and symptoms of the COVID-19 \& Organisms from they spread. It can be further extended that \textit{VatasleshmakJwarChikitsa} may given in COVID- 19 due to similarity between symptoms of COVID-19 \& \textit{VataShelamajaJwara}. This is also explained in \textit{Chikitsa}Tatwapradipita which is published by the Krushana Gopal Ayurvedic pharmacy in 1935, they have compared \textit{VatasleshmakJwar}Lakshana with modern clinical features which is same as COVID 19 \unskip~\citep{803998:19206230}.

There is one major difference between treatment modalities of \textit{VatasleshmakJwar}\& COVID-19 that there is great emphasis is given to correct first Agnimandya (digestive as well as metabolic (fire) in Ayurveda. Three treatment modalities e.g. \textit{Devaviprashya, Yuktiviprashya\&Satwavijaya} in Ayurveda are recommended for such type fever. But before adopting these different modalities \textit{NidanaParivarjan} is highly appreciated for prevention of such entities. In order to follow this principle of treatment, specific diet regimen according to impacts of physiological diurnal changes \& seasonal variation over human body \& lifestyle regulation in the form of \textit{Dinacharaya}\&\textit{Rutucharya} are vividly explained throughout various \textit{Samhita}.
    
\section{Conclusions}
\textit{Acharya Charak}had explained that without having knowledge about the modern or new disease one can treat it by the methodology of understanding the unknown disease that's \textit{AptopdeshaPariksha}. \textit{AptopdeshaPariksha} are \textit{Adhishthan}(location), \textit{Samsthana}( clinical feature), N\textit{idan} ( causative factors), \textit{Yoni} (site of origin), \textit{Amman} (cardinal symptoms), etc. 

Similarly, In COVID- 19 which is new disease having the \textit{Atmanam}(cardinal symptoms) same as the \textit{VatasleshmakJwar.} They are fever(J\textit{war}), cold(P\textit{ratishya}), cough (K\textit{asa}), etc and having related A\textit{gantujaHetu}( causative factors). In this cases the \textit{Vatasleshmak Jwar Chiktisa }(treatment) can be beneficial to manage the disease at some extend, if the \textit{RogiBala} is stronger than\textit{RogaBala. }

With extensive review of Ayurvedic approachtowards COVID -19, it can be possible to overcome this disease by preventing \& curing it with the help of basic principles of Ayurveda. Ayurvedic approach for management of COVID -19 with these principle \& knowledge can become a ray of hope in current scenario.
    
\section{Acknowledgement}
I would like to express my sincere gratitude to Dr. Vaishali Kuchewar, The Dean of MGACH \& RC, salod, Wardha. For Here enthusiastic encouragement, patient advice, guidance and Contribute in progress of research work. My gratified thanks to the Dr. Pratiksha Rathod for their constant support. Finally, I~want to thank my parents for their encouragement throughout it.

\textbf{Conflict of interest}

None.

\textbf{Funding support}

None.
    

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