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1 ANVESHANA Review Article AYURVEDA MEDICAL JOURNAL ISSN: IDEAL AYURVEDIC MANAGEMENT OF SWINE FLU Rakesh Shukla MD (Ayu) Corresponding Author: ABSTRACT Swine flu has been creating a terror effects all-round the globe and has been declared epidemic in most part of the world. In India day by day the graph of infected person has been climbed up so, it is important to take into consideration about this disease as it may prove deadly one. Ayurveda is ancient in its origin but its concept like Aupasargika Roga (communicable diseases) and Janapadodhvamsa (epidemics) still holds importance in this modern era. According to Ayurveda daily and dietary habits plays a major role in any disease. If our digestive fire is normal, our immunity will remain powerful and thus no infection can overrule. Ayurvedic herbals and preventive aspects helping detoxify the liver, fight allergies, stimulate digestion, and boost immunity. Ayurvedic drugs have anti-viral, cleansing and antioxidant properties. They are excellent for balancing Vata and Kapha, which are the prominent Dosha in Swine influenza or any other respiratory tract infections. Key words: Swine flu, Ayurveda, Abhinyasa Jwara, Antiviral herbs, Immunity INTRODUCTION Swine flu is an emerging viral infection that is a present global public health problem. Swine influenza (also called H1N1 flu, swine flu, hog flu, and pig flu) is an infection by any one of several types of swine influenza virus. Swine influenza virus (SIV) is any strain of the influenza family of viruses that is endemic in pigs. 1 As of 2009, the known SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H3N1, H3N2, and H2N3. Swine flu has become the world's first official pandemic in 41 years after the WHO raised the alert level on the H1N1 virus from phase 5 to 6, the highest on the scale. In India, the total number of laboratory confirmed cases crossed mark with death of more than 2000 peoples. The state of Gujarat and Rajasthan are the worst affected. 2 Due to the nature of respiratory virus, the transmission of this pathogenic virus is air borne transmission. Hence, the rapid spreading and difficulty in control of this infection can be expected. 3 People who work with poultry and swine, especially people with intense exposures, are at increased risk of zoonotic infection with influenza virus endemic in these animals, and constitute a population of human hosts in which zoonosis and re assortment can cooccur. Other professions at particular risk of infection are veterinarians and meat processing workers, although the risk of infection for both of these groups is lower than that of farm workers. 4

2 In Ayurveda, it may be defined as Aupasargika Roga / Samsargaj Roga (communicable disease). Charaka has dedicated a chapter on epidemic disorders named as Janapadodhvamsa vimanam. The four etiological factors responsible are Jala, Vayu, Desha and Kala. When contamination and vitiation of these factors take place, epidemics follow. 5 The mode of spread of infectious diseases has been described clearly by Sushruta in reference to Kustha (skin diseases), Jwara (pyrexia), Shosha (tuberculosis), Netrabhishyanda (conjunctivitis) etc., spread from human beings to human beings due to Prasangat (sexual route), Gatra-samsparsat (body contact), Nihshwasat (Droplet infection), Saha-bhojanat (taking food with diseased person), Saha-shayyasanat (sitting or sleeping with infected person), Vastra-malyaanulepanat (using clothes, cosmetics and ornaments of patient). 6 Signs and Symptoms According to the Centers for Disease Control and Prevention (CDC), in humans the symptoms of the 2009 "swine flu" H1N1 virus are similar to those of influenza and of influenza-like illness in general. Symptoms include fever, cough, sore throat, body aches, headache, chills and fatigue. The 2009 outbreak has shown an increased percentage of patients reporting diarrhea and vomiting. 7 The most common cause of death is respiratory failure, other causes of death are pneumonia (leading to sepsis), high fever (leading to neurological problems), dehydration (from excessive vomiting and diarrhea) and electrolyte imbalance. Fatalities are more likely in young children and the elderly. 8 Abhinyasa Jwara: It is mentioned as one among the thirteen types of Sannipataja Jwara. Vitiated Tridoshas due to Agantuka karanas (Bhutabhisangaja Swine flu virus) immediately lodges in Rasavaha and Pranavaha srotas simultaneously. It severely effects the circulation of Rasa and thereby causes the depletion of Ojas, factor responsible for life and death, which results in death of patient. As the Bhutabhisanga (Swine flu virus) is the direct factor for the causation of the disease Abhinyasa Jwara (Swine flu), it can also know by the name Bhutabhisanga Jwara. It is explained as a type of Agantuja Jwara. 9, 10 Ideal Ayurvedic Management Ojas is the product of a healthy digestive system, which helps the body in resisting infection. Low Ojas is lack of immunity at the physical level and absence of mental strength at the mind level. We can prevent the spread of flu by strengthening the Ojas and enhancing our body immunity. The treatment can be divided in following steps:- 1. Nidana Parivarjana 2. Shamana Chikitsa 3. Shodhana Chikitsa 4. Rasayana Prayoga 5. Pranayama, yoga or meditation 1. Nidana Parivarjana According to Ayurveda daily and dietary habits plays a major role in any disease. If your digestive fire is normal, your immunity will remain powerful and thus no infection can overrule you. So one should follow the ideal dietary regimen during seasons like monsoon and winter when the maximum chances are there for viral infections. Here are few Recommendations: Fumigation (Dhupana) for environmental purification - with of Neem, Sarsapa, Raala, Guggulu etc. Dhumapana (Medicated smoking) with Lavanga, Maricha, Ela, Eranda mula, Chitraka mula, Aragwadha & Gaw ghrita. Roots of Eranda, Bala, Bilwa, Aragwadha. Arka, Apamarga, Danti mula, Ingudi siddha vasa. AAMJ / Vol. 1 / Issue 4 / July Aug

3 Steam Inhalation -With Jeevandhara, Neelgiri oil. Kavala / Gandusha (Gargling with medicated liquids), Gargling with Oil prepared with Padmaka, Sarjarasa, Rakta chandana, Priyangu, Madhu, Sharkara, Draksha, Madhuka, Yashti. Achaman, Dantadhavan: Maintain oral hygiene. One should avoid sleeping during the day hours. One should avoid traveling or being outdoors during the early hours of the day when there is dew and cold winds blow. Individuals should avoid direct and strong cold winds. Clean and dry clothes should be worn. Avoid damp, humid and cold weather, and environment. Avoid use of air conditioners. Oil massage with oil possessing warm quality is beneficial. Try to move around the place of work instead of sitting in one place or do some kind of physical work. This will help you to refresh yourself, especially when you feel dull & lethargic. Try to avoid over exertion. Drink a glass of water with two teaspoons of honey every day early in the morning. Avoid skipping meals. Always have fresh meals, prepared using minimum quantity of oil, or prepared with the help of Cow s ghee. Always choose warm food over cold food. Dry Chutney & dry vegetables are recommended. Sprinkle your salads with dry ginger powder, and black pepper powder. Chewing of a bite of ginger before meals with little bit of salt is helpful to improve. Pickles made of Raw Haldi are recommended. Daily use of Honey helps to control the excessive Kapha. Avoid: Regular use of sweets, butter, cheese, paneer, Dairy products especially curd and butter. Avoid Refrigerated, rewarmed, day old stale food, etc. Avoid Non-vegetarian food. 2. Shamana Chikitsa If a person becomes sick with swine flu, antiviral drugs can make the illness milder and make the patient feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms). Beside antivirals, supportive care at home or in hospital, focuses on controlling fevers, relieving pain and maintaining fluid balance, as well as identifying and treating any secondary infections or other medical problems. In such condition following Ayurveda drugs may be started as soon as possible. Few of these drugs have been found very effective in current research works and are being practiced in India since thousands of years for combating various seasonal and viral infections. Swine flu (Abhinyasa Jwara) treatment follows Sannipataja Jwara Chikitsa. In Sannipataja Jwara, Kaphasthana- Anupurvi chikitsa should be done i.e. Kapha Shaman Chikitsa is done initially thereafter Pitta and Vata Shaman Chikitsa. Some useful Ayurvedic Preparations Sitopaladi Churna, Naradiya Laximivilas Ras, Classical Chyavanprash, Haridra Khanda, Talisadi Churna, Khadiradi Gutika, Lavangadi Gutika, Malla Sindura, Samirpannaga Rasa, Chandramrita Rasa, 64 Prahari Pippali, Suvarna Vasanta Malini Rasa, Shwasa Kuthara Rasa. Decoction Juice of 10 to 15 fresh leaves of Tulsi (Basil), 5 ml of fresh ginger root juice, half spoon powder of cloves, half spoon powder of cinnamon bark, half spoon powder of Guduchi (Tinospora cordifolia), half spoon powder of cardamom, half spoon of turmeric powder, half spoon of Guda (jaggery) mix all these properly, add one spoon of honey when the decoction is lukewarm and have it twice or thrice a day. Herbals like Tulsi (Ocimum sanctum), Chirayata (Swertia AAMJ / Vol. 1 / Issue 4 / July Aug

4 Chirata) and Haridra (Curcuma longa) are revered and worshipped throughout India for its amazing medicinal properties. It is known to: relieve stress, strengthen the immune system, enhance stamina, relieve congestion and colds, promote healthy metabolism, relieve inflammation, lower cholesterol and provide rich supply of antioxidants on the basis recent researches. 3. Shodhan Chikitsa Panchakarma procedures like Nasya Karma and Sadya Vamana Karma are also very useful for all respiratory tract infections. Nasya Karma (Trans nasal administration of medicinal preparations) is indicated as prime line of treatment in the management of all supraclavicular disease conditions in general, diseases of Nose in particular. It cleanses the nasal passages and sinuses, thereby relieves the symptoms. 4. Rasayana Prayoga Immunity enhancers: like Ashvagandha churna, Shatavari ghrita, Panchatikta ghrita, Indukanta ghirta, Amalaki Rasayana. Table 1: List of the plant which may prove useful to combat swine flu 11 Herbs Botanical name Properties Tulsi Ocimum sanctum Antimicrobial properties Ginger Zingiber officinale Anti-nausea & Anti-inflammatory Garlic Allium sativum Anti-inflammatory, antiviral, antibacterial and immune boosting Amla Phyllanthus emblica Anti viral activity Guduchi Tinospora cordifolia Anti-periodic, Anti-pyretic, Alterative, Diuretic, Anti-inflammatory properties Licorice Glycyrrhiza glabra Antiviral activity anti inflammatory, antioxidant, and immune modulating activities. Kalmegh Andrographis paniculata Anti inflammatory, antipyretic (anti fever), antiviral, and immunostimulatory properties Ashvagandha Withania somnifera Stimulant for the immune system, also a very potent adaptogen. Turmeric Curcuma longa Antioxidant, anti inflammatory properties Neem Azadirachta indica Antidiabetic, antibacterial, and antiviral properties. Bael Aegle marmelos Analgesic, anti-inflammatory, antibacterial, and antiviral properties Ajwain Trachyspermum ammi Antiseptic, antispasmodic activity. Mentha Mentha piperita Antimicrobial and antiviral activity. Haritaki Terminalia chebula 5. Pranayama & Yoga People with strong immune system cannot be affected with swine flu. Yoga practice builds up your immunity, Strengthen circulatory and respiratory systems. Nasal cleansing, also called Neti is a wonderful way to build up our natural defenses. What's more, it's had wonderful results in treating sinus infections and other ENT disorders. Breathing Pranayama like Bhastrika, Kapalbhati and Anulom Vilom- It improves lungs capacity and immunity against any infections from the virus. CONCLUSION The swine flu is one among the life threatening epidemic which can be prevented and managed by Ayurvedic means. Inflammatory, anthelmintic, cardiotonic, aphrodisiac, and restorative properties. It resembles with Abhinyasa Jwara including the features of Prana-vaha Sroto Dusti. The occurrence of any disease is the result of vitiation in Dosha, Dhatu and Srotas. To maintain the good health, it is necessary to keep them in equilibrium by adopting right way of diet regimen, lifestyle, seasonal biopurification, regular exercise and use of Rasayana. By following these methods one can be escaped from this epidemic. Further if someone suffers from the disease, than there are various herbal formulations to control this fatal disease. The concept of immunostimulation through Ayurveda has been used successfully in the treatment of immune compromised conditions. AAMJ / Vol. 1 / Issue 4 / July Aug

5 REFERENCES 1. "Swine influenza". The Merck Veterinary Manual http: // sp?cfile=htm/bc/ htm. Retrieved on April 30, an_swine_flu_outbreak [accessed on 22 July 2015] 3. Wiwanitkit, V. Swine flu: the present pandemic infectious disease. Kulak Burun Bogaz Ihtis Derg. 2009; 19: Myers, Kendall P., Christopher W. Olsen, and Gregory C. Gray. "Cases of swine influenza in humans: a review of the literature." Clinical infectious diseases 44.8 (2007): Tripathi Brahmanand. Charak Samhita, Viman Sthan 3/7. Chaukhambha Surbharti Prakashan, Varanasi: 2008; p Sharma Anant Ram. Sushruta Samhita, Nidana sthan 5/ Chaukhambha Surbharti Prakashan, Varanasi: 2008; p H1N1 Flu ("Swine Flu") and You. Accessed on ne-flu-h1n1-sings-symptoms-diagnosis-andprevention-of-the-deadly-h1n1-virus /. Accessed on Sharma Anant Ram. Sushruta Samhita, Uttara Sthan 39/ Chaukhambha Surbharti Prakashan, Varanasi: 2008; p Vaidya Laxmipati shastri. Yoga Ratnakara Purvardha. Jwaranidana 23. Chaukhambha Sanskrit series. Varanasi: 1999; p Shah, Avani, and R. Krishnamurthy. "Swine Flu and Its Herbal Remedies." The International Journal of Engineering and Science 2.5 (2013): How to cite this article: Rakesh Shukla. Ideal ayurvedic management of swine flu. AAMJ 2015; 1: Source of Support: Nil. Conflict of Interest: None declared AAMJ / Vol. 1 / Issue 4 / July Aug

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