key: cord-0869443-xvncfpd6
authors: Akhila, V.G.
title: Management Of Sannipata Jwara Wsr To Covid-19 – Case Report
date: 2021-03-06
journal: J Ayurveda Integr Med
DOI: 10.1016/j.jaim.2021.02.007
sha: 820c3aaa0d28f59a2a1d4fe5d1fb39d54876706f
doc_id: 869443
cord_uid: xvncfpd6

Jwara is considered to be the ‘lord’ of diseases. Sannipata jwara refers to a condition where there is disturbance in all the three dosha. COVID-19 is an infectious disease caused by the most recently discovered corona virus and has already acquired an epidemic nature. In the present scenario there is no evidence that conventional medical system can prevent or cure the disease while the time tested traditional knowledge of Ayurveda can help in management and prevention of the disease. The primary objective of this report is to highlight the role of Ayurveda in the management strategy of Covid-19 as a standalone therapy in uncomplicated cases. This article represents the case of a 36 year old male patient, who tested positive for Covid-19 with symptoms like fever, headache, body pain etc successfully managed with Ayurveda medicines alone. The prime aim of the management was to improve the Agni and facilitate ama pachana with medicines like Indukantham Kashyam, Amrutharishtam and Sudarshanam tablet along with other medicines like Vettumaran tablet, Nasarsha tailam and Legrain tablet for symptomatic relief. Post Covid phase management was done using Agastya rasayanam and Haridrakhandam with an aim to strengthen the respiratory system. The management strategy was formulated adopting the principles of Jwara, Janapadodhwamsa etc mentioned in the classics. The scope of ayurveda in the management of the pandemic is enormous which needs to be incorporated in the mainstream healthcare system judiciously.

Jwara is considered to be the 'lord' of diseases. Sannipata jwara refers to a condition where there is disturbance in all the three dosha. COVID-19 is an infectious disease caused by the most recently discovered corona virus and has already acquired an epidemic nature. In the present scenario there is no evidence that conventional medical system can prevent or cure the disease while the time tested traditional knowledge of Ayurveda can help in management and prevention of the disease. The primary objective of this report is to highlight the role of Ayurveda in the management strategy of Covid-19 as a standalone therapy in uncomplicated cases. This article represents the case of a 36 year old male patient, who tested positive for Covid-19 with symptoms like fever, headache, body pain etc successfully managed with Ayurveda medicines alone. The prime aim of the management was to improve the Agni and facilitate ama pachana with medicines like Indukantham Kashyam, Amrutharishtam and Sudarshanam tablet along with other medicines like Vettumaran tablet, Nasarsha tailam and Legrain tablet for symptomatic relief. Post Covid phase management was done using Agastya rasayanam and Haridrakhandam with an aim to strengthen the respiratory system. The management strategy was formulated adopting the principles of Jwara, Janapadodhwamsa etc mentioned in the classics. The scope of ayurveda in the management of the pandemic is enormous which needs to be incorporated in the mainstream healthcare system judiciously.

Keywords: Case report; Jwara; Covid-19; Janapadodhwamsa;

Classical textbooks of ayurveda describes Jwara as the most powerful among diseases capable of afflicting body, mind and the senses [1] . Increase in temperature of body or mind (disturbed mind) is considered as the main feature of the disease [1] . Jwara is a Rasadhatu Pradoshaja roga affecting the Abhyanthara roga marga which includes the kosta or the ama and pakvashaya together. Rasadhatu Pradoshaja roga is usually treated by langhana and the same in various forms is used in the management of Jwara also. Careful analysis of signs and symptoms of Covid-19 reveals that this disease affects the Abhyanthara roga marga with fever and respiratory symptoms as the main manifestations. Hence the management principles of Jwara can be adopted in the management of Covid-19 too.

J o u r n a l P r e -p r o o f Covid-19 caused by the SARS-CoV-2 virus has already acquired an epidemic nature.

Epidemics like Covid-19 are not new to Ayurveda and the classical textbooks have given a vivid description of such epidemics in the name of 'Janapadodhwamsa' [2] . Ayurveda clearly describes various aspects of such epidemics with respect to their cause (nidana), effects, management and prevention. Charaka samhita clearly explains that such epidemics manifest as a result of vitiation of air, water, environment and season which are common to all individuals. Hence such epidemics affects people irrespective of their physical constitution and the strength of affliction depends on the inherent dosha vitiation of the person.

Prajnaparadha (misuse of intellect), a causative factor for vitiation of all the dosha, is considered to be the main cause of 'Janapadodhwamsa' too [2] . Proper use of medicines to improve the physical health, judicial administration of five elimination therapies and rasayana, along with Daivavyapasraya chikitsa has been mentioned as preventive and as treatment for diseases leading to Janapadodhwamsa [2] This Jwara can also be classified as being agantu (external) caused by Bhoota Abhishanga (Virus), which aggravates all the three doshas. Considering the agantu and janapadodhwamsa nature of the disease, Covid 19 can be considered as a type of Sannipata Jwara with fever, tiredness, dry cough, aches and pains, nasal congestion, runny nose, sore throat, diarrhoea etc as the main symptoms.

An apparently normal male of 36 years working in an IT firm. The patient is well built with a height of 181 cm and 87 kg weight.

The patient presented with nasal congestion and mild rise in temperature since a day.

The Patient had a history of being in close contact with a Covid-19 case and hence was advised for Covid test and the patient was managed subsequently based on the symptoms as explained in Table 1 .

The patient had a history of laparoscopic removal of appendix two years before following acute appendicitis. He was admitted in an ayurveda hospital one year before for management of low back pain.

Prominent symptoms seen were fever, body pain, headache along with other mild symptoms like nasal congestion, heaviness of head, mild to moderate cough of productive nature etc. Such symptoms are usually seen in Sannipata jwara where vata excessively, pitta moderately and kapha is mildly vitiated. Hence medicines that can pacify the dosha and that are exclusively mentioned in the context of Jwara were selected for management of this case

Throat Swab for RT-PCR SARS-CoV-2 (COVID-19) was given on 29 September 2020 and the result was received the next day. 

During the course of the disease the following advises were given:

The patient was healthy with no co-morbidities so home quarantine was suggested.

He was asked to check his oxygen saturation daily and to report if the same fell below 95%. As he reported to have reduced appetite in the initial phase of fever light diet was advised. Steam inhalation was advised twice or thrice a day for alleviating symptoms like nasal congestion, heaviness of head etc. Complete fumigation of house was advised using 

Daily 

Indukantham kashayam (IK), prepared using the drugs of Indukantham Ghrta [3] was selected in this case as it is clinically proven to be effective in treating sannipata kind of fever associated with weakness of body. As mentioned in the reference of the formulation, it J o u r n a l P r e -p r o o f Agastya Rasayanam along with Haridrakhandam was selected for post Covid management to improve the immunity and respiratory health of the patient. The combination is found to be effective in improving the strength of the respiratory system especially in chronic cases of asthma.

The patient was highly motivated to take ayurvedic medicines and very communicative. He provided a very detailed daily follow up of his condition and informed any alleviation or aggravation of symptoms promptly which helped in effective management of the case. The limitation was that the follow ups were taken over phone and the patient condition was inferred through his words and management was decided based on that.

Covid-19 had already shook the world creating millions of death and other causalities.

This article is a simple representation of how Ayurveda can help in the management of Covid 19 cases. It's high time that the time tested traditional knowledge is integrated in the healthcare system to combat the epidemic. Ayurveda can certainly play a significant role in preventing and managing the epidemic if integrated into the main stream health system.

Nil 6. REFERENCES:

Varanasi: Choukamba Orientalia

Varanasi: Choukamba Orientalia

Sahasrayogam Sujanapriya Commentary (Malayalam)

In silico investigation of phytoconstituents from Indian medicinal herb