Life Style Modification During Coronaviruspandemic - An Ayurvedic Perspective

INTRODUCTION

The aim and objectives of Ayurveda is to preserve the health of a healthy person and also to treat and cure the sick person in such a way that the disease is nipped in the bud and does not appear again. This science recognised as foremost science which describes ways to prevent and manage current pandemics (COVID-19) with simple lifestyle modifications and following preventive principles. According to the World Health Organization (WHO), viral diseases continue to emerge and represent a serious issue to public health. In the last two decades, several viral epidemics such as the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) from 2002 to 2003, and H1N1 Influenza in 2009, have been recorded. Most recently, the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was first identified in Saudi Arabia in 2012¹ . Since 31st December 2019 and as of 29 July 2020, 16 708 920 cases of COVID-19 (in accordance with the applied case definitions and testing strategies in the affected countries) have been reported, including 660 123 deaths² . InIndia reported around 879 thousand confirmed cases of the Coronavirus (COVID-19) as of July 13, 2020. Out of these, around 554 thousand patients had recovered, while 23 thousand cases were fatal³ . People infected with the 2019 Novel Corona virus begin to experience mild cold or flulike symptoms in two to four days. Although the symptoms can vary from one person to the next, they typically include sneezing, coughing, runny nose, fatigue, sore throat, fever, loss of smell and taste sensation⁴ .

To combat the above mentioned symptoms regular practice of various preventive principles mentioned in Ayurveda like Dinacharya(Daily routine), Ushna jala pana (entire day), Ayush Kashaya Pana, Avoiding Diwaswapna, Chaitanya Yuktha (instead of being sluggish always involved in some regular activities), spend time for Yoga and Pranayama, Vyayama, Dhyana (meditation), KavalaGandusha (gargling with warm water/ salt water/ turmeric powder), Pathya Ahara sevana,(Consumption of Healthy food), Apathya Ahara Varjana (avoid cold foods like ice creams, refrigerated items, junk foods etc) RasayanaSevana (Immunity Booster) are very effective in managing COVID 19 Pandemics.

CONTENT OF THE PAPER:

Following Dinacharya regularly(as a tool to modify life style) and follow some preventive principles mentioned as per classics may help to overcome the current pandemic situation.

Dinacharya is defined as "the daily routine", PratidinamKartavyamCharyaDinacharya.⁵ Dina means 'daily' and Charya means 'practice or routine'. According to Ayurveda one should follow Dinacharya in order to lead a healthy and disease free life. Ayurveda in its literature has given detailed rituals or practices (Charya) that one should follow every day to establish the balance of Tridosha in our body, which helps to regulate a person's biological clock and synchronize us to nature's circadian rhythms. It starts from waking up in the morning in Bhramhi muhurtha, Ushna Jala pana, Mala-Mutra Visarjana, Saucha karma, Dantadavana, Jihwa Nirlekhana, Nasya, Gandusha, Kavala, Abhyanga, Vyayama, Snana etc along with some preventive principles like Pathya Ahara sevana, Apathya Ahara nisheda, Diwaswapna nisheda, Rasayana Sevana etc are focused in this article.

1.Brahmmuhurte Jagrana

It is considered as the apt time for waking up which is the fourteenth Muhurtha of Ratri (i.e. 48 to 96 minutes before sun rise at any particular region) varies from region to region as the time of sunrise is not uniform throughout the world. It is approximately two Muhurta i.e. 96 minutes before sunrise in that region. Period of Brahma Muhurta is an intermittent duration between respiration and photosynthesis in plant kingdom. There will be abundance of nascent oxygen which easily mixes with haemoglobin forming oxy haemoglobin reaching to the remote tissues and also boost the immune system as oxygen deficient bodies are highly prone to disease⁶ .

2.Ushnajala Paana

Ushnodaka increases digestive power, alleviates Kapha, Vataand Pitta dosha. It is useful in Swasa, KasaandJwara specially Kapha Vataja Jwara, It is desirable in some other diseases caused by Kapha, Medas, Vata, andAama anditisgoodforthroat also. The same benefits are applying for Ushnodaka whentakenatnight^7,8,9,10 Warm water is best in winter and after eating preparations of flour and those which are difficult to be digested¹¹.

Mechanism of Action: Deepana property of warm water causes expansion of Srotas carrying digestive juices, thus increasing their flow, resulting in proper digestion. Boiling water changes its nature, making it lighterandchangesitspotencyfromcoldtowarm. Byboilingthe drinking water for 5 minutes the properties of the element of fire are incorporated, which magnifies the properties of the water. This sharpness allows it to cleansethe channels and penetrate deeper levels of the physiology to hydrate the tissues, and thus it becomes easier for the body to flush out toxins and impurities¹².

(Ayush Kwatha a Special Recipe as suggested by Ministry of AYUSH as per current Pandemics)

Ayush Kwath: Recipe for Boosting the immunity is to be Prepared and taken. Dosage as suggested according to the Ministry, this decoction can be consumed once or twice daily to help, strengthen the immunity against COVID-19. The formulation, which may be manufactured and sold in generic name as ‘Ayush Kwath’ or ‘Ayush Kudineer’ or ‘Ayush Joshanda’, is suitable for consuming like tea or hot beverage every day.

Ingredients:

• Tulsi (Ocimum sanctum) leaves - 4parts

• Dalchini (Cinnamomum zeylanicum) stem bark - 2parts

• Sunthi (Zingiber officinale) rhizome - 2parts

• KrishnaMarich (Piper nigrum) fruit - 1part

Method of preparation : Mix 3gm powder (comprising all ingredients) in 150ml hot boiled water and can add Guda or Gur (jaggery) / Draksha (resins) and lemon juice to the decoction.13,14

3. Sauchakarma (Hygiene)

Daily evacuate the bodily waste (stool) in Sauchalaya (toilets). Relieving our self from the natural urge or perform excretory functions early in the morning prolongs life15. Maintenance of cleanliness whatever it is in general or after defecation, plays huge role in the maintenance of good health and also in the prevention of diseases.

Wash hands frequently with an alcohol-based hand rub or wash them with soap and water which kills the viruses that may be on hands. One should avoid physical touch and shaking hands to greet others, Spitting in the public areas is strictly discouraged to avoid transmission of disease by Droplet infection. Frequent touching of eyes, nose and mouth that can pick up viruses from various sources like surfaces of fomites etc., are to be avoided. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can easily enter your body and can cause infection. Usage of gloves (Polythene/Rubber) can be encouraged whenever possible.

Practicing good respiratory hygiene is to be encouraged always. This means covering mouth and nose with bent elbow or tissue paper / handkerchief when one cough or sneeze. After coughing or sneezing dispose the tissue paper / wash the handkerchief properly and sanitize your hands with Alcohol based Hand wash16.

Dhupana - (fumigation): DhoopanaKarma should be practised in every house daily in evening time with antimicrobial herbs such as Neem leaf, Sarshapa (Brassica campestris L), Loban (gum bezamin/benzoin - StyraxbezoinDryand), Karpura (Cinnamomum camphora (L) J.Presl.), Ghee etc. Also usage of AparajitaDhoomaChoorna (A.h. Jwara Chikitsa) as per availability can be adopted¹⁷.

4. Danta Dhavana:

Teeth should be cleaned twice a day, after elimination of urine and faeces at morning and after consumption of food at evening. Principally twigs of Kashaya, Katu and TiktaRasa dominant tree, like Arka, Nyagrodha, Khadira, Karanja, Kakubha Etc¹⁸. Dantadhavana abide the rule of Ayurveda obviously helpful in maintaining of oral health. It prevents dental carries by maintenance of salivary pH and promotion of salivary secretion. Regular mechanical removal of food debris and control over acid formation helps to prevent dental plaque which in turn prevents periodontal diseases. Further antimicrobial and healing property also present in the herbal twigs which are used for Dantadhavana¹⁹.

5.Jivha Nirlekhana:

The ancient Ayurvedic recommendation of tongue scraping is one that is often overlooked. The dirt deposited at the root of the tongue, obstructs expiration and gives rise to foul smell. So, the tongue should be scraped regularly²⁰.

Thus the Danta Dhavana, Jivha Nirlekhana helpful in maintenance of oral hygiene by removal of vitiated Kapha along with the harmful microbes which sticks in the oral cavity and also prevents further descent of the microbes either in digestive or in respiratory passage.

6.Nasya (Nasal instillation of drops)

As nasal health is also an important aspect to take care in this context, The concept of Nasya in Ayurveda which is capable of treating many number of diseases related to ear, nose, throat, mouth, eye and head. Nose is believed to be the entry to the head, hence all diseases of organs above the clavicle can be treated using nasal route i.e. Nasya²¹, PratimarshaNasya has been advised to use daily, usually AnuTail is used for this purpose²². Regular practise of PratimarshaNasya (2 drops of sesame / coconut oil each nostril)²³ is much beneficial in this pandemic condition.

It pacifies the Vata Dosha& gives unctuousness to head & neck region, so it prevents mainly the degenerative disorders of brain & sense organs. It prevents Shirah Shool (head ache), Peenasa (chronic rhinitis) and other Vataja disorders.

Mode of Action: Trapped pollutants mixed with exudates leads to further prohibition of absorption due to high thickness (concentrate) and expelled out through cilia movement with expiratory force. Whereas absorbed oil nourishes and strengthen the mucosa membrane. Strengthen mucosa membrane, liver etc organs have physiological ability to metabolise and neutralise the organic pollutant to large extent. If medicated oil is used having anti-microbial properties then it will also act as disinfectant against micro-organism. In this way it strengthen and keep moisten to mucosa membrane of nasal cavity and upper respiratory tract and make respiration smooth as done by mucin, acts as anti-inflammatory by reducing congestion and oedema, acts as a barrier by preventing contacts of pollutants like dusts, smoke, pollens etc and antimicrobial by killing or static effects of drugs used for oil processing²⁴.

7.Gandoosha and KavalaGraha:

Gandusha / Kavala (Oil Pulling) 1 tablespoon of Sesame or Coconut oil for Kavala followed by warm water rinse. Gargle with warm water added with a pinch of turmeric and salt, Triphala, and Yashtimadhu. Shuddha Tankana (2% aqueous solution), Madhoodaka (5% aqueous solution) also can be used for Kavala Graha.

In Gandooshaa medicated fluid is held mouthful for a specific period until there is lacrimation and nasal discharge, and then the patient spits it out. In Kavalagraha, the mouth is only three-fourths filled with the medicated fluid; the fluid is swished in the mouth for a specific time and then spat out^25,26.

Mode of action Gandoosha and Kavala:

The saliva consists of lysozyme, an enzyme and antibody IgA, which are bacteriostatic and antimicrobial in nature. The Gandoosha and Kavala increase the pressure in the mouth, which stimulates the stretch reflex i.e. the pressure receptors resulting in stimulation of the salivary nuclei in brain stem. This results in increased activity of parasympathetic motor fibres of facial and glosso pharyngeal nerves and increases the salivary output, through which the vitiated KaphaDosha present in the oral cavity and the microbes resided in the oral cavity are eliminated there by helpful in maintaining the oral hygiene²⁷.

8.Abhyanga (Massage):

Ayurveda always recommend that Abhyanga (oil massage) should be performed daily. If not possible, then at least apply oil to head, ears and feet²⁸. Abhyanga delays aging, reduces stress since it is evident to reducing physiological dealings of strain, including hormonal (Cortical, epinephrine and nor-epinephrine) as well as physical (heart rate and blood pressure) variables²⁹. Abhyanga is one of the soothening procedures which act as a stress buster, during the coronavirus pandemic as so many people are going to suffer psychologically which leads to severe depression and insomnia(sleeplessness), to avoid all such Physical as well as psychological stress one should daily undergo Abhyanga procedure as a preventive measure.

9.Vyayama (Exercise ):

Vyayama or physical exercise is an important preventive, curative and rehabilitative measure. The aims of Vyayama are to promote harmonious development of the whole body. In all the seasons’ daily Vyayama should be performed by persons desiring their wellbeing by Balardha (half of the strength). Moreover, Ardhashakti Vyayama is indicated in Sheeta and Vasanta Kala only. As Vyayama practiced beyond the capability of the body can be harmful³⁰.

Individuals practice daily Vyayama causes physical development, lustre, compactness of body parts, stimulation of digestive power, nonexistence of idleness, firmness, lightness, cleanliness, tolerance to fatigue, cold, heat and provide optimum immunity³¹.

Yoga: Itis designed to balance physical, mental, emotional, and spiritual well-being in an individual. It includes gentle stretching of muscles and breathing exercises with wide range of classical Asanas and Pranayama practices³².

Pranayama: It is an integral part of Yoga. It is a Yogic technique in which breathing is controlled voluntarily. There are various methods of Pranayama, mostly characterized by breath holding at the end of maximal inspiration or maximal expiration and slowing of the respiratory rate³³. It needed to be found out whether regular practice of Pranayama improves respiratory endurance.

The practice of meditation originated in the ancient Vedic times of India and is described in the Vedic texts^34,35,36,37. Meditation is one of the modalities used in Ayurveda (Science of Life), the comprehensive, natural health care system that originated in the ancient Vedic times of India³⁸. The term “Meditation” is now loosely used to refer to a large number of diverse techniques. These include contemplation, concentration, use of nature sounds such as the ocean, guided meditation, meditative movement exercises such as Yoga and taichi, qigong, breathing exercises, and Mantra. These techniques work at different levels such as the senses, mind, intellect, and emotions. Some techniques are easy to learn and practice, while others are more difficult and can result in participants giving up the practice rather quickly. According to Vedic science (the knowledge of the Vedic texts of ancient India), the true purpose of meditation is to connect oneself to one's deep inner Self. Techniques which achieve that goal serve the true purpose of meditation.

The following Yoga-Asanas can be practised for 15 to 20 minutes to improves flexibility of the body and relieve mental stress especially during such pandemics

• Sukshma Vyayama (warm up) loosening exercises for all joints

• Sitting postures like Padmasana, Sukhasana, Vajrasana, Paschimottasana

• Yogasana in supine position: PawanaMuktasana, Halasana, Matsyasana

• Yogasana in Prone position: Bhujangasana, Shalabhasana

• Relaxing postures: Shavasana, Makarasana

• Pranayama: Deep Breathing, NadishodhanaPranayama, BhramariPranayama 10 repetitions each

• Meditation – 10 minutes39

10.Snana (Bath)

Regularly bathing as a part of Dinacharya clears all the dirt of the skin caused by the environment. Daily bathing not only keep us fresh and smelling good but also serves to keep us fit and healthy. This is very effective in providing an adequate workout through resistance⁴⁰.

Acharyas have clearly explained about the qualities of Snana. Bathing is purifying, libidinal stimulant, longevity and it removes fatigue, sweating and dirt. It also brings about strength in the body and is an aid par excellence for the enhancement of Ojas⁴¹ (immunity). It also improves the appetite, removes itching, drowsiness, thirst, burning sensation, sin⁴².

11.Aahar (Diet):

Aahar is one and best beside the three sub pillars (Aahar, Nindra and Brahamcharya), helps to sustain life’s⁴³. It is possible to make a person disease free only through diet; no medicine can be equated with food as it is rightly said Arogyam Bojanadhinam which means health depends on the food which we consume so one has to consume Nithya Sevaniya Ahara as explained in classics like Rice (Shastika Shali), green gram (Mudga), rock salt (Saindhava Lavana), goose berry (Amalaki), barley (Yava), rain water (Anthariksha Jala), milk (Kshera), ghee (Go Gritha), meat (Jangala Mamsa) and honey (Madhu). These should be consumed regularly for maintenance of health and prevention of diseases. As these are correlated with the balanced diet in modern concept of nutrition, as nutrition plays a major role in maintenance of health and prevention of diseases, hence Nithya Sevaniya Ahara given a prime importance⁴⁴.

Proper nutrition is to be ensured through freshly cooked hot food considering individuals digestive power. Freshly prepared Laghu-Supachyaahara (easily digestible, light diet). Intake of comfortable warm fluids boiled with medicinal herbs (preferably Shunthi, Dalchini, Trikatu) should be used as a regular drink to maintain hydration.

Preferable vegetables are Shigru (Moringa Oleifera Lam), Karvellaka (Momordica Charantia Linn), Patola (Tricosanthes dioica. Roxb), Mudga (Vignaradiata (L.) R. Wilczek), Patha (Cissampelos parietal Linn.), Vaastuka (Chenopodium album L.), Jivanti (Leptadenia reticulate (Retz.) Wight &Arn), Tanduliyak (Amaranthus spinosus L.), Kakamachi (Solanumnigrum Linn), Draksha (Vitis vinifera L.), Kapittha (Feronia limonia (Linn.), Dadima (Punica granatum Linn), Lashuna (Allium sativum L.) etc. are to be taken⁴⁵.

Avoiding Sevana of ApathyaAhara, Viruddha Ahara, Kapha and Vata Vruddhikara Ahara (avoid cold foods like ice creams, refrigerated items, canned, junk foods etc) as Kapha and Vata are the major culprits in causation of Swasa Kasa Vyadhi further.

Diwaswapna nishedha

According to AyurvedaDivaswapna leads to incomplete processing of Annarasa, it becomes Ama, and it is selectively converted to Vikritakapha, this Vikrutakapha has role in the formation of Kasa, Swasa and Kapha-VatajaJwara, owing to the principle of homogeneity (KarmaSamanyaSiddhanth)46 so one should avoid Diwaswapna strictly.

Rasayana

Rasayana is made up of Rasa and Ayana, Rasa primarily means essential seven vital tissues, Rasa, Rakta, Mamsa, Meda, Asthi, Majja, Shukra. Aayana means the path or channel for the same. As Rasayanas are known for the improvement of VyadhiKshamathwa of an individual so it is advised to consume Rasayana in current pandemic situations.

MODE OF ACTION:

When Rasayana drugs of different Rasas are taken, they are digested by Jatharagni followed by Bhutagni. During this phase Vata, Pitta & Kapha produced along with pure SaaraBagha i.e. AhaaraRasa this qualitative Ahaara Rasa produces pure RasaDhatu, which then continues the chain of production of remaining other Raktadi Dhatus with the help of respective Dhatavagni up to Ojas formation. Therefore well formed Dhatus keep on nourishing the body till they are taken. Rasayana drugs act at the level of Rasa by improving the nutritional value of the PoshakRasa which helps to obtain the best quality of Dhatu e.g. Shatavari, Bala, Atibala etc.

Vyadhikshamatava depends on the presence of Bala in the Deha. RasayanaDravya also influences Oja which increases ShariraBala. A person with appropriate amount of Bala is also said Saptadhatusara Purusha. This provides the capacity to resist the external disease causing agents⁴⁷ some of the following Rasayanas can be consumed according to the need and its mode of action.

• DRAKSHARISHTA 15 - 20 ml thrice a day with equal volume of water after meal or

• DRAKSHADILEHA 10 - 12gm thrice a day 1 hour before meal (Draksha is having specific potential to rejuvenate lungs) OR

• VASAVALEHA / KANTAKARYAVLEHA 10 - 12 gm thrice a day 1 hour before meal (Vasa / Kantakari is a very useful drug for Jvara, Kasa, PittaVriddha conditions; so it would be helpful in removing the residual Khavaigunya in Srotasas)

• CHYAWANPRASH⁸ 10 - 12 gm/ ASHWAGANDHALEHA⁹ 10 - 12 gm thrice a day before meal

• VARDHAMANAPIPPALIRASAYANA

• VASANTAKALPA⁴⁸

DISCUSSION:

In order to maintain normal health, one has to follow the descriptions of Dinacharya (Daily Regimen) and various preventive measures mentioned in Ayurvedic classics and some of the Lifestyle changes are necessary that reflecting the whole range of activities, attitudes of everyday from sunrise to sunset. These simple rules, if promptly followed, will help in maintaining a good health.

Dinacharya Principles are more relevant in current era because everybody is in hurry and running according to fast life-styles at current times so no one has time for themselves. That which results in emergence of life-style disorders both communicable and non-communicable. This trend of present time cannot be changed as it is demand of this era but life-style can be modified by simple interventions like Dinacharya procedures like(Brahmi muhurtha, Dantha Dhawana, Jihwa Nirlekhan Saucha karma, Snana, Ushnajala pana, Nasya, Kavala, gandusha, Abhyanga, Vyayama, Yoga, Pranayama) and practicing Preventive principles mentioned in Ayurveda like Ayush Kasayapana as directed by ministry of Ayush, Dhoopana Karma as mentioned in classics, Pathya Ahara Sevana, Nisheda of Diwaswapna and Apathya Ahara Sevana is suggested. Because ApathyaAhara, Kapha Vata Vruddhikara Ahara sevana (Cold foods like ice creams, Curd, refrigerated items, canned, junk foods etc) leads to Vruddi of Vikrutha kapha and vata which are the responsible factors for the causation of kapahavataja Jwara, Swasa, Kasa. Regularconsumption of Rasayanas will brings about proper uptake, growth, and improvement of essential SapthaDathus which is ultimately, increases Ojas(Immunity). Thus there is regeneration of cells and revitalize the body tissues leading to increase of immunity factors in an Individual which is essentially required during the time of pandemics.

CONCLUSION:

As per the requirement for current era as various diseases are emerging very rapidly both communicable diseases and non-communicable diseases, Most of them like coronavirus are only preventable by strictly following various preventive measures and life style modifications like including Dinacharya procedures, in daily life as explained above according to Ayurveda.

These measures basically related with harmonization of human body with environment and practicing them regularly balances the Doshas which ultimately results in good health. Healthy habits should be inculcated in one’s own lifestyle even in busy schedule also, if one desires to be healthy forever. These points may looks very simple and negligible but play a vital role in maintenance of health during this coronavirus pandemic.