Dr. P. Rammanohar, Research Director, Amrita School of Ayurveda, Amritapuri, writes on Epidemics in Ayurveda. 

Epidemics were described in classical Ayurvedic literature dating back centuries before the common era. In Sanskrit, epidemics were called Janapadodhvamsa (Janapada - large human settlements, Udhvaṃsa - to be affected, to be destroyed). The Carakasaṃhitā devotes an entire chapter to this topic raising the question as to why people of different body constitutions, lifestyles, diet and genetic inhertiance become afflicted with the same disease. The text replies with the answer that climate, air, water and land can become a common medium through which the same disease can affect a large human settlement.

Interestingly, the Suśrutasaṃhitā, an ancient text book of surgery in Ayurveda, describes illnesses manifesting as epidemics affecting the respiratory system time and again, presenting with the symptoms of fever, cough, breathing difficulty, rhinorrhoea, headache and even anosmia. The clinical presentation of such diseases described in the Suśrutasaṃhitā are strikingly similar to epidemics like SARS, MERS, Swine Flu and even COVID-19 in exhibiting severe respiratory symptoms. Dalhaṇa, the commentator of this text, specifies that causative agent of such diseases enters the human body through the nasal passages.

The Suśrutasaṃhitā also describes the modes of contagion: by repeated physical contact (gātrasaṃsparśāt), by inhalation (niḥśvāsāt), by eating together (sahabhojanāt), by sitting and sleeping together (sahaśayyāsanāt), by contact with clothes, garlands, etc. (vastramālyānulepanāt). The importance of social distancing to prevent the spread of epidemic diseases is hinted at in this ancient medical text. Sthānaparityāga or abandoning the places of human activity is mentioned by Suśruta as the first and foremost measure in mitigating an epidemic. This reminds us of the stringent measures like lockdown that we have been forced to enforce in the wake of the COVID-19 pandemic.

Incidentally, Ayurvedic texts also discuss microbes. The word kṛmi in Sanskrit means that which migrates from one location to the other. This term covers pathogenic organisms in general, but also includes microbes. One category of kṛmi is minute, without feet and invisible to the naked eye. The existence of microbes was clearly documented in classical Ayurvedic texts. It is even more interesting to note that these organisms were classified into the natural (sahaja) and pathogenic (vaikārika). Cakrapāṇi, the commentator of Carakasaṃhitā says that the natural organisms and microbes living in the human body are innumerable and cannot be counted (aparisaṅkhyeya). This is perhaps a very early allusion to the human microbiome.

It would be pertinent to ask what medical measures Ayurveda has advised to deal with such epidemic diseases. Interestingly, the Carakasaṃhitā says that it will be difficult to find a remedy for an epidemic when there is an outbreak. The text advises that as soon as an outbreak is anticipated, people should be administered medicines that enhance their immunity (rasāyana). The importance of boosting one’s immune system to survive an epidemic was emphasised in ancient times in Ayurveda.

What is interesting about the Ayurvedic understanding of epidemics is the non-medical dimension. Ayurveda does not view an epidemic as merely the outbreak of a communicable disease. Rather, the texts point out that the root cause of an epidemic outbreak is adharma- meaning unsustainable ways of human thought and action that damage the plant and animal life around us, the environment around us and the natural resources available on our planet. We have seen major corrective measures being taken by countries in the world even before the pandemic has subsided. Wildlife trade has been banned, dogs have been classified as pets instead of livestock, we have even been forced to adopt spiritual gestures like Namaste to greet each other. The air around us is becoming purified and we understand that we can survive with less than half of the things that we thought were indispensable in our lives.

From the Ayurvedic point of view, an epidemic comes with a deep message. The message that we have to mend our ways.  We have to find sustainable ways of living and a deeper connection with the Universe, as well as practice compassion for other living forms, even to other human beings and Mother Earth herself. For this reason, many spiritual practices and compensatory actions are recommended in the Ayurvedic texts for mitigation of the epidemic, apart from medical measures. An epidemic is a challenge. But it is not the end of the road for humanity. It is a tough lesson for sure, but which can nevertheless become the turning point, a moment for introspection, self reflection and self transformation that can help us to construct a new chapter that changes the course and destiny of human life.

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