Jwara (fever) is the lord of the diseases, born from sin, causing death, feeds on ojas, lead to the final end…characterised by santapa(discomfort from heat), arising from improper conduct; is a cruel one, affecting all species of living beings and called by different names. (1)
In the Charak Samhita, Puranvasu explains that fever originated when Daksha, King of Kashi, excluded Shiva from his sacrifice. In his anger, Shiva emanated a boy who, heated with the fire of anger, could destroy Daksha’s irreverent sacrifice. Once Shiva calmed down, the emanation of his fire of wrath, possessed of three heads and nine eyes, holding a weapon of ashes and surrounded by flames, needed a job. Shiva told him, “You will be fever in the world.” (2) Since then the emanation of Shiva’s wrath has run around the world making immense trouble. Just in terms of influenza alone, there are 250,000-500,000 new cases each year in the United States, with a resultant 20,000 deaths and 200,000 hospitalizations annually. (3) The 1918 pandemic flu was more lethal that World War I, killing from 20,000,000 to 50,000,000 people in two short years. The magnitude of the health challenge presented by influenza and its common incidence render it an extremely important topic, particularly in the winter months when epidemics of influenza tend to occur. In this article we will consider differences in how Ayurveda and biomedicine see influenza, complementarity between the two, benefits of influenza, hazards of influenza, prevention, treatment, aftercare and pandemic influenza.
Differences in How Ayurveda and Biomedicine See Influenza
The biomedical approach to influenza is based in the sciences of virology, biochemistry and microbiology. From this standpoint, it is important to know the exact virus that caused the flu-like illness and the exact mechanisms of infectivity, transmission and morbidity or lethality of this virus. Viral cultures, immunofluorescent tests and serologic studies are required in order to make a definitive diagnosis. The disease entity characterised as influenza is caused by a single-stranded RNA virus, the influenza virus, which is subdivided into type A or B (causing epidemic flu) and type C (causing sporadic flu). Influenza is transmitted via the respiratory secretions over a time period from one day before until about five days after the onset of the disease. Non-influenzal flu-like illnesses are caused by other viruses, notably the adenoviruses, double-stranded DNA viruses which can survive for long periods of time in house dust and cause flu-like illnesses on an endemic basis throughout the year.
The Ayurvedic approach to influenza is based on the prakruti-vikruti paradigm and emphasises the condition of the host rather than the nature of the infective agent. Diagnosis depends not on serology and virology but on the age old methods of darshanam, sparshanamand prashanam, (observation, palpation and questioning). Two individuals affected with the same virus will likely receive a somewhat different Ayurvedic diagnosis, depending upon their presenting features. Strictly speaking, Ayurvedists should stay away from the word influenza (a diagnosis rooted in virology). From the Ayurvedic standpoint, the abhisanga (external) cause or infective agent (personified as Shiva’s anger-emanation) is still less important than the pre-existing doshas and ama. The infective agent is the seed butama is the fertile field in which the seeds can sprout. As Vagbhat describes the pathogenesis of fever,
Doshas, getting increased by their respective causes, enter amashaya (the stomach) combine with ama, obstruct the channels, drive the fire to the exterior and moving along with it make great increase of heat in the body. (4)
Based on the symptom picture, the fever is characterized as arising from vata, pitta, kapha, a combination of two doshas or all three (sannipata). A typical influenza might fit the description of a pitta-kapha fever, with symptoms of shivering, stiffness, sweating, burning sensations, thirst, cough, and elimination of phlegm and yellow or green secretions. (5) A pandemic influenza of high lethality would fit the picture of incurable sannipata jwara, with stupor, expectoration, vomiting and exhaustion. (6) Ayurvedically, it is also important to be aware of which dhatu is being affected by jwara. Acute fevers move swiftly through the astayi dhatus, penetrating deeper and deeper, giving rise to the ever changing symptom picture of flu-like illnesses as the symptom complexes of each dhatu appear sequentially. Initially there might be the body aches and nausea of rasa jwara, soon followed by the high fever and prostration of rakta jwara. This may be followed swiftly by fainting as doshas enter mamsa dhatu. The author recalls passing out on the London Underground during the pandemic flu of 1969! Soon after comes the onset of anorexia, thirst, malaise and sometimes vomiting as doshas reach meda. In more serious flus the intense bone pain and breathlessness of asthi jwara may follow and in extreme cases influenza may lead to encephalitis, an all-out majja jwara. (7)
Complementarities between the two views
In contemporary practice, the two views of influenza complement each other. Virology, biochemistry and phytochemistry offer the Ayurvedist valuable insights (8) in the selection of herbs that will be active against viral illnesses. For example, knowing of the impressive antiviral resumes of herbs such as Turmeric, Tulsi and Neem may lead us to include these herbs in our influenza chikitsa, while taking their rasa, virya and vipak into account within the prakruti-vikruti paradigm. At the same time, Ayurveda offers biomedicine and Western herbology potential answers to the question why only some exposed individuals will actually develop influenza, why some will be worse affected than others and why some are harmed by the same treatment that benefits others. A mother arrived in my clinic very concerned because her young daughter had not recovered from a flu-like illness despite dosing with Echinacea, which cured her step-brother. We discontinued Echinacea and she spontaneously recovered. As a vata, she was adversely affected by Echinacea, a bitter and pungent herb that was beneficial for her kapha step-brother.
Benefits of Influenza
From a biomedical standpoint, influenza has an effect in priming the immune system, raising levels of interferon that help combat other viral challenges. A small child’s frequent flu-like illnesses are a kind of immunological curriculum, training their immune system to recognize and combat a wide range of viruses. From an Ayurvedic standpoint, it is important to distinguish between prakrta andvaikruta fevers. Prakruta fevers occur at the change of seasons in Spring and Fall and are the body’s way of expelling excess doshas. These fevers are typically in the category of abhaisaja sadhya or illnesses that spontaneously remit without medicine. Suppressing these natural fevers leaves the doshas no way of being expelled and sets the stage for the onset of more serious conditions. On the other hand, vaikruta fevers occur unseasonably (such as kapha flu in summer) and should be treated vigorously as they represent an inherent imbalance. (9)
Hazards of influenza
Influenza is particularly troublesome in older adults (over fifty), in respiratory-compromised individuals such as asthmatics, in immuno-compromised situations like HIV and in those with chronic illnesses such as diabetes and heart disease. These groups are more likely to develop significant pranavahasrotas disorders such as bronchitis and pneumonia as a consequence of catching flu. In light of these dangers, prevention is an important aspect of the approach to influenza.
In working with those in the risk categories discussed above, it is particularly important to address influenza prevention during the fall and winter. An herbal formula to detoxify rasa and rakta and stimulate the immune response with herbs such as Pippali, turmeric, andTriphala, will be of value during this season. Immune Support is a combination that includes these traditional herbs as well as Echinacea and Osha, which have known effects in stimulating the immune system. Daily use of Chyavanprash during flu season is very traditional and will help maintain the health of pranavahasrotas and fight off flu. A home-made “Trinity Tea,” as we like to call it, is a tasty combination of Tulsi, Turmeric and Ginger to make a warming and anti-viral beverage for use in the winter months, particularly for the at-risk populations. Of course, regular pancha karma at the change of seasons takes flu prevention to another level. Shodhanatherapies expel the excess accumulated doshas, removing the need for the body to expel them through a prakrta fever.
Influenza is treated by langhana (reducing) therapies, particularly fasting (10). Loss of appetite during fever is a response of cellularprajna since agni has become externalized and is unable to digest solid food. A small child whose parent s encouraged her to eat during an influenzal fever developed sores on her mouth and tongue. These immediately abated when she was asked to fast for a short while and sip Fennel tea. While fasting, the patient should sip warm water frequently and should avoid cold water, which will cause further accumulation of vata and kapha. In the case of a strong pitta fever, room temperature water can be sipped. (11) Herbal teas containingMusta and Ginger are ideal. Musta is regarded as the pre-eminent herb for fevers (12). Cooling herbs are added to this blend, traditionally sandalwood, now unavailable for sustainability reasons. Rose and Coriander can be substituted to provide the cooling anti-febrile component. The texts emphasize that no solids, including powdered herbs, be taken at this time. (13) Sweating is applied using aginger bath or sauna but oiling or lepana should not be applied. As the fever comes down and appetite begins to be felt, the patient should use bitter herbs such as Mahasudarshan to dispel toxins and can consume a thin gruel containing digestive spices such as Ginger, Coriander, and Pippali(14). Kapha should add Dashamoola to these recipes. (15) Traditionally the reintroduction of foods progresses from manda (a liquid gruel) to peya, or semisolid gruel to yavagu or soup with boiled grains to vilepi, somewhat soupy boiled grains and finally to odana or solid boiled grains. (16) Vata and pitta can use rice for these recipes while kapha should use barley instead. Mung dal can also be used for the gruels while for gluten sensitive kaphas we have had good results substituting quinoa for barley in the traditional recipes. Non-vegetarians can also use chicken soup (‘Jewish penicillin’) as a substitute for the quail soup mentioned in the texts (17). Maya Tiwari’s book Secrets of Healing contains recipes for the traditional gruel preparations of manda, peya etc showing how to use spices such as cumin, coriander, turmeric and mineral salt in the recipes.
Following the reintroduction of food, it is wise to use rakta shodhan or blood cleansing herbs such as Guduchi and Musta (18) or a formula such as Blood Cleanse and to take Triphala to expel residual doshas.
Following influenza the patient may be debilitated for weeks, even if they shook off the initial fever in a few days. At this time it is best to remain celibate, to continue an easily digestible diet and to introduce physical exertion gradually (19). Walking can be increased from slowly strolling around the block to gentle walks. Restorative yoga will also be helpful. Lung rejuvenative herbs such as Licorice, Pippali or Lung Formula are of value at this time, to clear up residual cough and upper respiratory symptoms and strengthenpranavahasrotas. The post-flu formula par excellence is Chyavanprash, which heals the lungs, boosts immunity and restores strength and energy. Post-influenzal depression arises from penetration of the virus and disease process into majjavahasrotas and is best addressed by a tea combining equal portions of Brahmi and Tulsi.
A Word about Pandemic Influenza
Influenza viruses responsible for causing pandemics are influenza A viruses which emerge as a result of a process called "antigenic shift” causing sudden, major change in certain proteins on the surface of the influenza A virus. This change is great enough that the body’s immune system finds the new virus unrecognizable. Much of the severity of pandemic flu may result from over-reactivity of the immune system, a process known as ‘cytokine storm’ which results in severe lung damage and ultimately necrolysis of the vital organs. (20) In this situation it is vital to avoid immune stimulants such as Echinacea or Immune Support which are so valuable in epidemic and sporadic influenza. Honey should not be used for the same reason. Turmeric is the ideal herb to use in this situation since it will both fight the virus and calm the immune response.
As we have seen, biomedicine and Ayurveda view influenza through different lenses and yet the two approaches can complement each other. Ancient texts provide detailed instructions regarding the prevention, treatment and aftercare of influenza.
A composite Ayurvedic perspective on Flu
offered by Varadaan
Flu, or influenza infection, is a particularly interesting opportunity to explore the intersection of two related,but rather different, approaches to medicine. Because we rest within the context of Western Culture, in a sense our starting place is the perspective of Western Science, and thus Western or allopathic, medicine. But this is an article about an Ayurvedic approach to Flu, so actually, the author is working from an Ayurvedic perspective, resting within the Western framework. How does this work, or how should we begin?
Well first of all, we can start by exploring the main theoretical frameworks of these two medical systems, which incidentally share pretty much the same scheme of specializations or departments: Internal Medicine, Surgery, ENT/Ophthalmology, Toxicology, Pediatrics, Gerontology, Aphrodesiacs and Psychology (from Ayurveda, going back thousands of years). This is no accident: Ayurveda is probably the origin of much of early Western Medicine, and the 'humor' system that was discredited some 150 years ago, failed largely because it was not properly translated from Ayurveda. Baby. Bathwater. But here we are, in the 21st century we can keep our eyes open and draw upon the best opportunities of both worlds. In fact, when we are taking on influenza, which is a real challenge for Western Medicine, this will be a fantastic advantage. Now, back to framework. As everyone is likely well familiar with, in the case of infection, Western medicine is going to focus first on the invader, and will apply a recent and important theoretical development (in the West): so called "Germ Theory". Now Ayurveda has had the concept of "krumi" or invading organism for a long time, and quite specifically understood that infecting organisms of the blood could be invisible to the naked eye (Charaka circa approx 200BC1, Vagbhat circa 6thCentury AD2), and had descriptions of various types of infection and treatment including for leprosy, TB, etc, and generally characterized them in doshic terms. In fact I do have samples of Ayurvedic antibiotics which were formulated using ancient alchemical methods, and one day, when Western pharmacology is ready, these special compounds may become an important mainstay of the world's medicine cabinet. Maybe best this happens once we realize that modern animal husbandry is outrageously irresponsible with the few precious antibiotics we have been lucky enough to discover. . . but I digress. Western medicine and for that matter, hygeine and food science, took a very particular and important turn when Louis Pasteur in the 1860s, using the newly invented microscope, proposed a 'germ theory' to describe what he was observing, and then applied his hypothesis to formal experimentalstudyofetiologyofcertaindiseases.3 And the modern science of medical microbiology was born. Before this, the science of epidemiology based on a theory of contagious disease became more formal with the work of John Snow in 1849/1855, particularly in application to an outbreak of Cholera in London. Sadly, government resisted adopting this theory because the idea of fecal-oral transmission was political unpalatable (ahem!). Now we also have Ayurvedic history (see above, and which also included ideas about hygiene in general and also in particular around the site of infection4). There is also precursor work in Europe5 including clear evidence against spontaneous generation in the 17th century. And finally, it was formally in 1928 Alexander Fleming who discovered penicillin in a petri dish, and applied this to treatment of pathogenic infection, and as they say the rest is history. It is fair to say that because of the efficacy of the germ theory to prevent food spoilage and increase success in the prevention and treatment of contagious disease and to enhance outcomes in the surgical theater6, that the germ theory became a central tenet of Medical practice in the West, and ultimately worldwide.
But wait, even in Western allopathic medicine, there is no full and complete consensus that Pastuer’s version of germ theory is the whole story.
A brilliant Doctor, chemist, biologist and physicist, Antoine Béchamp had a bitter and protracted dispute with Louis Pasteur, a key point being his theory of mycrozymes, and one important element of his work was the observation that microzymes, including specific bacteria, could take on a number of forms during the host’s life cycle and these forms depended primarily on the chemisty of their environment, the biological terrain, the condition of the host.7
Interestingly, some of the organisms that provide greatest challenge to a traditional AMA style treatment include organisms that are pleomorphic, which can change their forms, as discovered by Béchamp, such as the spirochetes. Even in allopathy we know that Herpes zoster goes into a more passive state when blood chemistry changes. Pasteur operated from a ‘monomorphic’ theory which posited microbes having only fixed states. In his last book, Béchamp is presenting a view that correlates closely to the well-tested Ayurvedic model of the agni-âma paradigm:
". . . the microzyma, whatever its origin, is a ferment; it is organized, it is living, capable of multiplying, of becoming diseased and of communicating disease. . . All mycrozyma are ferments of the same order - that is to say, they are organisms, able to produce alcohol, acetic acid, lactic acid and butyric acid. . . In a state of health the microzymas of the organism act harmoniously, and our life is, in every meaning of the word, a regular fermentation. In a state of disease, the microzymas do not act harmoniously, and the fermentation is disturbed; the mycrozymas have either changed their function or are placed in an abnormal situation by some modification of the medium. . ."8
While the particular details of his theory have been aggressively discredited in formal circles of AMA-style medicine, some elements of this school of thought appear to have merit, especially when reviewed from an Ayurvedic perspective. Remember that before this period of ‘revolution in medicine’ it was largely a humoral theory9 that governed medical practice in the West. Ayurveda is in essence built upon a ‘humoral theory’, but the difference is that the four humor system in the west appears to be somewhat an adaptation, a poor translation, of Ayurvedic principles. Ayurveda has been successfully practiced for perhaps 10,000 years, on up to current day. While some would like to discredit Ayurveda, that might be difficult since, when it is correctly practiced, it works well. If we take a more complete humoral theory, combine it with some of Béchamp’s ideas and then include the idea that there are infective organisms which may be too small to see, well, then we have Ayurveda. A key point being that when Ayurveda tackles the biological terrain it does so with its own system of physics/biology/metaphysics which reaches into the natural world and into the realm of consciousness, and can do so with authority. Ayurveda is an evidence based medicine, albeit with a different methodology, including the concept of upashaya, or ‘clinical trial’, but on the basis of each individual, and practicing specific treatment for each person at each point in time. And it is backed by 10,000 years of hands-on research. Because it is mostly using actions the body can already accomplish and botanical medicine, it is or can be a very low cost and ecologically sustainable medical system. Its treatments essentially have no side effects. It is a complete and powerful medical system, and in the West it can outperform with complaints that stymie Western medicine like typeII diabetes, arthritis, anxiety disorders and irritable bowel syndrome. Things get especially interesting with an integrative approach where we combine the best of Western allopathy with a powerful approach like Ayurveda which combines completely different perspectives on biological terrain, subtle energetics and consciousness. The primary branches of allopathic medicine are surgery and the administration of poisons (internal medicine with pharmaceutical drugs). In Ayurveda these are included, but are considered to be measures of last resort.
OK. Now back to our topic: Influenza. Influenza is a rapidly mutating virus. It can be fought with vaccines, but that only works for some individuals, and only when the World Health Organization rolls the dice correctly and predicts the properties of next years’ outbreak(s). In a sense we can think of vaccination as altering the‘biological terrain’, making it less friendly for a given virus, but also because of mercury, aluminum or other contaminations, it is possible that vaccinations may damage the health of the biological terrain as well, with children possibly being more vulnerable. Ayurvedically, think about: ‘cellular intelligence’ plus ‘sthula ojas’ plus‘sukshma smruti’. So while some vaccinations are known to be extremely effective and probably a good idea, such as TB, Dyptheria, and Polio (DTP), the marginally effective chickenpox vaccine may not be worth whatever risks come from an injection requiring metals-based preservatives, etc. At some point there may be a new strain of influenza that allopathic medicine has little ability to address, except from the perspective of epidemiology, which means managing spread of a pandemic by minimizing exposure among the infected and the potential infectees. All well and fine, but we already have swine flu, avian flu, and are learning more every year about the serious potential for species jumping strains of RNA-viruses; most recently in the science news is discovery that bats are hosts to at least one very deadly ebola family virus.10 Key point: viruses fit into the theoriesof‘germs’or‘sukshma krumi’, but the challenge is that they are hard to kill once active in the host. Allopathy’s ‘magic bullets’ don’t work here. Actually because of misuse of these magic bullets, we are on the verge of a world where we may not have magic bullets for some virulent strains of bacteria too.11 So it’s time to dust off ideas about ‘biological terrain’ or more à propos, time to study our doshas. So yes, we should attend to doshas when fighting a virus. Most likely, the reason we got the flu and another family member did not, is because we had a doshic imbalance ‒ just like Béchamp suggested might happen. He was a brilliant chemist, and we know that acidic blood opens the door to all kinds of infections and disease conditions. Infection in Ayurveda goes with Pitta imbalance, which relates to sour taste and acidity. And Béchamp’s mycrozymes are “able to produce alcohol, acetic acid, lactic acid and butyric acid”. I am not saying that we should take Béchamp’s ideas lock stock and barrel, but if you take a closer look at the history between Bechamp and Paseur, we might begin to see a parallel between the narrow version of medicine offered by mainstream commercial Western medicine, which has allowed the abuse of antibiotics and in the USA isinadequately screening hospital patients for MRSAs, and something a bit broader in scope, something that includes complementary approaches at the heart of preventative care, and a more comprehensive approach to the management of disease. We could say that this is the future of medicine.12
Oh right, back to ‘Flu’. . . So in the past few months, hearing about so many people suffering from really bad flu this year, I created a special Ayurvedic ‘magic bullet’. It is pure Ayurveda, but crafted also with Osha root, one of the greatest herbs that grows in Colorado. We are calling it Flu•B•GoneTM, and we are selling it now at theVibrant Lotus Products store at 302 Pearl Street, 24 capsules to the bag, and it will be available for purchase online very soon (maybe now already). It is affordable, it is effective, and it is Ayurvedic. Because it is Ayurvedic, it works at any point during the progression of your body’s interaction with the virus: apparently it may prevent actually getting the flu if you catch it early, it might speed you into a recovery phase if you really have flu, and it is reported to accelerate the recovery phase. These are not medical claims, these are anecdotal reports from people who have taken Flu•B•Gone®13.
Be Well, Everyone!
©2013 Varadaan (Ben Lipman) and Boulder Ayurveda, Inc. 302 Pearl St, Boulder CO USA. All rights reserved.
1 Caraka, Vimaana 7:9-13, 19, 22-27
2 Vagbhat, Ashtanga Hrdayam
3 Louis Pasteur: http://en.wikipedia.org/wiki/Louis_Pasteur http://ebooks.adelaide.edu.au/p/pasteur/louis/exgerm/complete.html
4 Avoiding exposure to causative factors: Caraka, Vimaana 7:9-13, 5 http://en.wikipedia.org/wiki/Francesco_Redi
8 Antoine Béchamp, The Third Element of the Blood
10 Popular Science, October 2012, pp55-82. Science News, March 9 2013, Vol 183, No5, p.10-11.
11 News Flash:
LONDON, March 11, 2013 (Reuters) - Antibiotic resistance poses a catastrophic threat to medicine and could mean patients having minor surgery risk dying from infections that can no longer be treated, Britain's top health official said on Monday.
Sally Davies, the chief medical officer for England, said global action is needed to fight antibiotic, or antimicrobial, resistance and fill a drug "discovery void" by researching and developing new medicines to treat emerging, mutating infections.
One of the best known superbugs, MRSA, is alone estimated to kill around 19,000 people every year in the United States - far more than HIV and AIDS - and a similar number in Europe.
And others are spreading. Cases of totally drug resistant tuberculosis have appeared in recent years and a new wave of "super superbugs" with a mutation called NDM 1, which first emerged in India, has now turned up all over the world, from Britain to New Zealand.
Last year the WHO said untreatable superbug strains of gonorrhoea were spreading across the world.
12 In fact, the idea of oxygenation of tissues having a critical effect on the ability of the body to minimize inflammation and fight infection could be directly linked to the ancient Ayurvedic principal of the primacy of Prana in maintaining health, Prana being Jivanam, meaning ʻthat which gives lifeʼ. Here is a very interesting article, which originally was linked in the Boulder Ayurveda Winter News in 2009:http://www.townsendletter.com/June2009/oxyhomeo0609.htm
13 These statements have not been evaluated by the Food and Drug Administration. The product is not intended to diagnose, treat, cure or prevent any disease.
©2013 Varadaan (Ben Lipman) and Boulder Ayurveda, Inc. 302 Pearl St, Boulder CO USA. All rights reserved.
If you wish to use this material for classroom purposes or publication, etc, please contact Boulder Ayurveda.
From the professional and student members of Colorama