Concept of Krimi and its scientific understanding

Priyanka Bairagi; S Abhishek; Anita Dandappanavar; Abhishek Shukla

doi:http://dx.doi.org/10.21760/jaims.8.6.26

Concept of Krimi and its scientific understanding

Bairagi P.¹, Abhishek S.^2*, Dandappanavar A.³, Shukla A.⁴

DOI: http://dx.doi.org/10.21760/jaims.8.6.26

¹ Priyanka Bairagi, Post Graduate Scholar, Department of Kaumarabhritya, Shri BMK Ayurved Mahavidyalaya, Belagavi, Karnataka, India.

^2* S Abhishek, Assistant Professor, Department of Kaumarabhritya, BVVS Ayurveda Medical College and Hospital, Belagavi, Karnataka, India.

³ Anita Dandappanavar, Assistant Professor, Department of Kayachikitsa, BVVS Ayurveda Medical College and Hospital, Belagavi, Karnataka, India.

⁴ Abhishek Shukla, Post Graduate Scholar, Department of Kaumarabhritya, Shri BMK Ayurved Mahavidyalaya, Belagavi, Karnataka, India.

The term Krimi is frequently used in ancient Ayurveda classics from the Vedic period. In The etiology of many diseases, microbial relation played very important role and it is also a causative factor for various pathological condition like weight loss, Anemia, Vomiting, Headache etc. The Krimi may be external or internal in nature. Their mode of transmission, sign, symptoms are almost same as worm and microbes in contemporary science. They had given the description of structure, Naming of Krimi as far as possible. The Krimi described in ancient text are more or less similar to microbes and helminths mentioned in present time. The term Krimi has been used in broader sense. It indicates all pathogenic and non pathogenic organisms covering wide range of infectious pathogens. Ayurveda has advised specific drugs for specific Krimi. Here an effort has been made to understand the Krimi in all the ways possible.

Keywords: Krimi, Worm, Microbes, Helminthes, Abhyantara Krimi, Bahya Krimi

Corresponding Author	How to Cite this Article	To Browse
S Abhishek, Assistant Professor, Department of Kaumarabhritya, BVVS Ayurveda Medical College and Hospital, Belagavi, Karnataka, India. Email:	Priyanka Bairagi, S Abhishek, Anita Dandappanavar, Abhishek Shukla, Concept of Krimi and its scientific understanding. J Ayu Int Med Sci. 2023;8(6):158-164. Available From https://jaims.in/jaims/article/view/2298

Introduction

From very early times it is speculated that diseases may result from invasion of the body by external infectious organisms acknowledged as Krimi. Krimi is a condition, affecting all age groups, but Children are at risk due to their activities such as play and lack of proper personal hygiene. From the children, the entire family may eventually get affected.^[1]If we consider Drishya Krimi as worms, In India, more than 200 million children are infected with roundworm, hookworm, and whip worm. Hookworm is more prevalent among children in South India.^[^2]According to WHO, 1100 million people were defecating in the open resulting in high levels of environmental contamination and exposure to the risk of worm infestations in year 2008.^[3]

Samhitakaras were well aware regarding the presence of microorganisms and have given maximum descriptive contributions. As mentioned in Shabdakalpadruma, Krimi is derived as “Bhrame Samprasarane Cha” means which moves with Pada or legs (podia).^[4] Parvata, Vana, Oushadhi, Pashu, Apshu etc are the areas of Krimi origin according to Veda.^[5] Krimi derived from Dhatu “Kunja Himsayam” which literary means either to produce fatal effects or to destroy.^[6] Charaka informed one of the factors for Krimi production in the body is Kleda.^[7]As in contemporary science there is separate branch of helminthology and microbiology but in Ayurveda the word Krimi is for all worm and microbes either it is visible or invisible. It is very important to understand the term Krimi and step by step management of Krimiroga especially in children in proper way designated by text of Ayurveda as it is not well established practically.

Classification of Krimi: Atharva Veda divided the Krimi into 2 classifications, from which one is Drishta and Adrishta and the second is Durnama and Sunama Krimi, which may be accepted as visible, invisible, pathogenic and non-pathogenic.^[8]

Acharya Charaka classified Krimi into two broad groups i.e., Sahaja and Vaikarika. (Table. 1 & 2)

Table 1: Krimi classification

Sahaja Krimi / Avaikarika Krimi	Vaikarika Krimi
Live in human body right from birth until death	Live in human body not from birth
Not harmful but are helpful to human body	Harmful or cause disease or deformity in body
Numerous in number live in the buccal cavity, alimentary tract as well as in vaginal canal of female as a normal bacterial flora.	Pathogenic in nature

Table 2: Classification of Vaikarika Krimi

Bahya Krimi (Charaka and Vagbhata)	Abhyantara Krimi (Sushruta)
1. Yuka 2. Pippilika	Adrishya	Drishya
	Raktaja - 6	Kaphaja - 7	Purishaja - 5
	Keshada	Antrada	Kakeruka
	Lomada	Udarada	Makeruka
	Lomadvipa	Hridyachara	Leliha
	Sourasa	Churu	Sashulaka
	Audambara	Darbhapushpa	Sausurada
	Jantumatra	Saugandhika
		Mahaguda

Samprapti: Explained in Figure 1

Nidana: Nidanas for Krimi Utpatti are Mandagni, Dosha Vriddhi, Sankotha and Sankleda of Mala and suitable environment for growth and development of Krimi. “Mrija Barjana” means unhygienic and dirty habits produces the Bahya Krimi.^[9] Ajeernabhojana, regular intake of Madhura and Amla Rasa, consumption of Drava substances, Guda, Virudhha Bhojana, Some physical factors like Divaswapna and Avyayama are the common causative factors for Abhyantar Krimi.^[10]Vishista Nidanas are Dugdha, Guda, Tila, Matsya, Anupa Mamsa, undercooked, incompatible and unwholesome articles for Kaphaja Krimi.^[11] Susruta mentioned Vidala, Parnasaka, Masa, Pistanna etc. for Purisaja Krimi^[12] and Incompatible food and vegetables, change from cold to hot and vice versa, sudden change of diet, improper Santarpana and Apatarpana, excessive use of honey and molasses, fish, Lakucha, Chilichima fish with curd, sour berry, Kulattha, Masa, suppressing

the urge of vomiting etc. helps the production of Raktaja Krimi same as the etiology of Kustha^[13]

All the above said factors provide an appropriate environment for the worms to manifest and infest causing serious health hazards.

Samanya Lakshana: General sign and symptoms of Krimi Roga is described in Samhitas include Jvara (fever), Vivarnata (skin discoloration), Sula (acute pain in abdomen), Hridroga, Bhrama (vertigo), Bhaktadwesa (anorexia), Atisara (diarrhea) Sadana (malaise) and Chhardi (vomiting).^[14]

Vishesha Lakshana: Lakshanas are explained in Table. 3

Table 3: Lakshanas of Krimi

Bahya Krimi	1) Yuka	Krimi which mixes with the colour of hair and cloth and creates disease condition.
Bahya Krimi	2) Lakshyate - Leeksha	Eggs of “Yuka” and people can also see it on the hair and cloths.
Sleshmaja Krimi	Antrad	Eats Intestine and destroyer of Intestine.
	Hrudayadah	Responsible for heart disease.
	Udaradaha	Lives in abdomen.
	Charuhu	Steals digested food and also takes Rasadi Dhatu or Krimi which creates Avipaka and Arochaka.
	Sougandhika	Have specific odour and spreads specific smell.
	Darbhapushpa	Have shape like flower.
	Mahapushpa	Found in large number like the flower of “Aparajita”.
	Praluna	Have segmented body (like flat worms).
	Chipita	Very small in size and flat.
	Daruna	Create excessive pain.
	Udaraveshta	Produced in stomach and covered by abdomen.
Raktaja Krimi	Keshada	Catch the hair of scalp and destroy it.
	Lomada	Destroys skin hair.
	Lomadvipa	Lives in the root of skin hair.
	Saurasa	Born and grow due to excessive use of sweet food
	Udumbara	Have shape and color like fruit of Udumbar or Krimi which overcome the hollow space of blood vessels and create very much noise
	Romada	Destroys the skin hair.
	Nakhada	Creates the pathologies of nail which can also destroy the nail bed.
	Dantada	Causes dental disorders (caries).
	Kikkisa	Specifically found in pregnant lady and create itching and scars on lower abdomen.
	Kushthaja	Create skin diseases.
	Parisarpa	The crippling movement of Krimi.
	Matara	Have capacity of producing eggs excessively
Pureeshaja Krimi	Kakeruka	Highly motile in nature.
	Makeruka	Takes shape of Mudrika.
	Sausurada	Shelters on Madya etc. Fermented materials.
	Leliha	Continuously licks (feeds) and consumes the Dhatus (nutrients).
	Sashoolaka	Produce pain in host.
	Kipya	Grows by consuming Sarira Dathus (nutrients).
	Chipya	Chipatakara - flat.
	Gandupada	Resembles earthworm.
	Churu	Consumes formed Rasadi Dhatus.
	Dwimukha	One which has 2 faces (mouth/suckers)

According to Acharya Kashyapa (Ka.Chi.Krimichikitsa)

1. सर्वकृमीन् प्रणुदति वज्रो मुक्त इवासुरान्तिक्तोष्णकटुरूक्षाणां मूत्राणां लवणस्य चस्नेहस्वेदोपसेवा च पथ्यं च कृमिनाशने |

For destruction of Krimi, use of Tikta, Katu, Ruksha, Mutra, Lavana, Snehana, Swedana should be done.

2. प्रत्युष्णं कटुतैलं तु गुदे दत्त्वा ससैन्धवम् स्वेदयेद् गुदमङ्गल्या तथाऽऽशु लभते सुखम् |

Application of lukewarm mustard oil + Saindhava in Guda Pradesha, followed by Anguli Sweda this gives immediate relief to the child.

After considering different classics for the treatment, following treatment principle of Charaka can be adopted.

3 Aspects of Krimi Chikitsa - Apakarshana, Prakruti Vighata, Nidana Parivarjana

1. Apakarshana: The word Apakarshana derived as “Krush Vilekhane Dhatus”, It means to scratch or remove or extracted the Dosha, Mala or unwanted elements forcefully from the body. Apakarshana of Krimi includes the manual and instrumental removal of Krimi where it is applicable.

Apakarshana of the Bahyakrimi by manual method.

Apakarshana of Abhayantara Krimi is explained in Table. 4

Table 4: Apakarshana

Shirovirechana (Pradhaman, Pratimarsha and Avapidananasya)	Effect over the mucosa Stimulates the nerve ending.	With the Katu Tikta Rasa and Ushna Guna, the Krimi as well as Doshas are driven off by Shirovirechana.
Vamana	Amashaya - seat for production of Kapha	When it is vitiated, it produces Kaphajavikara as well as Kaphajakrimi, for its elimination Vamana therapy is applicable.
Virechana	Pachayamanashaya / Pakvashaya - main seat for acting Virechana drug.	When Krimi is in Pachyamanashaya the method of Apakarshana is Virechana with the Krimighna drug having the capacity to do Virechana.
Asthapana Basti	The active principles or the medicine will directly reach at the site of Krimi 1) Kriminashano Vidangaadya Prasritko Niruha (As.S.K.4) 2) Kriminashano Niruha Yoga (Chakrapani) 3) Dashmooladi Niruha Basti (Su.Chi.38/64-66) 4) Krimi Kusthaapaha Prasritiko Niruha Basti (As.S.K.4)	Kashayadravya i.e., contents of Asthapanabasti has Karshan Guna and they the growth of Krimi and its activities.

2. Prakriti Vighatana

Prakriti = Utpadakakarana.

Vighata = to destroy.

That is any measures which will be successful against the infestation and reinfestation of Krimi.

After doing Samshodhan Chikitsa, if their Prakriti is not altered, the disease will occur again.

Having Vitiated Kapha - Agnimandya - formation of Ama = formation of Kaphajakrimi. During Sara Kitta Vibhajan if Vijatiya portion (Kittabhaga) due to any reason accumulates in Pakwashaya, Kotha (Putrefaction) - formation of Pureeshajakrimi. [Here Pureesh = act as its Prakriti]

That’s why Charakacharya has advised to make use of Dravyas which possess the opposite properties to that of Kapha and Purisha for Prakritivighata which is mentioned in Table. 5

Table 5: Prakriti Vighatana

Swarasa	Palashabeeja with rice water, Paribhadra Patra with honey, Karanjatwak, Sireesa, Apamarga, Surasadi group medicines
Churna	Palashabeeja, Vidanga, Kampillaka, Yavani, Ativisa, Maricha, Vachadi, Nimba, Bhoonimba Churna, Vidangaadi Churna, Krimighna Churna
Kwatha	Triphala, Vidanga, Dadimatwak, Surasadi, Khadiradi, Kharjurapatra, Mustadi, Bhoonimbadi Kwath.
Kalka	Nimba Kalka, Vidanga - Pippali Kalka etc.
Avaleha	Pippalyadi, Paribhadra Avaleha.
Asava and Arista	Vidangarista, Khadirarista.
Taila	Surasadi Taila, Vidangadi Taila, Bhallataka Taila, Dhatura Taila, Katu Taila.
Ghrita	Vidanga Ghrita, Triphala Ghrita.
Yoga	Vidangadi Takra Yoga, Surasadiganayoga, Vidanga Bhallataka Yoga, Katukavidanga Yoga etc.
Gutika	Krumighatini Gutika, Lakshadivati.
Khanda	Haridrakhanda
Rasa	Krimimudgara Rasa, Krimi Kuthara Rasa, Vidangadi Loha, Krimikalanala Rasa.
Peya	Vidangadi Peya.
Manda	Vidangadi Manda.
Dhoopa	Krimighna Maheshwara Dhoopa, Lakshadi Dhoopa
Bhasm	Lohabhasma, Vangabhasma
Daiva Vyapashraya Chikitsa	Mantra, Japa, Puja etc., are included and the natural substances like Maruta, Jala, Megha are praised to destroy worms.

3. Nidana Parivarjana: It is followed after Prakruti Vighata. The factors told as Nidana and Dravya similar to the qualities of Nidana should be discarded or avoided from the usage, explained in Table. 6.^[13]

Table. 6: Nidana Parivarjana

Pathya	Ahara	Kasaya, Katu and Tikta Rasatmaka
	Herbs	Patola, Rasona, Amalaki, Paribhadra, Sarsapa, fruit of Brihati, Vidanga, Tambula, Haridra etc.
	Shakha	Karavellaka, Nimbapatra.
	Cereals	Raktashali Dhanya, Kulattha
	Taila	Til and Sarshapa Taila.
	Kshara	Kulattha & Yava Kshara.
Apathya	Ahara	Avoid diet articles of Madhura and Amla Rasa.
	Plant products	Parnasaka, Masha, Guda.
	Animal products	Eight types of milk, curd, ghee etc.
	Food regimen	Ajirna, Virudha, Asatmyabhojan and Adhyasana.
	Vihara	Having Day sleep & holding of natural urges like Nausea, vomiting etc.

Chikitsa: Chikitsa of Krimiroga, in almost all Samhitas is much emphasized and advised systematically.

In Atharva Veda, Sunrays are considered to kill the Krimi. Now a day it is proved that sun rays contain ultra violet radiations which have the properties to kill the bacteria. In Vedas, the reference of Agni is found for the treatment of Krimi.

Discussion

The word Krimi broadly described. From the Vedic period its existence was felt. But details of it is somewhat found in later period. In modern science due to invention of microscope the study of microbes become easy. Among the two types of Krimi - Drishya and Adrisya, the Adrishya one is Anumangamya. The three types of Rogipariksha mentioned in Ayurvedic text among which Anumana is used for Adrishya Krimi. Medical microbiology is the study of microbes, which are invisible to the unaided eye, includes bacteria, protozoa, algae, fungi and acellular agents like viruses. Whereas Medical parasitology deals with parasites includes unicellular protozoans and multicellular helminthes. But in Ayurveda single terminology Krimi includes both macro and micro organisms. The correlation of the Krimi with microbes and parasites depend upon their habitat, available morphological character along with sign and symptoms they produce in host. Individual probable correlation of all the Krimi with microorganisms is quite difficult but some of the Krimi produce similar features like microbes and parasites. Few attempts had been made by Ayurvedic scholars to correlate the types of Abhyantara Krimi with parasites and other microorganisms described in modern literature.

Bahya Krimi, Yuka can be compared with louse (head, body, pubic) and eggs of louse which stick to the root of hair.

Raktaja Krimi are those which reside and travel in Raktavaha Sira and Dhamani, they are very minute, without legs, coppery colour, can’t visualized by naked eye and produce Kustha like diseases, Nakha, Loma Dhwamsa, Brana, Twak, Sira, Snayu, Tarunasthi Bhakshana etc. Here some examples of microbes in blood stream which produce similar feature in body. Bacteria - Staphylococcus, Streptococcus Pyogens, Beta Streptococcus Haemolyticus. Fungi - Epidermophytes, Candida albicans, Tinea corporis, Tinea imbricata, Tinea cruris, Tinea barbae, Tinea capitis. Parasites - Plasmodium, Trypanosomes, Wuchereria.

The Kaphaja Krimi resides in upper part of gut, but when increases in numbers travel through both direction of gut. They have different shapes like thick, flat, elongated, rounded, ring like etc. and produce nausea, salivation, anorexia, indigestion, fever, syncope, vomiting, emaciation etc. The following parasites can be compared with Kaphaja Krimi. Parasite - Ancylostoma duodenale, Taenia solium,Taenia saginata, Trichinella spiralis, Ascaris lumbricoides

Purisaja Krimi lives in lower gut but when increase in numbers travels through upper and lower part of gut. Their size varies from microscopic to macroscopic and produces clinical features like diarrhea, emaciation, pallor, horripilation, perianal itching etc. The following organisms may be the probable correlation of Purisaja Krimi. Bacteria - Vibrio cholera, E.coli, Salmonella, Shigella. Virus - Rota virus, Astro virus, Adeno virus, Norwalk virus. Fungi - Candida albicans. Parasites - Trichuris trichiura, Enterobius vermicularis, Giardia lambia, Balantidium coli.

Conclusion

Worm infestation is very common in paediatric age group. According to Chakrapani “Atra Samshodhanam Apaharanam Samshamanam Vighataha Nidanavarjanam Tu Sabdhen Api Samaanam” Samshodhana (elimination therapies) for the removal, Samshamana (alleviation) is for the measures of counteracting the factors responsible for the treatment of Krimi and the third principle i.e., Nidanaparivarjana

(avoidance of causative factors) for prevention of further infection. Chikitsa is the one which helps to destroy the causes and pathogenesis of the disease completely. While explaining Chikitsa of Krimi, Acharyas given a systematic approach so that it can remove the pathology in a full-fledged form. The mode of treatment told is also helpful to overcome the further infections or the other diseases can cause by different types of Krimi.

So, it can be understood that the Kramanusaraprayoga of Thrividhachikitsa here is good in both preventive and curative aspects.

Reference

1. Sarkar M. Personal hygiene among primary school children living in a slum of Kolkata, India. J Prev Med Hyg 2013;54:153-8

2. Sitotaw B, Mekuriaw H, Damtie D. Prevalence of intestinal parasitic infections and associated risk factors among Jawi primary school children, Jawi Town, North-West Ethiopia. BMC Infect Dis 2019;19:341

3. WHO. Mortality and burden of disease 2010, World Health Statistics

4. Dev RK. Shabdakalpadruma. Vol. – 2. Varanasi: Chaukhamba Sanskrit Series Office; 1967. P. 178.

5. Shastri RG. Vedomain Ayurved. Delhi: Jamna Printing Works; 1956. P. 49.4) Kantadev R. Shabdhakalpadruma, 3rd edition, Chaukhambha Sanskrit Series Office, Varanasi, 1967; 178.

6. Kantadev R. Shabdhakalpadruma, 3rd edition, Chaukhambha Sanskrit Series Office, Varanasi, 1967; 178.

7. Tripathy BN. Charaka Samhita. Vol. – 1 (Sutra Sthana). Varanasi: Chaukhamba Surbharati Publication; 2013. P. 340.

8. Shastri RG. Vedomain Ayurved. Delhi: Jamna Printing Works; 1956. P. 55.

9. Tripathy BN. Charaka Samhita. Vol. -1 (Vimana Sthana). Varanasi: Chaukhamba Surbharati Publication; 2013. P. 711. 15.

10. Tripathy BN. Madhava Nidanam (Roga Viniscaya, Madhukosa). Vol. –I. Varanasi: Chaukhamba Surbharati Prakashan; 2014. P. 303. 16.

11. Tripathy BN. Charaka Samhita. Vol. -1 (Vimana Sthana). Varanasi: Chaukhamba Surbharati Publication; 2013. P. 713. 17.

12. Shastri AD. Susruta Samhita. Vol. –II. Varanasi: Chaukhamba Sankrit Sansthan; 2001. P.400. 18.

13. Tripathy BN. Charaka Samhita. Vol. -1 (Vimana Sthana). Varanasi: Chaukhamba Surbharati Publication; 2013. P. 712

14. Tripathy BN. Madhava Nidanam (Roga Viniscaya, Madhukosa). Vol. – I. Varanasi: Chaukhamba Surbharati Prakashan; 2014. P. 304.

Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2023-04-25	2023-04-27	2023-05-04	2023-05-11	2023-05-18
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
Nil	Nil	Yes	19%

Review Article

Krimi

Journal of Ayurveda and Integrated Medical Sciences

Concept of Krimi and its scientific understanding

Bairagi P.¹, Abhishek S.^2*, Dandappanavar A.³, Shukla A.⁴

Introduction

Discussion

Conclusion

Reference

Review Article

Krimi

Journal of Ayurveda and Integrated Medical Sciences

Concept of Krimi and its scientific understanding

Bairagi P.1, Abhishek S.2*, Dandappanavar A.3, Shukla A.4

Introduction

Discussion

Conclusion

Reference

Bairagi P.¹, Abhishek S.^2*, Dandappanavar A.³, Shukla A.⁴