Introduction
Nipah virus (NiV) is a highly virulent zoonotic pathogen classified under Agantuja Vyadhi. It exerts a profound impact on Pranavaha, Raktavaha, and Majjavaha Srotas. The disease progression is characterized by Dushita Vata-Kapha Sannipata, leading to Septicaemic Vishama Jwara, with predominant involvement of Shiras (brain), Sira (blood vessels), and Urah (lungs). Ayurvedic texts elaborate on interplay of Bahya Hetus (external factors) and Sharirika Dosha Vikriti, resulting in Vishakta Jwara (febrile condition due to vitiated Rakta and Pitta).[1] Hallmark clinical manifestations of NiV—encephalopathy, pneumonitis, and vascular inflammation—align with Krimija Jwara and Agantuja Abhishangaja Jwara, further complicated by Ojovyapat and Srotodushti, particularly Sira Granthi and Stambhana in Majjavaha and Pranavaha Srotas.[²] Given high fatality rate and absence of definitive antiviral therapy, Ayurveda provides a holistic model of pathogenesis (Samprapti) and therapeutic interventions, particularly through Rasayana Chikitsa, Krimighna Dravya Prayoga, and Shodhana Upakrama.[3] This article aims to establish pathophysiological correlation & explore Ayurvedic management principles to combat NiV infection effectively.
Samprapti (Pathogenesis) of Nipah Virus in Ayurveda
The pathogenesis of Nipah virus (NiV) infection can be understood through the Ayurvedic lens of Agantuja Vyadhi, wherein an external pathogenic factor (virus) initiates the disease process.
Samprapti Ghataka (Pathophysiological Components)
| Component | Ayurvedic Correlation with NiV |
|---|
| Nidana (Etiology) | Agantuja Karana (Viral invasion via Kapota-Sparsha Samsarga)[4] |
| Dosha | Vata-Kapha Pradhana, with secondary Pitta Dushti |
| Dushya | Rasa, Rakta, Majja |
| Srotas Pradosha | Pranavaha, Raktavaha, Majjavaha Srotas |
| Adhisthana | Shiras (brain), Hridaya (heart), Kloma (lungs) |
| Srotodushti Type | Sanga (obstruction), Vimarga Gamana (aberrant flow), Atipravritti (hyperfunction) |
| Vyaktasthana (Manifestation site) | Urah (lungs), Mastishka (brain), Raktavaha Sira (vascular endothelium) |
| Upadrava (Complications) | Ojovyapat, Ojokshaya leading to multi-organ failure |
Sequential Dosha Involvement in NiV
1. Primary Agantuja Jwara Stage:
A. The virus enters via the respiratory tract (Pranavaha Srotas), initiating a Vata-Kapha Dushti.
B. Symptoms: Gala Sotha (throat inflammation), Kasa (cough), Swarabheda (hoarseness), Jwara (fever).
2. Raktavaha & Majjavaha Srotas Involvement:
A. Viral replication in endothelial cells triggers Pitta Dushti, leading to Vishakta Rakta Lakshanas (vasculitis, thrombocytopenia).[5]
B. Symptoms: Mukhapaka (oral ulcers), Raktastambhana (clotting abnormalities), Angamarda (body pain).
3. Ojovyapat & Neurological Phase:
A. Majjavaha Srotodushti leads to Vata-Prakopa, causing Mastishka-Gata Jwara (brain fever) and Sankochana (seizures, encephalitis).[6]
B. Symptoms: Bhrama (vertigo), Manas Mandata (mental confusion), Smriti-Hani (memory loss), Murcha (coma-like state).
Ayurvedic Chikitsa Siddhanta for Nipah Virus (NiV) Infection
As NiV primarily disrupts Pranavaha, Raktavaha, and Majjavaha Srotas, a well-structured Trividha Chikitsa Krama (Shodhana, Sanshamana, Rasayana) must be employed for comprehensive Dosha, Dushya, and Srotas stabilization.
1. Shodhana Chikitsa (Panchakarma Detoxification Therapy)
Poorva Karma:
- Deepana-Pachana: Laghu Ahara, Shunthi, Pippali, Maricha, Chitraka to reduce
- Snehapana: Panchatikta Ghrita, Mahatikta Ghrita for Vata-Pitta Prashamana.
- Swedana: Nadi Sweda with Dashamoola Kwatha to pacify Kapha and reduce Pranavaha Srotorodha.
Pradhana Karma:
- Vamana Karma (Shodhana for Pranavaha Srotas) - Indicated in Kapha-Pitta Pradhana stage, for viral clearance from Urdhwabhaga Srotas. Yashtimadhu Kwatha, Saindhava Lavana, Madana Phala Yoga in the early morning on empty stomach.
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