Ayurvedic management of persistent Anosmia in

Covid-19 survived patient.- single case study

Dr Sucha lakshmi.R1,

Assistant professor, Dept of Shalakya tantra, Atreya Ayurveda medical college

Hospital and research centre, Doddaballapura Bengaluru.

ABSTRACT.

Covid – 19 became the pandemic and its symptoms , way of virulence are
updating day by day . Eventhough most of the cases are reporting
asymptomatic , patients are found to be having anosmia and is persisting for
days together .The temporary loss of smell affects with taste sensation and
happens with a depressive attire to the patients. A case presented with anosmia
since 1 month and was tested covid positive. After 24 days of the test , patient
became negative for Corona but anosmia was still persisting.At that stage,he
was intervened successfully with nasyam, kabala, ksheeradhoomam and
internal medications. After 7 days of treatments patients regained olfactory
and gustatory functions completely.

Keywords- Anosmia , Covid- 19 , nasyam, kabalam, ksheeradhoomam.

Introduction.
 The main objective of Ayurveda is to preserve and promote the health of
healthy persons as well as to cure the disease by means of different treatment
modalities.. The symptoms and features of the pandemic Covid -19 is
changing day by day.Reduction of smell and taste is now recognized as one
of the cardinal symptoms .The matter of relevance is that, evenafter
recovering from the virulence of disease , the symptoms like anosmia is
persisting for weeks together.It will be adding the stress to individual, and is
witnessing for other post covid mental traumas.
There is no direct reference or exact co relation regarding the morbidities
orginated in modern era like Covid -19 in Ayurveda. But it is really
astonishing that treatment modalities explained in different classical nasa
rogas can adopt to cure symptoms of such modern ailments in an effective
way.
In classical treatises , while dealing with nasa roga, in different diseases like
dushta prathishya, apeenasa and raktha prathishyaya, we can see the
symptoms regarding reduced smell perception and taste perception.

Nasal dysfunction occurs due to various diseases of nose but according to

Acharayas all nasal diseases manifests from Pratishyaya. Due to pollution,
dust particles in atmosphere and all vatakaphapradhanhetu, Rhinitis occurs,.
In Prathishyaya nasal mucosa get affected. Some nonspecific stimuli like
temperature, humidity, emotional status, air pollution along with viral
infection triggers the disfunction of nerve ending in nasal mucosa, which
results in persistent anosmia

According to Ayurveda gandha rasa agjnanathva is vata predominant

symptoms which affecting the sensory functions of the nerve ending in head.
There are several regimens in Samhitas for vatadhi dosa shamana, but
according to patient complaints and history of patient Nasyakarma, kabala
and ksheeradhooma was chosen.

Aim And Objective- To study the effect of ayurvedic treatment protocol like
nasya kabala ksheera dhooma with internal medications in anosmia persisting
in covid survived patient .
Material and Methods – A case of Anosmia was taken from shalakya OPD
of Atreya Ayurveda medical college, Doddaballapura, Bengaluru . Detail
history of the patient was taken, patient examined thoroughly, treatment given
to the patient for 7 days. Assessment was done after complete treatment.

Patient History – A 51 yrs old male patient came to shalakya OPD of Atreya
Ayurveda Medical college, Bengaluru, with complaints of absence of smell
sensation , reduced taste sensation and mild head ache since 1 month. He
traveled to Bengaluru from oman 40 days back in flight and was in home
quarantine for 14 days. On the 10 th day of quarantine he started with
symptoms of fever, sore throat , absence of smell sensation , reduced taste
sensation and difficulty in breathing. And was tested and confirmed as
COVID-19. He got admitted in nearby covid care centre and started with
allopathy medications .After one week he started with symptoms like nasal
blockage with yellowish nasal discharge occasionally. The nasal discharge
got reduced in 2 days .He got tested negative on 24 th day and all other
symptoms got reduced except smell sensation and reduced taste sensation.
So he consulted an ENT specialist and took nasal drops etc. but didn’t get
much relief. So he had been approached our hospital.

Patient was thoroughly checked,Anterior Rhinoscopy – hypertrophied

inferior turbinates on both sides with congested septal mucosa. On Xray PNS-
mild clouding. Blood investigation CBC, PS, ESR, BLOOD SUGAR were
checked. CBC-Total WBC Count 11000/cmm Differential count P -1.4
*106/ml, E-05, L-24, M-0. PS normal, ESR -30mm/hr BLOOD SUGAR
normal. Other haematology examinations found normal.
Cranial nerve assay – C1- no smell sensation with lemon grass oil
GP & HP glossal Assay – identified sugar and salt with gustatory reaction.

Treatment Given- Form his history, it is taken as kapha-avarana vata

pradosha vyadhi , where the derranged kapha and vata in shiras delayed the
functions of olfaction and gustation. Patient was treated with bahya kriya and
abhyanthara oushadhis.
 Days Treatment given Medicine & Dose Remarks
Day 1-2 Swarasa Nasyam Tulsi-Guda Dosha
ardhrakam – 6 sodhanardham
drops
Kashaya Dashamoolam Sthanika ama
kabalam and saindhavam- haranam
Q.S
Day 3-7 Taila nasyam Anutailam -6 Dosha
drops shamanam
sringataka
phanadhi marma
rakshanam,
Taila Arimedadhi taila- Indriya
gandoosham Q.S prasadham,
prabhodhanam
Ksheera Dashamoola Nadi
dhoomam yashti ksheeram- bruhmanardham
Q.S

In initial two days of treatment, patient was administered of nasyam with

squeezed drops of tulsi leaves, ardhrakam and guda – 6 drops. Patient was
having burning sensation in nostrils but got relieved very soon. After nasyam
he was given dashamoola kashayam and saidhavam for kabalam. Repeated
the kabalam in evening also with same quantity of medicine. From 3rd day
onwards he was given with taila nasyam with anu tailam 6 drops in each
nostrils, gandoosham with arimedhadhi tailam and ksheera dhoomam
inhalation in face and chest.
Internal medicines -Pathyaksha dhathradhi kashayam 20ml with 30ml
leukwarm water before food in morning and evening.
Vettumaran tab – one tab each with kashayam before food.
Khadhiradhi tab – 2 tab after food morning and evening.
Thalisadhi vatakam granules – 3 gm thrice daily after food.
After one week of treatment and internal medicines- Patient is adviced with
Vyaghri harithaki avaleha 1 teaspoon bedtime .
 Patient was stable through out the treatment period . on each day of treatment
, in evening patient smell sensation started assessing with smelling jasmine
flower . It was found that after 3 rd day of treatment patient started recognising
strong smell of Jasmine and garlic. He could identified the smell of ginger
garlic lemon grass in closed eyes at the 7th day of treatment.

DISCUSSION -In Ayurveda, It is said that treatment should be prompt to both

rogi and roga. It should be capable to treat the disease from its root cause, so
that complications and re-occurrence can be well prevented.Panchakarma
therapy is used for the maintenance of health and eradication of diseases from
their root . Nasya karma , kabala and ksheeradhooma will acts on the nadi
samsthana and doing indriya drudikaranam. The nasya with tulsi guda
ardhakam is thikshna in nature, helps to do shodhana of prakupitha dosha and
nasa mala etc. Clears the channels of the head. The kabalam with dashamoola
kashayam and saindhavam will do sthanika ama pachanam, removes the
aruchi from the mouth, helps to remove the coating of the tongue etc. Nasyam
with anutailam removes the sheshitha dosham, attains proper dosha
shamanam and doing rakshana of srungataka and phanadhi marma from
prakupitha dosha. Taila gandhoosham with arimedadhi will be doing indiya
prasadhana .ksheera dhooma etc stouting treatments helps to do the
drudikarana of nadi samsthana.

The aushadhi using for the treatment reaches to brain via nasal route and
acts on higher centers of brain controlling different neurological, endocrinal
and circulatory functions also. Even massage of oil which doing prior to
nasyadhi karma also helps to stimulate the olfactory nerve. Lipid soluble
substance have greater affinity for passive absorption through the cell wall of
nasal mucosa and oral mucosa and it is a route of absorption of anu taila
arimedadhi taila etc, further drug absorption can also be enhanced by local
massage and fomentation .Because of the treatment procedures the congestion
of nasal mucosa subsides. Nerve ending which had been exhausted by the
virulence of virus attack, can be activated back efficiently. Ksheera dhoopana
plays an important role , which gives soothing effect to the nasal mucosa and
oral mucosa.

CONCLUSION A Known case of persistent anosmia who had been survived

from COVID 19 was taken for the study . . Patient got 90%relief in 7 days.
Which implies treatment like nasya etc can be tried successfully in other cases
of post covid complications like anosmia etc. But as it’s a only single case,
multiple clinical trials should be conducted to establish this treatment as
reliable treatment in non responsive cases of anosmia in covid with oral drugs.

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