ISSN: 2322 - 0902 (P)

ISSN: 2322 - 0910 (O)

International Journal of Ayurveda
and Pharma Research

Review Article

SCIENTIFIC EVALUATION OF DHUMA YOGA (AN AYURVEDIC FUMIGATION MEDICINE) AS

PREVENTIVE AND CURATIVE ON SYMPTOMS OF COVID-19 DISEASE
Siva Ram
Chief Doctor, R&D, Charaka Hanf Pvt. Ltd., Odisha. India.
ABSTRACT
Covid-19, an infectious disease caused by a novel coronavirus SARS-CoV-2 spreads primarily
through droplets of saliva or discharge from the nose when an infected person talks, coughs or
sneezes where the viruses are active in the environment within the suspended micro droplets.
Sanitization of environment to weaken/terminate the virus and halting the replication of virus
inside the host along with symptomatic treatment is the primary approach to end the pandemic. In
Ayurveda, Dhupana (medicated fumigation of vicinity) and Dhumapana (medicated smoking)
therapies done by drugs of herbal/animal/mineral origin are a swift way to decontaminate the
environment and Respiratory system. Dhuma (medicated fumes) is a unique drug delivery system
acting directly on respiratory tissues which can deliver quick results in this Covid-19 pandemic by
its local and systematic effects recommended by AYUSH ministry in the guidelines for Covid-19. We
intend to put forward the scientific explanation of powerful Ayurvedic Cannabis based polyherbal
dhumapana (medicated smoking) medication named Dhuma Yoga available in the market as an
alternate remedy for Covid-19 whose four out of five herbal ingredients are in the list of WHO
manual of traditional medicine. We emphasized on Vijaya (Cannabis sativa Linn.) as the centre of
formulation because it is a Rasayana (rejuvenative) herb having Vyavayi (fast acting) and Yogavahi
(synergetic) properties. Phytochemicals of all the herbal ingredients of Dhuma Yoga formulation are
studied through in silico, In vitro and In vivo studies for Covid-19 with favourable outcomes.
KEYWORDS: Dhumapana, Dhupana, Dhuma, Herbal smokes, Fumigation, Cannabis.
INTRODUCTION
The Covid-19 pandemic is causing damage to viruses in environment is comparable to polluted air
public health irrespective of developed and and land which may cause Janapadodhwamsa or
developing nations across the globe. This disease is Maraka, a broad term used for epidemic or pandemic
caused by the virus classified as SARS (severe acute in Ayurveda.[4] The word Virus is derived from Latin
respiratory syndrome) due to its nature of inducing language which means poison.[5] The Covid-19
direct infection in respiration system with disease caused by SARS-CoV-2 can be compared to
suffocation and breathing disorders, hence named Bhuta, Rakshasa, Graha, etc, a kind of microbes
SARS-CoV-2. As per WHO (World Health elucidated in Ayurveda which may cause
Organisation) modes of SARS-CoV-2 transmission is Bhutabhishangaja Jwara (fever caused by invisible
mainly by droplets and also airborne through organisms), a kind of Agantu Jwara (fever caused by
aerosols (micro particles/droplets).[1] Researchers external factors) negatively effecting Pranavaha
are striving to investigate anti-viral drugs, immunity srotas (the vessels carrying the vitals) related to
modulators and vaccines for SARS-CoV-2 with not Lungs, Heart and Brain.[6]
much efficacy and bringing backend side effects too Respiratory disorders like Swasa (asthma,
like the steroid medications which cause immune dyspnoea/breathing difficulty), Kasa (cough)
suppression.[2] developing in deadly diseases like in Covid-19
Ayurveda, the science of life is an Indian pandemic require quick relief and Dhuma (medicated
medical science well established and practiced for fumes) is one such rapid drug delivery method in
several thousand years which is the oldest medicinal Ayurveda which gives various local and also systemic
literature known to mankind and traditionally effects in Vata and Kapha Dosha origin diseases by
considered a part of Adharvana Veda (4th text of swiftly entering the circulation through inhalation
ancient Indian knowledge).[3] The exposure to giving instant results mainly acting on
droplets/ aerosols contaminated with novel corona Urdhvajatrugata roga (diseases/disorders of head
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 Int. J. Ayur. Pharma Research, 2021;9(6):1-6
and neck) and respiratory system.[7] Acharya Charaka body and mind for improving immune system and
advised to perform fire ritual like Yagna, etc, a kind of fitness of the body to help tackle the Covid-19
Dhuma (medicated fumes) in Janapadodhwamsa disease.
(pandemic diseases).[8] Dhuma (medicated fumes) Vyavayi guna (fast diffusing quality) is a
shows predominance of Agni (fire) and Vayu (air) of specific property of few herbs in Ayurveda which
Panca-mahabhuta (five fundamental elements) first spreads/ circulates quickly throughout the body
having subtle, microscopic and all-pervading quality to exert its action and them undergoes Paka
known as Sukshma guna which helps in enhanced (digestion).[14] Sattva (goodness) is the purest quality
bioavailability and quick spread of medicine into all among the three primary attributes of mind which is
the nooks and corners of the head and neck regions. said to be required for homeostasis in the neuronal
On the basis of mode of administration there are two impulses which triggers all the physiological
varieties of Dhuma (medicated fumes) one is functions in the body.[15] Medhya (intellect
internally given to a patient as a part of inhalation promoting) is also a unique quality among certain
therapy called Dhumapana (medicated smoking/ herbs to help maintain the neuronal health and
inhalation therapy) and the other Dhupana psychological balance.[16] Vajikarana-Rasayana
(medicated fumigation of vicinity) which is (aphrodisiac and rejuvenative) herbs are the best in
fumigation of the environment commonly performed improving and maintaining energy levels, stamina
in ceremonies of holy places, during fire ritual like and storm and to an extent halting the replication of
Homa, Havana, Yajna and in wards of Ayurvedic SARS-CoV-2 which will be explained below in brief.
hospitals viz. Sutikagara (labour wards), Kumaragara There are more than 200 formulations of Vijaya
(paediatric wards), Vranitagara (post-operative), etc, (Cannabis sativa Linn.) in Ayurveda that are mostly
for benefits like Rakshoghna (ward off infectious unexplored.[19]
microorganisms), krimi-hara (anti-parasitic), We searched online journals for scientific
Balagraha-nasa (attenuate microbes that specifically research articles on Elsevier, PubMed, Research Gate,
affect newborn and children), bhutagraha-nasa Science Direct, Medline, Google Scholar, Semantic
(attenuate disease causing microbes) to sanitise the Scholar, Ayush research portal, etc, for Ayurvedic
atmosphere from infectious bacteria, virus, fungi, etc herbs useful in Covid-19 disease; in parallel also
harmful organisms. Dhupana (medicated fumigation explored classical Vijaya (Cannabis sativa Linn.)
of vicinity) is frequently used for sterilizing the pots based Dhumapana or Dhupana formulations with
in which medicines are to be prepared or stored.[9] It respect to ailments Viz. Swasa (Asthma, Dyspnoea),
is also used for quick modulation of muscular and Kasa (Cough) in the classical Ayurvedic texts listed in
connective tissue function like in Garbhasanga the first schedule of drugs and cosmetics act (1940)
(obstructed labour), Aparasanga (retained placenta), that are presently available in the AYUSH medical
Arsas (piles) and also shows systemic effects in Jwara shops or online pharmaceutical markets having such
(fevers), Visha (poisoning), Unmada (psychosis), etc combination of researched herbs on Covid-19.
ailments. [10]
RESULTS
MATERIALS AND METHODS
We found only one classical Cannabis based
Ayurveda divides the universe into two broad Ayurvedic Dhumapana formulation available in the
categories: Sthavara means immobile beings which market called Dhuma Yoga from a GMP certified
include plants, minerals and Jangama means mobile Ayurvedic company Charaka Hanf Pvt. Ltd.[20] Dhuma
beings which include animal kingdom, micro- Yoga is a polyherbal formulation taken from a
organisms, etc. For every disease that is caused by classical book Siddha yoga sangraha, containing
any Jangama, there exists a cure from Sthavara.[11] herbs Viz. Vasa (Adhatoda vasica Nees.), Kala Dhatura
Likewise Virus like SARS-CoV-2 which is included in (Datura metel Linn.), Vijaya (Cannabis sativa Linn.),
Jangama category can be cured by plant or mineral Cavya (Piper retrofractum Vahl.) and Parasika yavani
based medicines. Globally accepted potent herbal (Hyoscyamus niger Linn.).[21] In silico, In vitro and In
based (Sthavara) medicines are required to quickly vivo research is available on the phytochemicals of
address the damage/infection caused by the Covid- these five herbal ingredients for symptomatically
19 disease. Immune modulators, anti-inflammatory treating Covid-19 and also inhibiting the replication
drugs and symptomatic treatment are the main focus of SARS-CoV-2 with positive outcomes which will be
in tackling the Covid-19 disease by AYUSH discussed below in brief. Dhuma Yoga is indicated for
personnel.[12,13] So, apart from looking for a rapid Swasa (Asthma, Dyspnoea/breathing difficulty) as
drug delivery system like Dhuma (medicated fumes) per the classical Ayurvedic text.[21] The above herbal
we focused on certain attributes said in Ayurveda coarse powder is used as an inhalation therapy and
which are required for the quick stimulation of both can also be fumigated to sanitise the environment.

Available online at: http://ijapr.in 2

 G. Siva Ram. Scientific Evaluation of Dhuma Yoga As Preventive And Curative on Symptoms of Covid-19 Disease
Table1: Showing the herbal ingredients of Dhuma Yoga [22]
S.No. Sanskrit name Scientific name Family Part used
1. Vijaya Cannabis sativa Linn. Cannabinaceae Leaf
2. Kala Dhatura Datura metel Linn. Solanaceae Leaf
3. Vasa Adhatoda vasica Nees. Acanthaceae Leaf
4. Cavya Piper retrofractum Vahl. Piperaceae Root
5. Parasika yavani Hyoscyamus niger Linn. Solanaceae Leaf
Table 2: Showing the Ayurvedic pharmacological properties of the above researched herbs [22]
Vipaka (taste Dosha
Guna Virya
S.No. Herbs Rasa (taste) after (fundamental bio-
(qualities) (potency)
digestion) elements)
Tikta (bitter), Laghu (light), Ushna alleviates Kapha-
1. Vijaya Katu (pungent)
Katu (pungent) Tikshna (sharp) (hot) Vata
Madhura
Guru
Kala (sweet), Tikta Ushna alleviates Kapha-
2. (heaviness), Katu (pungent)
Dhatura (bitter), Kashaya (hot) Vata
Tikshna (sharp)
(astringent)
Tikta (bitter),
Laghu (light), alleviates Kapha-
3. Vasa Kashaya Sita (cold) Katu (pungent)
Ruksha (dry) pitta
(astringent)
Laghu (light),
Ushna alleviates Kapha-
4. Cavya Katu (pungent) Ruksha (dry), Katu (pungent)
(hot) Vata
Tikshna (sharp)
Parasika Tikta (bitter), Laghu (light), Ushna alleviates Kapha-
5. Katu (pungent)
yavani Katu (pungent) Tikshna (sharp) (hot) Vata
Scientific research on phytocompounds in the 10 mg of delta 9-THC induced significant
herbs of Dhuma Yoga on SARS-CoV-2 bronchodilation.[31]
Vijaya (Cannabis sativa Linn.) The endocannabinoid system is found in multiple
Inhaling fumes of cannabis is being systems within the human body, including the
researched across the globe for its potential use in immune system. Its activation can lead to beneficial
Asthma. The bronchodilator effect is because of the results such as decreased viral entry, decreased viral
THC (delta-9 tetrahydrocannabinol) which activates replication, and a decrease in pro-inflammatory
prejunctional CB1 receptors to mediate the inhibition cytokines such as IL-2, IL-4, IL-6, IL-12, TNF-α or
of cholinergic contractions in human bronchus.[23] TNF-γ. Moreover, endocannabinoid system activation
Endo-cannabinoid Anandamide (AEA) has can lead to an increase in anti-inflammatory
bronchodilator effect whose levels are increased by cytokines, mainly represented by IL-10. Overall, the
phyto-cannabinoid CBD.[24] CBD inhibits FAAH which cannabinoid system can potentially reduce
is responsible for breakdown of Anandamide pulmonary inflammation, increase the immuno-
(AEA).[25] Both THC & CBD are good antioxidants and modulatory effect, decrease PMN infiltration, reduce
prevent hydroperoxide-induced oxidative fibrosis, and decrease viral replication, as well as
damage. [26,27] In a study aerosolized tetrahydro- decrease the cytokine storm.[32] In an in vitro study
cannabinol (THC) has been investigated for Cannabis compounds Viz. CBD, CBG and THCV
bronchodilator effect showed satisfactory results at a exhibited anti-inflammatory activity in COVID-19-
dose of 100μg of THC as measured by improvement related inflammation in lung epithelial cells and pro-
in peak expiratory flow rate (PEFR), forced inflammatory activity in macrophages.[33]
expiratory volume in 1 second (FEV1) and forced In an experimental study CBD (Cannabidiol)
vital capacity (FVC).[28,29] Research is also done on and its metabolite, 7-OH-CBD potently blocks SARS-
CB1 receptors as target for bronchodilator therapy in CoV-2 replication in lung epithelial cells. CBD acts
β2-receceptor agonist resistant asthma.[30] An after 5 cellular infections, inhibiting viral gene
experimental study concluded oral administration of expression and reversing many effects of SARS-CoV-2

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 Int. J. Ayur. Pharma Research, 2021;9(6):1-6
on host gene transcription. CBD induces interferon the development of pulmonary fibrosis, thus
expression and up-regulates its antiviral signaling ameliorating lung function.[38]
pathway.[34] CBD might represent as a potential anti- Kala Dhatura (Datura metel Linn.)
inflammatory therapeutic approach against SARS- The main compounds of Kala Dhatura
CoV2-induced inflammation.[35] In an animal (Datura metel Linn.) are tropane alkaloids Viz.
experimental study the treatment of SEB-mediated Scopolamine (Hyoscine), Hypocyamine (Daturine),
ARDS mice with Delta-9 Tetrahydrocannabinol (THC) Atropine which have anti-cholinergic and anti-
led to a 100% survival, decreased lung inflammation, muscarinic activity that exhibit strong
and the suppression of cytokine storm. This was bronchodilation, prophylactic anti-emetic and
associated with immune cell apoptosis involving the antispasmodic (relieving abdominal pain/ spasms)
mitochondrial pathway, as suggested by single-cell property.[39] Datura ameliorates asthma symptoms
RNA sequencing. A transcriptomic analysis of by promoting naive T-cell development and reducing
immune cells from the lungs revealed an increase in activated T-cells. Asthma relief is attributed by
mitochondrial respiratory chain enzymes following blocking the action of the neurotransmitter
THC treatment. THC caused the downregulation of acetylcholine (ACh) at synapses to cause depression
miR-185, which correlated with an increase in the of the receptive mechanism of the parasympathetic
pro-apoptotic gene targets. Interestingly, the gene nerves in the bronchi.[40] Researches on Datura
expression datasets from the bronchoalveolar lavage smoking are also conducted to know its
fluid (BALF) of human Covid-19 patients showed pharmacological effects.[41,42,43,44]
some similarities between cytokine and apoptotic
It is a potential source of antioxidants which
genes with SEB-induced ARDS. Collectively, this study
neutralise free radicals and is being researched for its
suggests that the activation of cannabinoid receptors
potent anti-bacterial and anti-fungal action.[45,46,47] In
may serve as a therapeutic modality to treat ARDS
a molecular docking study Scopolamine showed a
associated with Covid-19.[36]
favourable binding affinity of -8.7 kcal/mol towards
Ghrelin, an endogenous ligand for the growth Mpro of SARS-CoV-2. It forms hydrogen bonds with
hormone secretagogue receptor, is a peptide Phe294 and Thr304 apart from interacting with
hormone secreted mainly by the stomach. Asp295 and Val303 residues of Mpro (main
Interestingly, ghrelin possesses promising protease).[48] In siloco studies of Hyoscyamine
antioxidant, anti-and inflammatory effects, making it showed significant binding potential to spike
an attractive agent to reduce the complications of the glycoprotein of SARS-Cov-2 in the post-fusion, closed
SARS-CoV-2. In addition, ghrelin exerts a wide range state, open state conformations with a binding
of immunomodulatory and anti-inflammatory effects affinity of -8.14, -6.0, -5.7 kcal/mol respectively with
and can mitigate the uncontrolled cytokine better interaction and stability. The binding energy of
production responsible for acute lung injury by the docked complex of Hyoscyamine and spike
upregulating PPARγ and down-regulating NF-κB glycoprotein is estimated to be -48. 25 kcal/mol
expression. Ghrelin has also been reported to suggests that Hyoscyamine can act as a potential lead
enhance Nrf2 expression in inflammatory conditions molecule against the spike glycoprotein of SARS-CoV-
which led to the suppression of oxidative stress. The 2.[49]
current opinion summarizes the evidence for the
Vasa (Adhatoda vasica Nees.)
possible pharmacological benefits of ghrelin in the
therapeutic management of SARS-CoV-2 infection. An in-silico docking of Adhatoda vasica
Delta-9 Tetrahydrocannabinol (THC) compound of constituents reveal higher negative binding affinity
cannabis is responsible for the stimulation and for C and O-glycosides for HIF-1α, IL-6, Janus kinase
release of ghrelin.[37] 1/3, TNF-α and TGF-β key players of hypoxia-
inflammation. This study for the first time provides a
High cannabidiol Cannabis sativa extracts are
molecular basis of action and effect of Vasa (Malabar
able to down‐regulate the expression of the two key
nut) whole extract that is widely used in Ayurveda
receptors for SARS‐CoV2 in several models of human
practice for diverse respiratory ailments.[50] These
epithelia. Cannabidiol exerts a wide range of
alkaloids inhibit antigen-induced mast cell
immunomodulatory and anti‐inflammatory effects
degranulation and histamine secretion from target
and it can mitigate the uncontrolled cytokine
tissues. By its mucolytic property it reduces the
production responsible for acute lung injury. CBD
viscosity of mucus and helps to expel the mucus out
being a PPARγ agonist, it can display a direct antiviral
through its expectorant action.[51,52,53] It is a proven
activity and PPARγ agonists are regulators of
anxiolytic (anti-anxiety), nootropic (improves
fibroblast/myofibroblast activation and can inhibit
cognition) and the herb Adhatoda as a whole (full-
spectrum) has dual action which counteracts the
Available online at: http://ijapr.in 4
 G. Siva Ram. Scientific Evaluation of Dhuma Yoga As Preventive And Curative on Symptoms of Covid-19 Disease
overdose of anti-cholinergic compounds by its Covid-19.[64] These results substantiate the potential
cholinesterase inhibiting activity.[54,55] It maintains of Adhatoda Vasica in management of Covid-19.
cardiac and respiratory health by inhibition of Cavya (Piper retrofractum Vahl.)
oxidative stress and inflammatory factors.[56] Prime alkaloids of Cavya (Piper retrofractum
Researchers claim smoking Adhatoda Vasica herb Vahl.) Piperine, Guineesine collectively exhibits a
reduces tobacco withdrawal symptoms and hence is potent bronchodilation and also regulates
very useful in de-addiction of tobacco smoking.[57,58] thermogenesis to maintain the energy balance in the
In an in-vitro experiment Vasicinone, a body. These active alkaloid compounds help in
quinazoline alkaloid of Vasa (Adhatoda vasica) enhancing the effect of other drugs by its synergetic
exhibited anti-proliferative activity in lung carcinoma action. Piperine alkaloid effectively treats Asthma by
cells.[59] Adhatoda Vasica extract attenuated anti-histaminic activity, inhibiting eosinophil
inflammatory and hypoxic responses in preclinical infiltration and airway hyper-responsiveness by
mouse models. It reduces the levels of transforming suppressing T cell activity and Th2 cytokine
growth factor-β1 (TGF-β1), IL-6, Hypoxia inducible production.[65,66] Guineesine alkaloid an anti-
factor-1 α (HIF-1α) and improves the overall survival inflammatory agent is an Anandamide (AEA)
rates of mice in the models of pulmonary fibrosis and reuptake inhibitor[67] and this fatty acid endo-
sepsis and rescues the siRNA induced inflammation cannabinoid ligand-AEA acts as a bronchodilator by
and associated blood coagulation phenotypes in mice. inhibiting the release of the neurotransmitter
There was downregulation of hypoxia, inflammation, acetylcholine (ACh) from the cholinergic nerve
TGF-β1, and angiogenesis genes and upregulation of endings.[68,69] Research on the inhalation of vapour
adaptive immunity-related genes in the lung from black pepper, a member of piper family having
transcriptome. Adhatoda Vasica (100µg/ml) similar API’s to Cavya (Java long pepper) reduced
treatment also reduced the viral load in Vero cells cues to tobacco smoking.[70] In a study chabamide, a
infected with SARS-CoV-2 by 63%.[60] Trans phytochemical in Cavya (Java long pepper) has anti-
membrane protease serine type 2 (TMPRSS2) is inflammatory effects via the activation of the
responsible for the priming of the viral S-protein to Nrf2/heme-oxygenase-1 pathway.[71]
enter into the human alveolar epithelial cells. An in A computational study revealed piperine, an
vitro study revealed the inhibition of protease alkaloid present in Cavya (Java long pepper) showed
TMPRSS2 by bromhexine hydrochloride, one of the high binding affinity of -7.0 kcal/mol with RNA-
derivatives of alkaloid vasicinone of Adhatoda vasica binding pocket of the nucleocapsid of SARS-CoV-2
plant.[61] which shows its potential anti-viral property.[72]
The quinazoline alkaloids Viz. Vasicoline, Scutifoliamide-A, a phytochemical in Cavya (Java long
Anisotine of Adhatoda vasica has shown acceptable pepper) has shown favourable binding potential to
binding energy values in a docking study towards the spike glycoprotein in the post-fusion, closed state,
inhibition of SARS-CoV-2 protease and RdRp (RNA- open state conformations with the significant binding
dependent RNA polymerase) which are the essential energies of -6.4, -5.4, -6.6 kcal/mol, respectively.
enzymes for viral genome replication. Vasicoline and Scutifoliamide-A showed highest binding energy (-6.9
Anisotine displayed binding energies of -7.0, -7.8 kcal/mol) to replicase polyprotein 1 ab which is
kcal/mol with protease and -8.5, -9.2 kcal/mol with responsible for the transcription and replication of
RdRp respectively.[62] Another molecular docking SARS-CoV-2 RNAs. The binding energies of the
study revealed the primary alkaloid Vasicine of docked complex of replicase polyprotein 1 ab and
Adhatoda vasica with ACE-2 Receptor shown higher Scutifoliamide-A was estimated to be -45. 97
docking affinity score -7.1 K/cal and also showed kcal/mol. Scutifoliamide-A could be a therapeutic
good inhibitory constant 486.54 mM on 3CL agent for Covid-19.[73]
protease..[63] An in silico experimentation with the DISCUSSION
alkaloid Anisotine of Adhatoda vasica interacted with
Dhuma (medicated fumes) shows its local
both the catalytic residues (His41 and Cys145) of
therapeutic effects mostly in Urdhvajatrugata roga
Mpro of SARS-CoV-2 and exhibited good binding
(diseases/disorders of head and neck), respiratory
affinity (-7.9 kcal/mol). Mpro-anisotine complex is
ailments and also has systemic effects like in Jwara
was stable, conformationally less fluctuated. Even the
(fever), Sopha (inflammation), Visha (poisoning),
number of intermolecular H-bonds and MM-GBSA
Unmada (psychosis), etc as per Ayurvedic
analysis suggested that anisotine is a more potent
literature.[8,9,10] Nasal and oral are the routes of
Mpro inhibitor than the two previously
administration of Dhumapana (medicated smoking/
recommended antiviral drugs (lopinavir and
inhalation therapy). Nasal cavity is the pathway to
darunavir) and may evolve as a promising anti-
brain said the great sage Charaka and other Acharyas
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 Int. J. Ayur. Pharma Research, 2021;9(6):1-6
(physicians) of Ayurveda,[74] also is the quickest route (pungent taste after digestion) which can decrease
to the respiratory system. Through inhalation the the excess mucus/ phlegm and helps to recover from
medicated fumes will directly enter the lung tissue to respiratory ailments like Swasa (asthma, dyspnoea/
show its effect. The olfactory region is one of the breathing difficulties), Kasa (cough) by controlling
prominent sites from where the API’s (active the cytokine storm with their anti-inflammatory
pharmaceutical ingredients) will be absorbed directly action as per contemporary research and classical
into the brain by olfactory and trigeminal nerve Ayurvedic literature. These five herbs also exhibit
pathways. When the drug is administered it comes in anticoagulant or thrombolytic properties which in
contact with mucosa and it is directly transported combination may have more pronounced effect. In an
into the brain bypassing the BBB, thereby achieving animal study cannabinoids viz. THC (tetrahydro-
excellent bioavailability. Through the oral route of cannabinol) and CBN (cannabinol) showed
administration the GI-tract ailments can also be anticoagulant activity in obese rat model.[85] An in
addressed. The mucous membranes in the oral and vitro study on anticoagulant activity of chloroform
nasal cavity are thin and allow quick absorption into and methanol extract of Datura showed significant
the blood stream. Avoidance of hepatic first pass results.[86] Another in vitro study revealed favourable
metabolism is the main advantage.[75] Ayurveda has anticoagulant and clot-lysis activity with aqueous
vast knowledge regarding the nasal route of drug extract of leaves of Datura metel.[87] Molecular
administration long before than the contemporary docking studies on Adhatoda vasica methanol extract
modern researchers. Indications, contraindications, showed favourable thrombolytic activity (breakdown
appropriate time, method of inhaling smoke have of blood clots).[88] An in vitro and in vivo studies on
been specifically mentioned. Inhalation and Piperlonguminine, a phytochemical present in Cavya
exhalation are two main aspects of dhumapana. (Piper retrofractum) exhibited significant
Inhalation/ Puff drag is done by mouth or nostrils as anticoagulant activity.[89] In an animal study Yavani
per requirement and exhalation has to be breathed (Trachyspermum ammi Linn.) methanol extract
out/ exhaled only by mouth which is the correct way significantly increased the prothrombin time which
to smoke as per as Ayurveda. No smoke should come reveals its anti-thrombotic effect.[90] As per Ayurveda
out of the nostrils or else eyes will be damaged.[76] Parasika yavani (Hyoscyamus niger Linn.) has similar
Major symptoms of COVID-19 are fever, properties like Yavani (Trachyspermum ammi Linn.),
cough, shortness of breath and severe inflammation. So the anti-thrombotic effect can be correlated to
Other common symptoms are headache, loss of taste Henbane (Hyoscyamus niger Linn.) too.
and smell, tiredness, aches, sore throat, chest pain, Cannabis is the sacred plant of Ayurveda and
loss of appetite, nausea, diarrhoea, etc.[77,78] Excess by mythology is believed to be originated from the
mucus/phlegm secretions in throat, nostrils, sinus Gods.[18] It is called Vijaya in Sanskrit which means
cavities, trachea, etc, may increase the severity of victory from all ailments and imparts sukham
bacterial, viral or fungal infections developing in the (health) and satvam (highest level of consciousness/
body especially in the lungs like in Covid-19.[79] The goodness).[91] Cannabis has a unique relation to
cytokine storm caused by SARS-CoV-2 in the neuroendocrine signalling specifically related to
respiratory tissues may result in decreased oxygen Endocannabinoid System (ECS) which has been
intake by damaging the thin walls/ lining found to be pervasive in mammalian species.
(endothelium) of air-sacs (alveoli) and capillaries Cannabis plant produces phyto-cannabinoids which
(small blood vessels) causing thickening of inter- are similar to endo-cannabinoid molecules produced
alveolar septa which disrupt the gas exchange naturally in the body.[92] They are involved in various
mechanism in the lungs leading to loss of elasticity physiological functions such as immune modulation,
and may also lead to the collapse of alveoli.[80,81] stress response, respiratory health, appetite
Micro-vascular thrombosis (micro blood clots) or stimulation, reproduction, analgesia, sleep,
embolism resulting from the damaged walls/ lining thermoregulation, memory and learning, etc, by
within the pulmonary circulation and also hyper- binding to cannabinoid receptors (CBRs) that are
coagulation and immune-thrombosis by deranged spread throughout the tissues to maintain
immunity is one of the reason Covid-19 patients are homeostasis (equilibrium state of psychological and
facing hypoxemia (decreased oxygen saturation in physiological activities).[93] In Ayurvedic texts Vijaya
blood) which can also lead to multiple organ (Cannabis) has been incorporated in many
damage.[82,83,84] formulations related to respiratory system and GI-
All the five herbs of Dhuma Yoga have tract ailments. Vijaya herb (Cannabis) has a special
common properties Viz. Kapha Dosha alleviating, property to act as a catalyst and enhance the
Tikshna guna (sharp attribute) and Katu vipaka bioavailability of the other medicinal drugs used

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 G. Siva Ram. Scientific Evaluation of Dhuma Yoga As Preventive And Curative on Symptoms of Covid-19 Disease
along.[94] Selective strains of Cannabis of varied of SARS-CoV2 invasion. In an animal study, CBD
cannabinoid ratios can be used for different ailments. (cannabidiol) caused marked amelioration of the
Cannabis has Grahi (Absorbent), Dipana (appetiser), pulmonary function by acting at adenosine A2
Pachana (digestive) and Ruchya (improves taste) receptor site and reducing of leukocyte migration
properties[18] which can quickly correct the into the lung, accompanied to a marked inhibition of
metabolism of impaired digestion, the root cause both pro-inflammatory cytokines (TNF-α, IL-6) and
leading to complications in most of the diseases chemokines (MCP-1 and MIP-2).[38] THC (delta-9
(Rogah Sarve api mandagnou)[95] said by Vagbhata. Tetrahydrocannabinol), the main phytocannabinoid
Ojas (immunity) is the Upadhatu[96] (tissue in an animal study prevented mortality from ARDS
derivatives) of Sukra dhatu (tissues and components (Acute Respiratory Distress Syndrome) by inducing
of reproductive system present in both males and apoptosis in immune cells responsible for increase in
females)[97] which is circulated all over the body[98] pro-inflammatory molecules, leading to the
along with Rasa dhatu (blood plasma). This may be suppression of cytokine storm.[36] Ghrelin, a peptide
the Ayurvedic explanation why plasma donation was hormone whose secretion is stimulated by THC
once an off label recommendation for patients to (delta-9 Tetrahydrocannabinol) can decrease the
recover fast from Covid-19 as the Ojas/ antibodies uncontrolled cytokine production responsible for
(immune components) are in circulation with blood acute lung injury by upregulating PPARγ and down-
plasma, but was discontinued from Covid-19 regulating NF-κB expression. Ghrelin also enhance
treatment guidelines as the antibodies in donor’s transcription factor Nrf2 expression in inflammatory
plasma were not sufficient enough for patient conditions which can suppress oxidative stress.[37]
recovery and also researchers hypothesized the risk This shows the preliminary antiviral property of the
of developing new variants of Virus. Sukra is the par phytocannabinoids of Cannabis herb.
excellence of well digested food said in Charaka Kala Dhatura (Datura metel Linn.) is the best
samhita which is later converted to Ojas (immune and potent among various species of Datura having
system components).[99] Diminished Sukra may lead Jwaraghna (antipyretic), Krimi-hara (anti-parasitic),
to various diseases and even death so, one should Visha-hara (antitoxic), Agnidipana (appetiser)
preserve the Sukra dhatu by indulging in wholesome properties[102] and the Arka (distillate) of Datura is
food and lifestyle; hence potent Vajikarana said to be Ojo-vardhaka[103] (Immune booster) too.
(aphrodisiac) and Sukra Stambhana[100] (drugs Inhaling Kala dhatura (Datura metel) smoke is a
prolonging ejaculation time) herbs like Vijaya famous age old traditional folk medicine[104,105] for
(Cannabis sativa Linn.) can improve Ojas (immune quick relief in asthma attacks and all types of
system). Vijaya (Cannabis sativa Linn.) is a Vata- productive and non-productive cough
Kapha alleviating herb which according to Acharya (antitussive). [106] It dries up the excess mucus
charaka is an essential Dosha karma for curing Swasa secretions in the body by its mucolytic action. It is
(breathing difficulty/asthma)[101]. used internally in Jwara (fevers) and Vajikarana
The cytokine storm is one of the major side (aphrodisiac) formulations as per traditional
effects of SARS-CoV-2 virus infection. Pro- literature. Datura is also a Sukra Stambhana[107] herb
inflammatory cytokines like interleukins, TNF-α and (drugs prolonging ejaculation time) like Vijaya
TNF-γ that are involved in the inflammation of alveoli (Cannabis sativa Linn.) which explains its immune
and damage the lungs can be controlled by activating boosting property. Datura is a potent anti-
the endocannabinoid system through Vijaya inflammatory and Pain killer herb[108] which can
(Cannabis sativa Linn.).[32] In vitro experiment with control the cytokine storm of Covid-19 specific to
CBD (cannabidiol), a major phytocannabinoid was respiratory system. Active alkaloids of Datura Viz.
effective in stopping the replication of SARS-CoV-2 in Scopolamine and Hyoscyamine act on the SARS-CoV-
lung epithelial cells.[35] CBD (cannabidiol) is a known 2 Mpro (main protease) and spike glycoprotein
anti-inflammatory and immune modulator molecule. respectively, showing their anti-viral property.
CBD (cannabidiol) being an agonist at PPAR-γ Vasa (Adhatoda vasica Nees.), common name
receptor (peroxisome proliferator-activated Malabar nut is a Hridya (cardiotonic), Jwaraghna
receptor) reduced pulmonary inflammation and (antipyretic), Swarya (voice promoting), antitussive
fibrosis in animal models of asthma. High CBD and respiratory healer indicated in Swasa (asthma,
(cannabidiol) extracts have been reported to dyspnoea/ breathing difficulty), Kasa (cough) as per
downregulate Angiotensin-converting enzyme 2 Vedic literature[109]. Leaves of Adhatoda are
(ACE2) and Transmembrane Serine Protease 2 commonly smoked in asthma and bronchitis as per
(TMPRSS2) receptors, viral gateways in oral, lung folk lore. [110] Major alkaloids of Vasa (Adhatoda
and intestinal epithelia constituting important routes vasica Nees.), Viz. Vasicine (peganine) and Vasicinone

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 Int. J. Ayur. Pharma Research, 2021;9(6):1-6
are very effective bronchodilators and have Guidelines for Ayurveda, Siddha and Unani
antihistamine activity. API’s of Vasa (Adhatoda Practitioners for Covid-19 pandemic.[122] The above
vasica) relaxes the tracheal smooth muscle to researched herbs if used as Dhupana (medicated
produce bronchodilator effect by anti-cholinergic fumigation of vicinity) may weaken the Virus in the
action on the vagal innervations of the bronchii.[111] environment which probably can break the chain of
Vasa Kashaya (aqueous extract of Adhatoda vasica) in transmission and if used as Dhumapana (medicated
mouse (in vitro study) reduced the levels of smoking/ inhalation therapy) can be helpful in
transforming growth factor-β1 (TGF-β1), IL-6, decreasing the need of emergency artificial oxygen
Hypoxia inducible factor-1 α (HIF-1α) which are supply for the patient and also reduce the virus load
responsible for cytokine storm. [112] Vasicoline, inside the body. All the herbs of Dhuma Yoga are
Anisotine alkaloids inhibits main protease (Mpro) being scientifically studied for their beneficial aspects
and RdRp (RNA-dependent RNA polymerase) of as prophylactic and curative to Covid-19 symptoms,
SARS-CoV-2 in molecular docking studies which resist the entry of virus into the host along with
shows their antiviral properties. halting the replication of SARS-CoV-2 with
Cavya (Piper retrofractum Wahl.) preliminary significant outcomes. Also the Ayurvedic
It is commonly called Java long pepper is a properties of these five herbs mentioned above
stimulant herb which improves taste and appetite. It reveal their benefits in handling the prime symptoms
is indicated in Krimi (parasites), Swasa (Asthma, of Covid-19.
dyspnoea/ breathing difficulty), Kasa (cough), As per Ayurveda polyherbal combinations are
commonly prescribed for respiratory and GI-tract effective than single herbs and a whole herb (full
ailments in traditional medicine.[113] Cavya (Piper spectrum) if used as medicine will have an entourage
retrofractum) phytochemicals Viz. Piperine, effect with negligible side effects when compared to
Guineesine and chabamide exhibits potent anti- phytochemical extracts and isolates. So, we propose
inflammatory activity. Piperine is proven to be a the combination of these herbs in the form of Dhuma
bioavailability enhancer to several compounds Yoga formulation may act in synergy to amplify the
including Vasicine, an alkaloid in Adhatoda vasica.[114- benefits which in a blend of powerful quinazoline and
118] In silico studies reveals Piperine binds to RNA- tropane alkaloids along with highly potent
binding pocket of the nucleocapsid thereby inhibiting cannabinoids infused with bio-enhancing molecules
virus replication; Scutifoliamide-A, an alkaloid in which have a potential to deliver quick results in
Cavya (Piper retrofractum) showed favourable Covid-19 by their bronchodilation, mucolytic, anti-
inhibition of spike glycoprotein and replicase inflammatory, antitussive, antipyretic, appetising,
polyprotein 1 ab of SARS-CoV-2 which reveals its absorbent, anticoagulant, thrombolytic and
antiviral action. immunomodulatory properties, which needs to be
Smoking of Parasika yavani (Hyoscyamus evaluated with proper clinical trials.
niger Linn.) in folk medicine has been in wide CONCLUSION
practice to relieve respiratory ailments.[119] Active Dhuma (Medicated fumes) has been validated
alkaloid compounds are similar to those found in by many traditional medical systems since ages and
Kala Dhatura Viz. Scopolamine and Hyoscyamine acts is also recommended in the Guidelines for Covid-19
as bronchodilator besides improving digestive power by ministry of AYUSH. Dhuma Yoga is a very effective
along with helping in anorexia. It manages bronchodilator which has many additional
psychological disorders by modulating monoamine therapeutic benefits as per the present review. Pre-
oxidase activity and possesses neuroprotective clinical experimentations like in silico, in vitro and in
potential by scavenging hydroxyl radical.[120] Parasika vivo studies on phytochemicals of Dhuma Yoga herbs
yavani (Henbane) as per Ayurveda is having similar Viz. Vijaya (Cannabis sativa Linn.), Kala Dhatura
properties like Yavani herb (Trachyspermum ammi (Datura metel Linn.), Vasa (Adhatoda vasica Nees.),
Linn.) having Dipana (appetiser), Pachana Cavya (Piper retrofractum Wahl.) and Parasika Yavani
(digestive), Hridya (cardiotonic), Anaha-prasama (Hyoscyamus niger Linn.) showed encouraging results
(alleviating abdominal distension/ bloating), Krimi- in alleviating major symptoms of Covid-19 disease
hara (anti-parasitic) properties.[121] Henbanes’s and to an extent may stop the entry and also halt the
Tropane alkaloids Scopolamine, Hyoscyamine acts on replication of SARS-CoV-2. The medicine Dhuma Yoga
Mpro (main protease), spike glycoprotein of SARS- can be used as an alternate remedy in the form of
CoV-2 respectively showing their anti-viral property. Dhumapana (medicated smoking/ inhalation
therapy) and Dhupana (medicated fumigation of
Dhupana (medicated fumigation of vicinity) has been vicinity) in decreasing the severity of Covid-19
recommended by ministry of AYUSH as per the disease which needs further scientific evaluation.

Available online at: http://ijapr.in 8

 G. Siva Ram. Scientific Evaluation of Dhuma Yoga As Preventive And Curative on Symptoms of Covid-19 Disease
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G. Siva Ram. Scientific Evaluation Of Dhuma Yoga (An Ayurvedic Fumigation Dr. Siva Ram
Medicine) As Preventive And Curative on Symptoms of Covid-19 Disease. Chief Doctor, R&D,
International Journal of Ayurveda and Pharma Research. 2021;9(6):1-6. Charaka Hanf Pvt. Ltd., Odisha.
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