Krumi (Microorganisms) in Ayurveda- A critical review

The microorganism or bacteria and their role in the cause of several infectious diseases have been recognized and elaborated in Ayurveda since Vedic period. There are many references relating to bacteria in ancient literature such as Rigveda, Atharveda, Shatapatha Bramhana etc. Krimi, Rakshas, Pishacha, Apsara , etc. terms are used for microorganisms and several types of microorganism have been recognized and described in Vedic literature. Some organisms are visible and macroscopic ( Drishya ) and some are of microscopic ( adrishya ). They may originate either inside or outside of the body. They have identified for the primary seat of infection ( vesa ) and the secondary seat of infection ( parivesa ) in the body. Ayurveda recommended four methods to destroy microorganisms; viz. refraining, disentangling, removing and fumigating. This paper attempts to review the Vedic and Ayurveda understanding of the microbes is essential here to follow the contemporary knowledge for recognition and development of microbiological science in Ayurveda.


Introduction
The Krumi (microorganism or bacteria) and their role in the cause of several infectious diseases have been recognized since Vedic period and elaborated in Ayurveda. There are many references pertaining to bacteria in ancient literature such as Rigveda, Atherveda, Satapadha -Brahmana, Taittireeya Upanidshad, Aranyaka, Chandyogyopanishad, Vishnupurana, Vayupurana, Bhagwatpurana, Raghuvansha, Kamasutra, Mahabharata (minute water borne microbes), etc. Ancient Indians were aware of the existence of microorganism or bacteria as well as causation of disease by them since Vedic period. The references in Vedas for microbes and infectious diseases are in the name of Krumi and Krumi Rogas.
Krumi are thought to be the causative factors of many number of diseases by entering into the body to produces various diseases.
The knowledge of microorganism, both pathogenic and non-pathogenic could be traced to the well codified descriptions in various texts of Ayurveda. Many terms are used for microorganisms and approximately hundreds of microorganism have been recognized and described in Vedic literature. Krumi, Rakshas, Pishacha, Bhuta, Apsara and other terminologies are used for Krumi. The Visible or invisible minute organisms that affect on living and non living things of biosphere are described very efficiently in Ayurvedic science (1). Ayurveda recommended four methods to destroy microorganisms; viz. refraining, disentangling, removing and fumigating (2) .
Pertinently it may be pointed out here that the modern pathologists might have even got some clue to the germ theory of diseases from Ayurveda. It is well known that with the beginning of the European contact with India many valuable manuscripts on science and culture were passed on to the West to interpret the knowledge treasured in them (3) .
The harsh conditions in the urban industrialization leads to disease (4) and during the industrial revolution led to efforts in social reform preceding and contributing to sanitary reform even before the germ theory of disease causation was proven and the science of microbiology established. Pioneering breakthroughs, based on trial and error, challenged the established dogmas of the time, and produced the sanitary revolution, one of the important foundations of public health to control the microbes. Therefore modern pathologists should know the Vedic and Ayurveda understanding of the microbes are essential here.

Materials and methods
The literature on Krumi collected from all available classical as well as modern texts. Data studied, reviewed and the appropriate conclusions have been withdrawn from reviewed literature. Tried to identify and understand the terms used and types mentioned for microorganisms in ancient literature. This article will be helpful to know about microorganisms from ancient science.

Observations and Discussion
Krumi in vedic literature: Approximately hundred types of organisms have been identified to flourish in mountains, forests, plants, animals, water,

Review Article
International Journal of Ayurvedic Medicine, 2019, 10(4), 297-300 ISSN: 0976-5921 etc. They flee through atmosphere and reach into food, water, milk etc., and invade the body through the food, sucks the blood, ruin the flesh, restrict the growth and cause diseases. Some organisms are visible and macroscopic (Drishya) and some are of microscopic (adrishya). They may originate either inside or outside of body. They have identified for their primary (vesa) and secondary (parivesha) seat of infection in the body (5) .
Bala grahas like Putana and Revati were mentioned in Brihatsamhita (3.3), Shremadbhagwata (6.6.14), Vishnupurana (5.5.723), Markandeyapurana (43-9), and Vayupurana (9.89). These diseases were thought to be very difficult to be cure at that time. The symptoms of Balgrahas and their treatment have been maintioned in vishnupurana (1-231, 32). Kalidasa has observed that the grahas enter the body as the image enters the mirror in his Raghuvamsa (16.6), Shri Shankaracharaya has observed that they destroy the smriti in his commentary on Chandogyopanishat. Vatsayana has observed that persons suffering from Rajayakshama were used to be isolated from the society. The method of vaccination for prevention of masurika (small pox) was also described in Sakteya grandha of Dhanvantri which was revoked by the present day scientists.

Ayurveda literature
Ayurveda, the science of life, based on principles routed from Vedas was gradually evolved for centuries. It had developed to its hugeness, that it had been divided into 8 branches by Sushruta in 5 th cent B.C. Bhuta (microbes) Vaidyam (V idya) (13) is one among them that mimics present day bacteriology. There are a vast number of citations available in Ayurvedic literature pertaining to Jeevanuvada or bacteriology.
In connection with the prognosis of seven kinds of leprosy (Kustha) Charaka has mentioned the presence of bacteria or microbes under the term of "Krumi" and "Jantumanti". Charaka affirms that the "Krumi is found in the blood vessels (16) in microscopic size (A nu), circular or disc like (V ritta) etc. He further corroborates the microbial aetiology of Kushta and says that these microbes or krumis, at certain advanced stages, start invading the skin (twak), flesh (mamsa), blood (rudhira), blood vessels (sira dhamani), tendons (snayu) and cartilages (tarunasthi). Similarly Susruta also advocated the microbial aetiology of kushta and states "Sarvani kusthani savatani sapittani saslemani sakrminica" which means Krumis or bacteria along with Tridosa (Vata, Pitta and Kapha) are involved in the causation of all kinds of Kushta (17).
In dealing with other diseases Charaka classifies five kinds of brain diseases as Siroroga. He states that "Panca siroroga" as "Vata, Pitta, Kapha, sannipata, Krumijah" (18). With all probability, this Krumija variety of brain disease may/can be equated with the diseases of the meningo coccal infection or precisely Meningitis. Likewise in the aetiology of chest diseases (Hrudroga) Charaka confirms bacterial origin as one out of five causes. Thus Charaka says "Pancahrid roga iti Sirorogairvyakhyatah" (19). In Charaka Sutra 19 th chapter, it has a generalization of the pathogenic organisms that are classified in to twenty varieties (20,21). The classification in total is as follows in the Figure 1. Krumis' (natural or healthy microbes) as opposed to the former groups 'Sanjata Krumis' (infective microbes) which are infectious in origin (25).
Further, Madhava Kara has described various pathological manifestations, which take place with bacterial infection in general, and says that there may be fever (Jwara), paleness (V ivarnata), various kinds of pain (sulam), chest affection (Hridroga), loss of physical coordination (Sadanam), coma (Bhrama), apathy for food (Bhaktadwesha) and diarrhoea (Atisara). Next, it is quite striking to note there about the knowledge of communicable diseases held by the ancient Ayurvedic authorities. Naturally communicability of diseases definitely presupposes the existence of pathogenic microorganisms -through the agency of which only infection can run from one person to another under various kinds of personal contacts. Shri Kantha datta in his Madhukosa commentary has observed that the A upasargika rogas are caused due to papa and Bhutapasarga. The term Bhutapasarga indicate invasion of bacteria. The different mode of infection spread described by Ayurveda is depicted in table-1.
It is mesmerizing to find that the Sushruta Samhita mentions about communicable diseases and the way of it spreads from one person to the other by contact. He has mentioned the modes of transmission of disease as-sexual contact by touching someone who is infected, frequent interaction with the diseased person, physical contact of the body, through breath, by eating together, by sitting together, by sleeping together and by wearing the same garlands and ornaments (26). There is reference of epidemic diseases found in Charaka samhita. It is clearly mentioned that such diseases spread and kill large number of people at the same time (27). There are also interesting observations on communicable diseases, epidemics and infection. This indicates that ancient Ayurvedic physicians were aware of microscopic life i.e. Krumi or microorganisms.

Conclusion
To summarize the Vedic and Ayurvedaic understanding of the microbes is essential here to follow the contemporary knowledge. The Vedic literature is well known with infection and its invasion over blood, flesh, and other organs through air, water, food borne contamination and spread. Ancient physicians were aware of not only pathogenic organisms but also non-pathogenic organisms that naturally inhabited the human body. A reference found in Aṣṭāṅga Hṛdaya, illuminates that the pathogens of the blood are indeed totally invisible to the human eye and are therefore microscopic. Therefore the term kṛumi comprise worms, bugs, parasites, and probably microorganisms also.