People seek ancient remedies for herpes zoster treatment. Doctors say medication is necessary.Many Nepalis believe herpes zoster is the bite of a serpent. They don’t know that it is a disease caused by the varicella-zoster virus, which needs medical attention.
A few years ago, Surya Mati Bajracharya of Kwabahal, Thamel, had gone to Badri Ratna Bajracharya, a Newar priest, to treat an infection that most Newars believe to be the bite of a serpent: jala naga. It is a common Newar superstition in which the infection is believed to be the manifestation of the serpent’s curse, naga ko dosh.
The disease is medically recognised as ‘herpes zoster’ and is also known locally as ‘janai khatira.’ Its traditional healing practice includes drawing two lions (sometimes dragons) roaring at the two ends of the infection using three colours—black, red and white—for days, and a recitation of a sacred incantation by a priest. Then, a separate puja is also done in a well in front of the Tara-nani shrine at Itumbahal.
“At first, I thought it was an allergy. It came below my left breast and slowly spread below my armpit and touched my left shoulder blade, and it continuously burned; it was excruciating,” she recalls.
Surya Mati had gone to see Badri Ratna Bajracharya after she had reached out for help from her family members about her infection. They had promptly termed the infection as ‘jala naga’ and asked her to immediately see Badri Ratna in Maha Boudha, who at the time used to treat the disease using ancient remedies. However, after the pujas, Surya Mati on the fifth day of the infection, which had not yet subdued, went to see a skin doctor who strictly asked her to take medication for the infection.
Herpes zoster is an infection reactivated by the same virus that causes chickenpox (varicella-zoster), and most who are infected by the virus are likely to have had chickenpox earlier in life. However, most Nepali families, before seeking a doctor for cure resolve to ancient remedies recommended by their families who have experienced the torment of the disease. But dermatologists say the ancient practice is just an idiosyncratic belief and patients should seek medication only from skin doctors before the infection aggravates.
“When the virus grasps a nerve fibre, most people feel an uneasiness for two days before getting a red rash [often accompanied with stripes of blisters] that starts a continuous tingling burn, and it usually happens to people who are middle-aged. The virus can affect anyone if they don’t have a good immune system,” says Hari Narayan Gupta, a dermatologist.
However, despite doctors urging patients to use scientifically proven methods, there are many who swear by the effectiveness of traditional methods.
“Traditionally, we apply a paste made with white sesame seeds, white dubo (Cynodon dactylon) and cow’s milk. We also draw two singhas (lions) roaring at the infection, which suppresses the pain and curbs the spread. When I got the infection, my guru (teacher) said an incantation and also asked to do a small puja at Itumbahal’s well,” says Punya Bajracharya, a Newar priest, who had followed the ancient remedies when he had herpes zoster years back. Bajracharya says he recovered soon after, and therefore believes that the incantation and the naga puja works and can heal the infection.
At Yatkha, a father-son duo Amir Man Shakya and Phiroj Shakya have been making singhas for patients suffering from herpes zoster for years. “Most Nepalis call it janai khatira because the infection usually comes around the lower abdomen, near the chest and neck area, and it resembles how the janai (sacred thread) is tied across their chest,” says Phiroj Shakya.
He further claims that they have made singhas for thousands of people and that those who have recovered have recommended many others to their place for treatment. However, he too understands that the medical case of herpes zoster contradicts the traditional belief.
“Medically, it is caused by the same virus that causes chickenpox, but we call it the bite of jala naga, and it can happen to anyone. I have had it too,” says Shakya.
Despite knowing about the virus, Shakya and many elders still believe the infection is a result of the wrath of the serpent and planetary movement. “Naga ko dosh bhanincha,” says Amir Man Shakya.
Many locals in Kathmandu too have heard about the serpent’s bite and have seen people recover through ancient remedies. “I have heard about janai khatira through many of my family members and they have said that the puja and the singhas have helped them heal,” says Ram Bhakta Shrestha, a local of Jhochhen. People also believe a person can die if the infection spirals and makes a full circle around the body, and that bearing the singhas can protect their life and stop the infection from spreading throughout the body.
“The infection doesn’t spread. For some, it can come near the chest area and lower abdomen, for others it can come in the hands or near the eyes. But that is the only extent to which the infection will manifest,” says Hari Narayan Gupta. “Also, if it comes back repeatedly, it could imply that you may have other sexual diseases, so you need to be careful,” added Gupta.
Doctors’ course of medication includes acyclovir 800 mg to kill the virus and pregabalin 75 mg as pain killer and acyclovir cream as an ointment. Patients are also asked not to share their belongings, as it can spread the varicella-zoster virus, which can cause chickenpox to those who have never had it before, but the disease in itself is not communicable.
“Most people come too late for treatment, and by then, the infection becomes severe and takes more time to heal. If not taken care of, it can develop into postherpetic neuralgia, a lasting pain even after the blisters have healed,” says Gupta.
Another skin doctor, Vinaya Shrestha, agrees with Gupta. “I have scolded many patients for accepting traditional methods earnestly. Just today, I treated four people with the same infection. Ancient practices can’t heal herpes zoster; it needs a thorough course of medication,” says Shrestha.
Surya Mati eventually recovered after a month of taking medication prescribed by her dermatologist. “I think it was the medication that helped cure the infection; however, after bearing the lions on my back, I did feel a bit of relief,” says Surya Mati. “Worshipping the naga might have consoled my mind a little and perhaps that’s why I felt better.”
However, Gupta addresses the practice as absurd and a hindrance for medical treatment. “The tradition is silly, but it is seen that most patients become less psychologically stressed after doing the pujas. But people should consult doctors; they can’t rely on this practice because the infection can get very severe and can spread,” says Gupta.