Jwara: Difference between revisions
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|title=Jwara (fevers) | |title=Jwara (fevers) | ||
|titlemode=append | |titlemode=append | ||
|keywords= fever, viral fever, ayurveda, infectious diseases in ayurveda, acute fever, pyrexia, treatment of fever, | |keywords= fever, viral fever, ayurveda, infectious diseases in ayurveda, acute fever, pyrexia, treatment of fever, indian systems of medicine, carak samhita, samhita, Jwara roga, Santapa, pitta fever, ushma, heat regulation, Ayurveda, charak samhita, Indian system of medicine. | ||
|description=Chikitsa Sthana Chapter 3. Management of Jwara | |description=Chikitsa Sthana Chapter 3. Management of Jwara | ||
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg | |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg | ||
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'''Jwara (different types of fever)''' | '''Jwara (different types of fever)''' | ||
<p style="text-align:justify;"> | |||
Jwara is an important disease. The term ‘Jwara’ implies the ability of a disease to cause anguish to body and mind. [SAT-C.7]<ref>http://namstp.ayush.gov.in/#/sat</ref> This suggests suffering or illness. Based on the similarity in clinical features, Jwara is often considered as fever or pyrexia in medical terminologies. However, according to [[Ayurveda]], the classical description of jwara includes variety of other clinical conditions with or without rise in body temperature. Therefore, fever or hyperpyrexia is considered as only one among the many features of jwara. | Jwara is an important disease. The term ‘Jwara’ implies the ability of a disease to cause anguish to body and mind. [SAT-C.7]<ref>http://namstp.ayush.gov.in/#/sat</ref> This suggests suffering or illness. Based on the similarity in clinical features, Jwara is often considered as fever or pyrexia in medical terminologies. However, according to [[Ayurveda]], the classical description of jwara includes variety of other clinical conditions with or without rise in body temperature. Therefore, fever or hyperpyrexia is considered as only one among the many features of jwara.</p> | ||
{{Infobox | {{Infobox | ||
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|label2 = Authors | |label2 = Authors | ||
|data2 = Deole Y.S.<sup>1</sup>,Aneesh E.G.<sup>2</sup> | |data2 = [[Yogesh Deole|Deole Y.S.]]<sup>1</sup>, Aneesh E.G.<sup>2</sup> | ||
|label3 = Reviewed and edited by | |label3 = Reviewed and edited by | ||
|data3 = Basisht G.<sup>3</sup> | |data3 = [[Gopal Basisht|Basisht G.]]<sup>3</sup> | ||
|label4 = Affiliations | |label4 = Affiliations | ||
|data4 = <sup>1</sup>Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabhvidya Nagar, Anand, Gujarat, India <sup>2</sup>[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar,India | |data4 = <sup>1</sup>Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabhvidya Nagar, Anand, Gujarat, India <br/><sup>2</sup>[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar,India <br/><sup>3</sup>Rheumatologist, Orlando, Florida, U.S.A. | ||
<sup>3</sup>Rheumatologist, Orlando, Florida, U.S.A. | |||
|label5 = Correspondence emails: | |label5 = Correspondence emails: | ||
|data5 = dryogeshdeole@gmail.com, carakasamhita@gmail.com | |data5 = dryogeshdeole@gmail.com, carakasamhita@gmail.com | ||
| | |label8 = Publisher | ||
| | |data8 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India | ||
| | |label6 = Date of first publication: | ||
| | |data6 = February 15, 2022 | ||
| | |label7 = DOI | ||
| | |data7 = {{DoiWithLink}} | ||
}} | }} | ||
<p style="text-align:justify;"> | |||
Jwara is the commonest clinical condition observed in medical practice either as a primary disease or as a secondary sign owing to other morbidities. Hence it is given prime importance among all diseases. [Cha.Sa. [[Sutra Sthana]] 25/40] Calor (rise in temperature), rubor (redness), dolor(pain), tumor (swelling) are the cardinal signs of inflammation. Pathogenesis of jwara includes change in body temperature, discoloration, aches. Therefore, jwara is also an indicator of inflammatory changes in body. | Jwara is the commonest clinical condition observed in medical practice either as a primary disease or as a secondary sign owing to other morbidities. Hence it is given prime importance among all diseases. [Cha.Sa. [[Sutra Sthana]] 25/40] Calor (rise in temperature), rubor (redness), dolor(pain), tumor (swelling) are the cardinal signs of inflammation. Pathogenesis of jwara includes change in body temperature, discoloration, aches. Therefore, jwara is also an indicator of inflammatory changes in body. | ||
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As per conventional medical literature, the word fever has its etymological basis in Latin, meaning simply ‘heat’, and pyrexia comes from the Greek ‘pyr’, meaning fire or fever. It is caused by pyrogenic and non-pyrogenic conditions. Micro-organisms like bacteria, viruses etc. cause infection and body temperature is raised as an immune response to fight infection. Inflammatory chemicals like prostaglandins, cytokines play key role in pathophysiology of fever.<ref>Walter EJ, Hanna-Jumma S, Carraretto M, Forni L. The pathophysiological basis and consequences of fever. Crit Care. 2016;20(1):200. Published 2016 Jul 14. doi:10.1186/s13054-016-1375-5</ref> | As per conventional medical literature, the word fever has its etymological basis in Latin, meaning simply ‘heat’, and pyrexia comes from the Greek ‘pyr’, meaning fire or fever. It is caused by pyrogenic and non-pyrogenic conditions. Micro-organisms like bacteria, viruses etc. cause infection and body temperature is raised as an immune response to fight infection. Inflammatory chemicals like prostaglandins, cytokines play key role in pathophysiology of fever.<ref>Walter EJ, Hanna-Jumma S, Carraretto M, Forni L. The pathophysiological basis and consequences of fever. Crit Care. 2016;20(1):200. Published 2016 Jul 14. doi:10.1186/s13054-016-1375-5</ref> | ||
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Considering conventional literature on fever and ayurvedic perspective of jwara, similarities about involvement of thermoregulatory mechanisms are observed in etiopathogenesis and clinical features. However, the treatment measures are different. The conventional measures focus on reducing body temperature and removing the origin of infection using anti-biotic medicines. [[Ayurveda]] medical literature emphasizes on strengthening the host immune response or defense mechanism, correcting the equilibrium of body components and preservation of health. | Considering conventional literature on fever and ayurvedic perspective of jwara, similarities about involvement of thermoregulatory mechanisms are observed in etiopathogenesis and clinical features. However, the treatment measures are different. The conventional measures focus on reducing body temperature and removing the origin of infection using anti-biotic medicines. [[Ayurveda]] medical literature emphasizes on strengthening the host immune response or defense mechanism, correcting the equilibrium of body components and preservation of health. | ||
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This article describes general etiology, premonitory features, clinical features, pathogenesis, and management principles of jwara. Classification of the disease is also highlighted. Specific types of jwara like acute stage (nava jwara), chronic stage (jeerna jwara), irregular pattern (vishama jwara), jwara involving all three [[dosha]] (sannipataja jwara), jwara affecting body components (dhatugata jwara) are dealt in separate articles. | This article describes general etiology, premonitory features, clinical features, pathogenesis, and management principles of jwara. Classification of the disease is also highlighted. Specific types of jwara like acute stage (nava jwara), chronic stage (jeerna jwara), irregular pattern (vishama jwara), jwara involving all three [[dosha]] (sannipataja jwara), jwara affecting body components (dhatugata jwara) are dealt in separate articles. </p> | ||
== Diagnostic codes == | == Diagnostic codes == | ||
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*[Cha.Sa.[[Chikitsa Sthana]].3/61-62, 73], #[Su.Sa.Uttara Sthana 39/83-88], $[M.Ni.2/39]<ref name=Madava/> | |||
*[Cha.Sa.[[Chikitsa Sthana]].3/61-62, 73], #[Su.Sa.Uttara Sthana 39/83-88], $[M.Ni.2/39]<ref name=Madava/> | |||
==[[Dosha]] specific presentations== | ==[[Dosha]] specific presentations== | ||
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==Prognosis== | ==Prognosis== | ||
Santata jwara is | Santata jwara is difficult to treat. [Cha.Sa.[[Chikitsa Sthana]] 3/55] | ||
==Management== | ==Management== | ||
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The five types of vishama jwara are managed by five decoctions made from drugs described below: | The five types of vishama jwara are managed by five decoctions made from drugs described below: | ||
#In | #In santata jwara, Kalingaka, patola leaves and katukarohini | ||
#In | #In satata jwara, Patola, sariva, musta, patha and katukarohini | ||
#In | #In anyedyushka jwara, Nimba, patola, triphala, mrudvika, musta and vatsaka | ||
#In tritiyaka jwara, Kiratatikta, amrita, chandana, vishvabheshaja | #In tritiyaka jwara, Kiratatikta, [[Guduchi|amrita]], chandana, vishvabheshaja | ||
#In chaturthaka jwara, Guduchi, | #In chaturthaka jwara, [[Guduchi]], [[Amalaki]] and Musta. [ Cha.Sa. [[Chikitsa Sthana]] 200-203] | ||
{| class="wikitable" | {| class="wikitable" | ||
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Decoction enema and untuous enema [Cha.Sa.[[Chikitsa Sthana]] 3/315-17] | Decoction enema and untuous enema [Cha.Sa.[[Chikitsa Sthana]] 3/315-17] | ||
Drug of choice: Triphala (Terminalia chebula, | Drug of choice: Triphala (Terminalia chebula, Terminalia bellirica and Phyllanthus emblica) <ref name=Ranade/> | ||
==Jwara affecting Bone marrow ([[majja dhatu]])== | ==Jwara affecting Bone marrow ([[majja dhatu]])== | ||