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no edit summary
Oh lord! You have already stated earlier that (in [[Nidana Sthana]]) “''jwara'' afflicts the body, senses and the mind, is the first disease to be manifested, and is the principal and the most powerful disease.” This enemy of human beings is invariably associated with the birth and death of creatures. Therefore, kindly elucidate the following points for the benefit of the humanity –
Oh lord! You have already stated earlier that (in [[Nidana Sthana]]) “''jwara'' afflicts the body, senses and the mind, is the first disease to be manifested, and is the principal and the most powerful disease.” This enemy of human beings is invariably associated with the birth and death of creatures. Therefore, kindly elucidate the following points for the benefit of the humanity –
*''Prakriti'' or the nature of the disease
*''[[Prakriti]]'' or the nature of the disease
*Pravritti or origin of the disease
*Pravritti or origin of the disease
*''Prabhava'', the sequels of the disease
*''Prabhava'', the sequels of the disease
''Jwara, vikara, roga, vyadhi'' and ''atanka'' – these terms are synonymous and used to indicate this condition. [11]
''Jwara, vikara, roga, vyadhi'' and ''atanka'' – these terms are synonymous and used to indicate this condition. [11]
=== ''Prakriti'' or nature of ''jwara'' ===
=== ''[[Prakriti]]'' or nature of ''jwara'' ===
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The three physical ''doshas'' and the two ''manasika doshas'' are the natural factors responsible for ''jwara'' (''prakriti'') as ''jwara'' cannot originate in a person having the balance of these three ''dosha'' (''nirdosha'' – in the state of homeostasis). Therefore, these ''sharirika'' and ''manasika doshas'' are the prakriti of ''jwara''.
The three physical ''[[dosha]]s'' and the two ''manasika [[dosha]]s'' are the natural factors responsible for ''jwara'' (''[[prakriti]]'') as ''jwara'' cannot originate in a person having the balance of these three ''[[dosha]]'' (''nirdosha'' – in the state of homeostasis). Therefore, these ''sharirika'' and ''manasika [[dosha]]s'' are the prakriti of ''jwara''.
''Kshaya'' (emaciation), ''tama'' (feeling of entering into darkness), ''jwara, papma'' (manifestations of the sinful acts) and ''mrityu'' (death) are all the various presentations of Yamaraja (lord of deaths). These are the causes of death (''panchatva'') in individuals suffering from various grievances, due to their own deeds and hence have been accepted as equivalent to Yama (lord of death). In this way the ''prakriti'' (basic nature) of ''jwara'' has been described. [12-13]
''Kshaya'' (emaciation), ''tama'' (feeling of entering into darkness), ''jwara, papma'' (manifestations of the sinful acts) and ''mrityu'' (death) are all the various presentations of Yamaraja (lord of deaths). These are the causes of death (''panchatva'') in individuals suffering from various grievances, due to their own deeds and hence have been accepted as equivalent to Yama (lord of death). In this way the ''[[prakriti]]'' (basic nature) of ''jwara'' has been described. [12-13]
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=== ''Pravritti'' (origin of the disease) ===
=== ''Pravritti'' (origin of the disease) ===
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''Santapa'' (feeling of heat or raised temperature), ''aruchi'' (anorexia), ''trishna'' (morbid thirst), ''angamarda'' (body ache), ''hrid vyatha'' (pain in the cardiac region) – these are the invariable manifestations of ''jwara''. At the time of birth and death, ''jwara'' is manifested in the form of tamas (''moha''- altered state of consciousness). In this way the ''prakriti'' (nature), ''pravritti'' (origin) and the ''prabhava'' (invariable manifestations) of ''jwara'' are described. [26-27]
''Santapa'' (feeling of heat or raised temperature), ''aruchi'' (anorexia), ''trishna'' (morbid thirst), ''angamarda'' (body ache), ''hrid vyatha'' (pain in the cardiac region) – these are the invariable manifestations of ''jwara''. At the time of birth and death, ''jwara'' is manifested in the form of tamas (''moha''- altered state of consciousness). In this way the ''[[prakriti]]'' (nature), ''pravritti'' (origin) and the ''prabhava'' (invariable manifestations) of ''jwara'' are described. [26-27]
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''Jwara'' is classified into two types each on the basis of the following criteria –
''Jwara'' is classified into two types each on the basis of the following criteria –
*''Sharira'' (physical) and ''manasa'' (mental)
*''Sharira'' (physical) and ''[[manas]]a'' (mental)
*''Saumya'' (predominated by cold) and ''agneya'' (predominated by heat)
*''Saumya'' (predominated by cold) and ''agneya'' (predominated by heat)
*''Antarvega'' (internal) and ''bahirvega'' (external)
*''Antarvega'' (internal) and ''bahirvega'' (external)
#''Tritiyaka''
#''Tritiyaka''
#''Chaturthaka''.
#''Chaturthaka''.
Depending upon the ''ashraya'' (site of manifestation in the body) among the seven ''dhatus'' (body tissues) ''jwara'' is again classified into seven categories.
Depending upon the ''ashraya'' (site of manifestation in the body) among the seven ''[[dhatu]]s'' (body tissues) ''jwara'' is again classified into seven categories.
''Jwara'' is classified into eight types on the basis of eight causes of ''jwara'' (''dosha'' predominance). [32-35]
''Jwara'' is classified into eight types on the basis of eight causes of ''jwara'' (''dosha'' predominance). [32-35]
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The ''sharira'' type of ''jwara'' first appears in the body and the ''manasa'' type, first appears in the mind. ''Vaichitya'' (mental instability), ''arati'' (disliking for everything) and ''glani'' (feeling of weakness in the body) are the signs and symptoms of the ''manas tapa'' (mental affliction of ''jwara''). The loss of ease in sensing the objects is the feature of the ''santapa'' of the ''indriya''. [36-37]
The ''sharira'' type of ''jwara'' first appears in the body and the ''manasa'' type, first appears in the mind. ''Vaichitya'' (mental instability), ''arati'' (disliking for everything) and ''glani'' (feeling of weakness in the body) are the signs and symptoms of the ''manas tapa'' (mental affliction of ''jwara''). The loss of ease in sensing the objects is the feature of the ''santapa'' of the ''[[indriya]]''. [36-37]
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=== Desires of patient to diagnose ''dosha'' dominance ===
=== Desires of patient to diagnose ''[[dosha]]'' dominance ===
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A patient suffering from ''vatapittaja'' variety of ''jwara'' desires for cold things, while, a patient suffering from ''jwara'' caused by ''vata'' and ''kapha dosha'' longs for hot things. However, when both of these types of ''doshas'' get mixed then such patient manifests both the kinds of symptoms. [37-38]
A patient suffering from ''[[vata]][[pitta]]ja'' variety of ''jwara'' desires for cold things, while, a patient suffering from ''jwara'' caused by ''[[vata]]'' and ''[[kapha]] [[dosha]]'' longs for hot things. However, when both of these types of ''[[dosha]]s'' get mixed then such patient manifests both the kinds of symptoms. [37-38]
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=== Attenuating nature of ''vata dosha'' ===
=== Attenuating nature of ''[[vata]] [[dosha]]'' ===
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''Vata dosha'' is exceedingly ''yogavahi'' (which accentuates the properties of others) in nature. It produces both type of effects on combination with the two ''doshas''. On combining with ''tejas'' it produces burning sensation while in combination with ''soma'' it produces cooling effect. [38-39]
''[[Vata dosha]]'' is exceedingly ''yogavahi'' (which accentuates the properties of others) in nature. It produces both type of effects on combination with the two ''[[dosha]]s''. On combining with ''[[teja]]s'' it produces burning sensation while in combination with ''soma'' it produces cooling effect. [38-39]
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=== Features of internal and external ''jwara'' ===
=== Features of internal and external ''jwara'' ===
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Excessive burning sensation inside the body, morbid thirst, delirium, dyspnea, giddiness, pain in bones and joints, absence of sweating, non-excretion of ''doshas'' and the feces – are the clinical features of ''antarvegi jwara'' (internal manifestation of ''jwara'').
Excessive burning sensation inside the body, morbid thirst, delirium, dyspnea, giddiness, pain in bones and joints, absence of sweating, non-excretion of ''[[dosha]]s'' and the feces – are the clinical features of ''antarvegi jwara'' (internal manifestation of ''jwara'').
Excessive rise in the body temperature and above features in mild form are the features of ''bahirvegi'' (external type of ''jwara'') and this type of ''jwara'' is easily curable. [39-41]
Excessive rise in the body temperature and above features in mild form are the features of ''bahirvegi'' (external type of ''jwara'') and this type of ''jwara'' is easily curable. [39-41]
''Jwara'' manifesting in the ''vasanta'' or spring season and ''sharada'' or autumn season is called ''prakrita'' (seasonal) ''jwara'' and is easily curable.
''Jwara'' manifesting in the ''vasanta'' or spring season and ''sharada'' or autumn season is called ''prakrita'' (seasonal) ''jwara'' and is easily curable.
''Pitta'' gets aggravated during autumn season because of its inherent hot properties and hot environment. ''Kapha'' gets accumulated in winters and gets aggravated during spring season.
''[[Pitta]]'' gets aggravated during autumn season because of its inherent hot properties and hot environment. ''[[Kapha]]'' gets accumulated in winters and gets aggravated during spring season.
The water and drugs (including the eatables) become sour in ''vipaka'' (taste that emerges after digestion) during the rainy season, which results in the accumulation of ''pitta''. This accumulated ''pitta'' gets aggravated or excited (by the hot sunrays) during the autumn season. This can immediately produce ''jwara'' in which ''kapha dosha'' is secondarily associated. As ''vasanta'' is the part of ''visarga kala'' (the time of year when, body has good strength imparted by nature), no problem is created by fasting.
The water and drugs (including the eatables) become sour in ''vipaka'' (taste that emerges after digestion) during the rainy season, which results in the accumulation of ''[[pitta]]''. This accumulated ''[[pitta]]'' gets aggravated or excited (by the hot sunrays) during the autumn season. This can immediately produce ''jwara'' in which ''[[kapha dosha]]'' is secondarily associated. As ''vasanta'' is the part of ''visarga kala'' (the time of year when, body has good strength imparted by nature), no problem is created by fasting.
During ''hemanta'' (early winter) the water and drugs (including eatables) become sweet in taste, which helps in accumulation of ''kapha''. This ''kapha'' gets aggravated during the subsequent spring season due to the strong sunrays (which melt this ''kapha''). Therefore, ''jwara'' caused by ''kapha'' is manifested during the spring season. The spring is the part of the ''adana kala'' (the time when the strength of the creatures is the least as the nature withdraws the strength) and in the ''jwara'' caused in this period ''vata'' and ''pitta dosha'' constitute the secondary associates.
During ''hemanta'' (early winter) the water and drugs (including eatables) become sweet in taste, which helps in accumulation of ''[[kapha]]''. This ''[[kapha]]'' gets aggravated during the subsequent spring season due to the strong sunrays (which melt this ''[[kapha]]''). Therefore, ''jwara'' caused by ''[[kapha]]'' is manifested during the spring season. The spring is the part of the ''adana kala'' (the time when the strength of the creatures is the least as the nature withdraws the strength) and in the ''jwara'' caused in this period ''[[vata]]'' and ''[[pitta dosha]]'' constitute the secondary associates.
A patient of ''jwara'' should be treated keeping in view the strength of the ''doshas'' in the beginning, middle and the end of the spring and autumn seasons. This way, depending upon the nature of the seasons, the seasonal types of ''jwara'' are described.
A patient of ''jwara'' should be treated keeping in view the strength of the ''doshas'' in the beginning, middle and the end of the spring and autumn seasons. This way, depending upon the nature of the seasons, the seasonal types of ''jwara'' are described.
==== ''Vaikrita jwara'' ====
==== ''Vaikrita jwara'' ====
Generally, the ''jwara'' caused by ''vata dosha'' is difficult to treat in every season. The other types of ''jwara'', get their initial strength from the predominant season, those are (''Vaikrita jwara'') difficult to treat are:
Generally, the ''jwara'' caused by ''[[vata dosha]]'' is difficult to treat in every season. The other types of ''jwara'', get their initial strength from the predominant season, those are (''Vaikrita jwara'') difficult to treat are:
*''vatika jwara'' irrespective of its season of occurrence
*''vatika jwara'' irrespective of its season of occurrence
*''paitika jwara'' occurring in seasons other than autumn and
*''paitika jwara'' occurring in seasons other than autumn and
The causative factors of the different types of ''jwara'' have been described in [[Nidana Sthana]] (in ''jwara''). [42-49]
The causative factors of the different types of ''jwara'' have been described in [[Nidana Sthana]] (in ''jwara''). [42-49]
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=== Prognosis of ''jwara'' ===
=== Prognosis of ''jwara'' ===
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==== ''Sadhya'' (curable) ''jwara'' ====
==== ''Sadhya'' (curable) ''jwara'' ====
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''Jwara'' is easily curable if it occurs in a person with strong physique, or if it is caused by the vitiation of lesser amount of ''dosha'' and if there are no complications.
''Jwara'' is easily curable if it occurs in a person with strong physique, or if it is caused by the vitiation of lesser amount of ''[[dosha]]'' and if there are no complications.
==== ''Asadhya'' (incurable) ''jwara'' ====
==== ''Asadhya'' (incurable) ''jwara'' ====
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The aggravated ''dosha'' circulate through the channels carrying ''rasa'' (the first nutritional dhatu equivalent to plasma) and spread all over the body and gets stagnated, causes ''santata jwara''. This ''santata jwara'' is extremely difficult to treat and manifests its symptoms very quickly. In this type the patient either gets cured (on the pacification of ''dosha'') or killed (on the further aggravation of ''dosha'') on the 10th, 12th or 7th day.
The aggravated ''[[dosha]]'' circulate through the channels carrying ''[[rasa]]'' (the first nutritional dhatu equivalent to plasma) and spread all over the body and gets stagnated, causes ''santata jwara''. This ''santata jwara'' is extremely difficult to treat and manifests its symptoms very quickly. In this type the patient either gets cured (on the pacification of ''[[dosha]]'') or killed (on the further aggravation of ''[[dosha]]'') on the 10th, 12th or 7th day.
The ''dosha'' involved in the manifestation of ''santata jwara'' is in accordance with season (''kala''), vitiated factors (''dushya''), and the physical constitution of the patient (''prakriti'') due to which it is ''nispratyanika'' (having no opponent / which cannot be inhibited). Thus, it is known to be unbearable.
The ''[[dosha]]'' involved in the manifestation of ''santata jwara'' is in accordance with season (''[[kala]]''), vitiated factors (''[[dushya]]''), and the physical constitution of the patient (''[[prakriti]]'') due to which it is ''nispratyanika'' (having no opponent / which cannot be inhibited). Thus, it is known to be unbearable.
Additionally, the other ''dhatu'', urine, stool and ''vata'' etc. ''dosha'', also get affected simultaneously in this fever. If the involved factors like ''rasa'' are purified optimally the fever gets subsided in either 7 or 10 or 12 days, otherwise, the fever kills the patient within that period.
Additionally, the other ''[[dhatu]]'', urine, stool and ''[[vata]]'' etc. ''[[dosha]]'', also get affected simultaneously in this fever. If the involved factors like ''[[rasa]]'' are purified optimally the fever gets subsided in either 7 or 10 or 12 days, otherwise, the fever kills the patient within that period.
If, some of the 12 constituents of this fever get purified, while some others remain unpurified, then the fever goes in latent stage on the 12th day and reappears on the 13th day and may persist for longer duration. In this way, a physician should understand the causes and features of this type of fever and should initiate the treatment only after a proper understanding of these factors, mostly by the methods beginning with ''apatarpana''. [53-61]
If, some of the 12 constituents of this fever get purified, while some others remain unpurified, then the fever goes in latent stage on the 12th day and reappears on the 13th day and may persist for longer duration. In this way, a physician should understand the causes and features of this type of fever and should initiate the treatment only after a proper understanding of these factors, mostly by the methods beginning with ''apatarpana''. [53-61]
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The aggravated ''dosha'' when generally lodges in the ''rakta dhatu'', then they manifest with fever twice in 24 hours (Nycthemeron) depending on the time of ''dosha'' aggravation or subsidence. The ''dosha'' in this type of ''jwara'' can be counteracted. [61-62]
The aggravated ''[[dosha]]'' when generally lodges in the ''[[rakta dhatu]]'', then they manifest with fever twice in 24 hours (Nycthemeron) depending on the time of ''[[dosha]]'' aggravation or subsidence. The ''[[dosha]]'' in this type of ''jwara'' can be counteracted. [61-62]
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==== ''Anyedyushka jwara'' ====
==== ''Anyedyushka jwara'' ====
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Vitiated ''dosha'' produce ''anyedushka'' type of ''jwara'' with the support of any one factor amongst the ''kala'' (time), ''prakriti'' (physical constitution) and ''dushya'' (vitiated factors) leading to obstruction in ''medo vaha sira'' (the channel of circulation of ''medasa'' (fat)). It can be counteracted. This ''jwara'' occurs only once during day and night. [63-64]
Vitiated ''[[dosha]]'' produce ''anyedushka'' type of ''jwara'' with the support of any one factor amongst the ''[[kala]]'' (time), ''[[prakriti]]'' (physical constitution) and ''[[dushya]]'' (vitiated factors) leading to obstruction in ''medo vaha sira'' (the channel of circulation of ''medasa'' (fat)). It can be counteracted. This ''jwara'' occurs only once during day and night. [63-64]
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==== ''Tritiyaka'' and ''chaturthaka jwara'' ====
==== ''Tritiyaka'' and ''chaturthaka jwara'' ====
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When the ''dosha'' afflict the ''asthi dhatu'' (bone tissue) and ''majja dhatu'' (bone marrow), they cause the ''tritiyaka'' and ''chaturthaka jwara'' respectively.
When the ''[[dosha]]'' afflict the ''[[asthi dhatu]]'' (bone tissue) and ''[[majja dhatu]]'' (bone marrow), they cause the ''tritiyaka'' and ''chaturthaka jwara'' respectively.
Some scholars opine that the different types of ''jwara'' viz the ''anyedushaka, tritiyaka'' and ''chaturthaka jwara'' manifest because of the affliction of the some alternate ''dhatu'' by the ''dosha''. ''Anyedushyaka jwara'' is caused by the affliction of ''rakta dhatu'' (blood) also. ''Tritiyaka jwara'' manifests when the ''dosha'' afflict the ''mansa dhatu'' (muscular tissues). ''Dosha'' lodging in the channels of circulation of ''medo dhatu'' cause ''chaturthaka jwara''.
Some scholars opine that the different types of ''jwara'' viz the ''anyedushaka, tritiyaka'' and ''chaturthaka jwara'' manifest because of the affliction of the some alternate ''[[dhatu]]'' by the ''[[dosha]]''. ''Anyedushyaka jwara'' is caused by the affliction of ''[[rakta dhatu]]'' (blood) also. ''Tritiyaka jwara'' manifests when the ''[[dosha]]'' afflict the ''[[mamsa dhatu]]'' (muscular tissues). ''[[Dosha]]'' lodging in the channels of circulation of ''[[medo dhatu]]'' cause ''chaturthaka jwara''.
''Anyedushka jwara'' occurs every day, while ''tritiyaka jwara'' occurs after a gap of one day and ''chaurthaka'' occurs after two days gap. [64-67]
''Anyedushka jwara'' occurs every day, while ''tritiyaka jwara'' occurs after a gap of one day and ''chaurthaka'' occurs after two days gap. [64-67]
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As a seed remains dormant in the soil and germinates at a favorable time, similarly the ''doshas'' remain in dormant condition in the ''dhatu'' and get aggravated at a favorable time. These ''dosha'' gain strength at an appropriate time and when the power of the inhibiting (disease preventing) factors has subsided, then the ''tritiyaka'' and ''chaturthaka jwara'' manifest.
As a seed remains dormant in the soil and germinates at a favorable time, similarly the ''[[dosha]]s'' remain in dormant condition in the ''[[dhatu]]'' and get aggravated at a favorable time. These ''[[dosha]]'' gain strength at an appropriate time and when the power of the inhibiting (disease preventing) factors has subsided, then the ''tritiyaka'' and ''chaturthaka jwara'' manifest.
The ''dosha'' lose their strength after manifesting their signs and symptoms of aggravation and get lodged in their respective places. They again get aggravated and afflict the person with ''jwara''.
The ''[[dosha]]'' lose their strength after manifesting their signs and symptoms of aggravation and get lodged in their respective places. They again get aggravated and afflict the person with ''jwara''.
The ''tritiyaka jwara'' manifests in three types –
The ''tritiyaka jwara'' manifests in three types –
*When the ''kapha'' and ''pitta dosha'' are aggravated then it afflicts the ''trika pradesh'' (sacral region)
*When the ''[[kapha]]'' and ''[[pitta dosha]]'' are aggravated then it afflicts the ''trika pradesh'' (sacral region)
*When the ''vata'' and ''kapha dosha'' are aggravated then the back (''prishtha'') region are affected
*When the ''[[vata]]'' and ''[[kapha dosha]]'' are aggravated then the back (''prishtha'') region are affected
*The head region is affected in the case of aggravation of ''vata'' and ''pitta dosha''.
*The head region is affected in the case of aggravation of ''[[vata]]'' and ''[[pitta dosha]]''.
Similarly ''chaturthaka jwara'' is also of two types –
Similarly ''chaturthaka jwara'' is also of two types –
*Calf region is afflicted in the in the beginning by the vitiation of ''kapha''
*Calf region is afflicted in the in the beginning by the vitiation of ''[[kapha]]''
*Head region is afflicted in the beginning by the vitiation of ''vata''. [70-72]
*Head region is afflicted in the beginning by the vitiation of ''[[vata]]''. [70-72]
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''Chaturthaka viparyaya jwara'' is another variety of ''vishama jwara''. Each of the three ''dosha'' i.e. ''vata, pitta'' and ''kapha'' cause this disease by afflicting the two dhatu viz ''asthi'' (bone) and ''majja'' (bone marrow).[73]
''Chaturthaka viparyaya jwara'' is another variety of ''vishama jwara''. Each of the three ''[[dosha]]'' i.e. ''[[vata]], [[pitta]]'' and ''[[kapha]]'' cause this disease by afflicting the two dhatu viz ''[[asthi]]'' (bone) and ''[[majja]]'' (bone marrow).[73]
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These five types of ''jwara'' are mostly caused by ''sannipata'' (simultaneous vitiation of the three ''dosha''), however, the ''dosha'', which is predominant among the three ''doshas'' is generally attributed as the causative factors. [74]
These five types of ''jwara'' are mostly caused by ''sannipata'' (simultaneous vitiation of the three ''dosha''), however, the ''[[dosha]]'', which is predominant among the three ''[[dosha]]s'' is generally attributed as the causative factors. [74]
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=== ''Dhatugata jwara'' ===
=== ''Dhatugata jwara'' ===
Manifestation of ''jwara'' at a particular time or a change in the time of manifestation takes place due to following factors:
Manifestation of ''jwara'' at a particular time or a change in the time of manifestation takes place due to following factors:
''Jwara'' occurs according to the strength or weakness of factors like ''dosha'', seasons, day, night, mental status and ''artha'' (deeds of previous life).
''Jwara'' occurs according to the strength or weakness of factors like ''[[dosha]]'', seasons, day, night, mental status and ''artha'' (deeds of previous life).
Manifestation of ''jwara'' in the different ''dhatu'' (body tissues):
Manifestation of ''jwara'' in the different ''dhatu'' (body tissues):
#When the vitiated ''dosha'' are located in the ''rasa dhatu'', the clinical features manifesting are – heaviness, miserable feeling, anxiety, exhaustion, vomiting, anorexia, increase in external temperature, body ache and yawning.
#When the vitiated ''[[dosha]]'' are located in the ''[[rasa dhatu]]'', the clinical features manifesting are – heaviness, miserable feeling, anxiety, exhaustion, vomiting, anorexia, increase in external temperature, body ache and yawning.
#The vitiated ''doshas'' causing ''jwara'' are located in the ''rakta dhatu'', the clinical features are – Increase in body temperature, eruptions, thirst, frequent spitting mixed with blood burning sensation, discoloration, giddiness, intoxication and incoherent speech.
#The vitiated ''[[dosha]]s'' causing ''jwara'' are located in the ''[[rakta dhatu]]'', the clinical features are – Increase in body temperature, eruptions, thirst, frequent spitting mixed with blood burning sensation, discoloration, giddiness, intoxication and incoherent speech.
#Burning sensation inside the body, thirst, unconsciousness, weakness, diarrhea, foul smell from the body and throwing movement of the limbs are the features manifesting when the ''doshas'' causing ''jwara'' are lodged in the ''mamsa dhatu''.
#Burning sensation inside the body, thirst, unconsciousness, weakness, diarrhea, foul smell from the body and throwing movement of the limbs are the features manifesting when the ''[[dosha]]s'' causing ''jwara'' are lodged in the ''[[mamsa dhatu]]''.
#Vitiated ''dosha'' located in the ''medo dhatu'' present with the following clinical features – excessive sweating, thirst, incoherent speech, frequent emesis, inability to tolerate the smell of one’s own body, wet feeling in the body and anorexia.
#Vitiated ''[[dosha]]'' located in the ''[[meda dhatu]]'' present with the following clinical features – excessive sweating, thirst, incoherent speech, frequent emesis, inability to tolerate the smell of one’s own body, wet feeling in the body and anorexia.
#Vitiated ''dosha'' located in the ''asthi dhatu'' cause the following clinical features – diarrhea, emesis, pain in the bones, production of ''kujana'' (a sort of cooing sound) convulsive movements of the body and limbs.
#Vitiated ''[[dosha]]'' located in the ''[[asthi dhatu]]'' cause the following clinical features – diarrhea, emesis, pain in the bones, production of ''kujana'' (a sort of cooing sound) convulsive movements of the body and limbs.
#When the vitiated ''dosha'' are located in the ''majja dhatu'' then the following signs and symptoms appear – hiccup, bronchitis, cough, feeling of entering into darkness frequently, cutting pain in the vital organs (''marmas''), feeling of cold externally and internal burning sensation.
#When the vitiated ''dosha'' are located in the ''majja dhatu'' then the following signs and symptoms appear – hiccup, bronchitis, cough, feeling of entering into darkness frequently, cutting pain in the vital organs (''marmas''), feeling of cold externally and internal burning sensation.
#Vitiated ''dosha'' causing ''jwara'' located in the ''sukra dhatu'' cause ejaculation and destruction of ''shukra'' resulting in the extinction of life along with ''vayu, agni'' and ''soma'' of the subtle body (''sukshma sharira'').
#Vitiated ''[[dosha]]'' causing ''[[jwara]]'' located in the ''[[sukra dhatu]]'' cause ejaculation and destruction of ''[[shukra]]'' resulting in the extinction of life along with ''vayu, agni'' and ''soma'' of the subtle body (''sukshma sharira'').
The ''jwara'' in which ''doshas'' are located in the ''rasa, rakta, mamsa'' and ''medas dhatu'' are curable, while those in which the location is in the ''asthi'' and ''majja dhatu'' are difficult to treat. The ''jwara'' in which the vitiated ''dosha'' are located in ''shukra dhatu'' is incurable. [75-83]
The ''jwara'' in which ''[[dosha]]s'' are located in the ''[[rasa]], [[rakta]], [[mamsa]]'' and ''[[meda dhatu]]'' are curable, while those in which the location is in the ''[[asthi]]'' and ''[[majja dhatu]]'' are difficult to treat. The ''jwara'' in which the vitiated ''[[dosha]]'' are located in ''[[shukra dhatu]]'' is incurable. [75-83]
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=== Clinical features of ''jwara'' due to combination of two ''dosha'' ===
=== Clinical features of ''jwara'' due to combination of two ''[[dosha]]'' ===
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Signs and symptoms of ''jwara'' by combination of ''vata'' and ''pitta'':
Signs and symptoms of ''jwara'' by combination of ''[[vata]]'' and ''[[pitta]]'':
In [[Nidana Sthana]] the eight varieties of ''jwara'' along with their causative factors, signs and symptoms have been described in brief. Now their signs and symptoms will be described in detail:
In [[Nidana Sthana]] the eight varieties of ''jwara'' along with their causative factors, signs and symptoms have been described in brief. Now their signs and symptoms will be described in detail:
Headache, breaking pain in joints, burning sensation, horripilation, dryness of throat and mouth, nausea, thirst, fainting, giddiness, anorexia, sleeplessness, talkativeness and yawning – all these are the signs and symptoms of ''jwara'' by combination of ''vata'' and ''pitta''.
Headache, breaking pain in joints, burning sensation, horripilation, dryness of throat and mouth, nausea, thirst, fainting, giddiness, anorexia, sleeplessness, talkativeness and yawning – all these are the signs and symptoms of ''jwara'' by combination of ''[[vata]]'' and ''[[pitta]]''.
Signs and symptoms of ''jwara'' by combination of ''vata'' and ''kapha'':
Signs and symptoms of ''jwara'' by combination of ''[[vata]]'' and ''[[kapha]]'':
Feeling cold, heaviness, drowsiness, timidity, pain in joints, feeling of stiffness of head (''sirograha''), coryza, cough, impaired sweating and moderate rise in temperature are the signs and symptoms of ''jwara'' caused by ''vata'' and ''kapha''.
Feeling cold, heaviness, drowsiness, timidity, pain in joints, feeling of stiffness of head (''sirograha''), coryza, cough, impaired sweating and moderate rise in temperature are the signs and symptoms of ''jwara'' caused by ''[[vata]]'' and ''[[kapha]]''.
Signs and symptoms of ''jwara'' by combination of ''kapha'' and ''pitta'':
Signs and symptoms of ''jwara'' by combination of ''[[kapha]]'' and ''[[pitta]]'':
Frequently changing sensation of hot and cold, frequent increased or decreased sweating, delusions, cough, anorexia, thirst, elimination of phlegm and bile, coating and bitterness in the mouth and drowsiness – all are the clinical features of ''jwara'' caused by ''kapha'' and ''pitta''.
Frequently changing sensation of hot and cold, frequent increased or decreased sweating, delusions, cough, anorexia, thirst, elimination of phlegm and bile, coating and bitterness in the mouth and drowsiness – all are the clinical features of ''jwara'' caused by ''[[kapha]]'' and ''[[pitta]]''.
Thus, here the features of different types of ''jwara'' caused by the simultaneous vitiation of two ''dosha'' have been described. [84-89]
Thus, here the features of different types of ''jwara'' caused by the simultaneous vitiation of two ''[[dosha]]'' have been described. [84-89]
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=== ''Sannipataja jwara'' ===
=== ''Sannipataja jwara'' ===
The ''sannipataja'' variety of ''jwara'', has thirteen sub types have been described in [[Nidana Sthana]]. Now the clinical features of each type will be described separately:
The ''sannipataja'' variety of ''jwara'', has thirteen sub types have been described in [[Nidana Sthana]]. Now the clinical features of each type will be described separately:
*''Sannipataja jwara'' in which ''vata'' and ''pitta'' are codominant while ''kapha'' is recessive has the following clinical features – giddiness, thirst, burning sensation, heaviness and excessive headache. [91]
*''Sannipataja jwara'' in which ''[[vata]]'' and ''[[pitta]]'' are codominant while ''[[kapha]]'' is recessive has the following clinical features – giddiness, thirst, burning sensation, heaviness and excessive headache. [91]
*''Sannipataja jwara'' in which ''vata'' and ''kapha'' are codominant while ''pitta'' is recessive has the following clinical features – Coldness, cough, anorexia, drowsiness, thirst, burning sensation and pain. [92]
*''Sannipataja jwara'' in which ''[[vata]]'' and ''[[kapha]]'' are codominant while ''[[pitta]]'' is recessive has the following clinical features – Coldness, cough, anorexia, drowsiness, thirst, burning sensation and pain. [92]
*''Sannipataja jwara'' in which ''pitta'' and ''kapha'' are codominant while ''vata'' is recessive has the following clinical features – Emesis, coldness, frequent burning sensation, thirst, unconsciousness and pain in the bones. [93]
*''Sannipataja jwara'' in which ''[[pitta]]'' and ''[[kapha]]'' are codominant while ''[[vata]]'' is recessive has the following clinical features – Emesis, coldness, frequent burning sensation, thirst, unconsciousness and pain in the bones. [93]
*''Sannipataja jwara'' in which vitiated ''vata'' predominates over the other two ''doshas'' presents with the following signs and symptoms **pain in the joints, bones and head; delirium, heaviness, giddiness, thirst and dryness of the throat as well as the mouth [94]
*''Sannipataja jwara'' in which vitiated ''[[vata]]'' predominates over the other two ''[[dosha]]s'' presents with the following signs and symptoms **pain in the joints, bones and head; delirium, heaviness, giddiness, thirst and dryness of the throat as well as the mouth [94]
*''Sannipataja jwara'' in which vitiated ''pitta'' predominates over the other two ''doshas'' presents with the following signs and symptoms – blood in stool and urine, burning sensation, vomiting, ''arati'' (disliking for doing any work), giddiness, drowsiness and cough. [95]
*''Sannipataja jwara'' in which vitiated ''[[pitta]]'' predominates over the other two ''[[dosha]]s'' presents with the following signs and symptoms – blood in stool and urine, burning sensation, vomiting, ''arati'' (disliking for doing any work), giddiness, drowsiness and cough. [95]
*''Sannipataja jwara'' in which vitiated ''kapha'' predominates over the other two ''doshas'' presents with the following signs and symptoms – laziness, anorexia, nausea, burning sensation, vomiting, ''arati'' (restlessness), giddiness, drowsiness and cough. [96]
*''Sannipataja jwara'' in which vitiated ''[[kapha]]'' predominates over the other two ''[[dosha]]s'' presents with the following signs and symptoms – laziness, anorexia, nausea, burning sensation, vomiting, ''arati'' (restlessness), giddiness, drowsiness and cough. [96]
*''Sannipataja jwara'' in which vitiated ''kapha'' is excessively vitiated, ''pitta'' moderately vitiated and ''vata'' is less vitiated presents with the following clinical features – coryza, vomiting, laziness, drowsiness, anorexia and weak digestion. [97]
*''Sannipataja jwara'' in which vitiated ''[[kapha]]'' is excessively vitiated, ''[[pitta]]'' moderately vitiated and ''[[vata]]'' is less vitiated presents with the following clinical features – coryza, vomiting, laziness, drowsiness, anorexia and weak digestion. [97]
*''Sannipataja jwara'' in which vitiated ''pitta'' is excessively vitiated, ''kapha'' moderately vitiated and ''vata'' is less vitiated presents with the following clinical features – yellowish discoloration of urine and eyes, burning sensation, thirst, giddiness and anorexia. [98]
*''Sannipataja jwara'' in which vitiated ''pitta'' is excessively vitiated, ''kapha'' moderately vitiated and ''vata'' is less vitiated presents with the following clinical features – yellowish discoloration of urine and eyes, burning sensation, thirst, giddiness and anorexia. [98]
*''Sannipataja jwara'' in which vitiated ''vata'' is excessively vitiated, ''kapha'' moderately vitiated and ''pitta'' is less vitiated presents with the following clinical features – headache, trembling, breathlessness, delirium, vomiting and anorexia. [99]
*''Sannipataja jwara'' in which vitiated ''vata'' is excessively vitiated, ''kapha'' moderately vitiated and ''pitta'' is less vitiated presents with the following clinical features – headache, trembling, breathlessness, delirium, vomiting and anorexia. [99]