Jwara Chikitsa

Chikitsa Sthana Chapter 3: Jwara Chikitsa Abstract : This chapter on jwara, or fever, has special importance from standpoint of managing it. Modern medicine literature describes two components of fever - one where the cause or etiology is known and the other where it is unknown and is described as FUO (Fever of Unknown Origin). In the latter case, there is no curative treatment of fever available or documented in modern medicine. On the other hand, this chapter describes important Ayurvedic concepts of jwara or fever which are important to understand the etiology of fever and thus, its management. Keywords – Jwara roga, Santāpa, pitta,

Introduction: The first two chapters of Chikitsa Sthana describe rasayana and vajikarana to serve the primary purpose of health preservation, promotion, and rejuvenation. The second purpose, of treatment of disease, is dealt in subsequent chapters of this sthana. Jwara chikitsa has been dealt first because Ayurveda holds that jwara is not merely the increase in body temperature (fever) but also a feeling of being unwell or discomfort, and it involves the deha, indriya, and mana (physical body, sensory organs, and mind). Whereas the balanced state of vata, pitta, and kapha manifest health by rhythmic circulation of fluids, digestion, metabolism, and nutrition respectively, and if imbalanced their respective altered manifestations are, pain, an increase of body heat, and inflammation. Jwara is an imbalanced state of pitta, which damages the physiology of digestion and metabolism. Inappropriately digested food transforms into a product called amavisha which is a predisposing cause of many diseases. The initial manifestation of stagnated aamvisha in rasa dhatu (plasma) is jwara. Thus, jwara is an important indication for the circulating aamvisha and requires early treatment before its progression. This chapter of jwarachikitsa establishes many guiding principles for treatment of various diseases described later in this section. These are classification, types, association with body tissues, and identification of progression, precautions and specific order of treatment. Causes and symptoms of recurrence and their remedies are widely described in this chapter. The Sanskrit Text, Transliteration, and Translation: Shloka - अथातो ज्वरचिकित्सितं व्याख्यास्यामः||१|| इति ह स्माह भगवानात्रेयः||२|| Transliteration – athātō jwaracikitsitaṁ vyākhyāsyāmaḥ||1|| iti ha smāha bhagavānātrēyaḥ||2|| athAto jwaracikitsitaM vyAkhyAsyAmaH||1|| iti ha smAha bhagavAnAtreyaH||2|| Translation in English – We shall now explain the chapter on the treatment of jwara (different types of fever). Thus told by lord Atreya [1-2] Shloka - विज्वरं ज्वरसन्देहं पर्यपृच्छत् पुनर्वसुम्| विविक्ते शान्तमासीनमग्निवेशः कृताञ्जलिः||३|| देहेन्द्रियमनस्तापी सर्वरोगाग्रजो बली| ज्वरः प्रधानो रोगाणामुक्तो भगवता पुरा||४|| तस्य प्राणिसपत्नस्य ध्रुवस्य प्रलयोदये| प्रकृतिं च प्रवृत्तिं च प्रभावं कारणानि च||५|| पूर्वरूपमधिष्ठानं बलकालात्मलक्षणम्| व्यासतो विधिभेदाच्च [२] पृथग्भिन्नस्य चाकृतिम्||६|| लिङ्गमामस्य जीर्णस्य सौषधं च क्रियाक्रमम्| विमुञ्चतः प्रशान्तस्य चिह्नं यच्च पृथक् पृथक्||७|| ज्वरावसृष्टो रक्ष्यश्च यावत्कालं यतो यतः| प्रशान्तः कारणैर्यैश्च पुनरावर्तते ज्वरः||८|| याश्चापि पुनरावृत्तं क्रियाः प्रशमयन्ति तम्| जगद्धितार्थं तत् सर्वं भगवन्! वक्तुमर्हसि||९|| तदग्निवेशस्य वचो निशम्य गुरुरब्रवीत्| ज्वराधिकारे यद्वाच्यं तत् सौम्य! निखिलं शृणु||१०|| Transliteration – vijwaraṁ jwarasandēhaṁ paryapr̥cchat punarvasum| viviktē śāntamāsīnamagnivēśaḥ kr̥tāñjaliḥ||3|| dēhēndriyamanastāpī sarvarōgāgrajō balī| jwaraḥ pradhānō rōgāṇāmuktō bhagavatā purā||4|| tasya prāṇisapatnasya dhruvasya pralayōdayē| prakr̥tiṁ ca pravr̥ttiṁ ca prabhāvaṁ kāraṇāni ca||5|| pūrvarūpamadhiṣṭhānaṁ balakālātmalakṣaṇam| vyāsatō vidhibhēdācca [2] pr̥thagbhinnasya cākr̥tim||6|| liṅgamāmasya jīrṇasya sauṣadhaṁ ca kriyākramam| vimuñcataḥ praśāntasya cihnaṁ yacca pr̥thak pr̥thak||7|| jvarāvasr̥ṣṭō rakṣyaśca yāvatkālaṁ yatō yataḥ| praśāntaḥ kāraṇairyaiśca punarāvartatē jwaraḥ||8|| yāścāpi punarāvr̥ttaṁ kriyāḥ praśamayanti tam| jagaddhitārthaṁ tat sarvaṁ bhagavan! vaktumarhasi||9|| tadagnivēśasya vacō niśamya gururabravīt| jvarādhikārē yadvācyaṁ tat saumya! nikhilaṁ śr̥ṇu||10||

vijwaraM jwarasandehaM paryapRucchat punarvasum| vivikte shAntamAsInamagniveshaH kRutA~jjaliH||3|| dehendriyamanastApI sarvarogAgrajo balI| jwaraH pradhAno rogANAmukto bhagavatA purA||4|| tasya prANisapatnasya dhruvasya pralayodaye| prakRutiM ca pravRuttiM ca prabhAvaM kAraNAni ca||5|| pUrvarUpamadhiShThAnaM balakAlAtmalakShaNam| vyAsato vidhibhedAcca [2] pRuthagbhinnasya cAkRutim||6|| li~ggamAmasya jIrNasya sauShadhaM ca kriyAkramam| vimu~jcataH prashAntasya cihnaM yacca pRuthak pRuthak||7|| jwaravasRuShTo rakShyashca yAvatkAlaM yato yataH| prashAntaH kAraNairyaishca punarAvartate jwaraH||8|| yAshcApi punarAvRuttaM kriyAH prashamayanti tam| jagaddhitArthaM tat sarvaM bhagavan! vaktumarhasi||9|| tadagniveshasya vaco nishamya gururabravIt| jwaradhikAre yadvAcyaM tat saumya! nikhilaM shRuNu||10||

Translation in English – Punarvasu, who was free from all types of diseases (jwara) and was having complete peace of mind, was sitting in a lonely place; where Agnivesha approached him with folded hands regarding his queries about jwara. 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 – • Prakrti or the nature of the disease • Pravritti or origin of the disease • Prabhava, the manifestation of the disease • Karana or the causative factors • Purvarupa or the premonitory signs and symptoms • Adhisthana or place of manifestation • Bala kala or its power and the time of manifestation • Atma laksana or clinical features which are invariably associated with this disease (Cardinal features) • Details of classification (vidhi bheda) • Signs and symptoms of each type of the disease • Sign and symptoms of ama jwara i.e. primary stage of the disease • Sign and symptoms of jirna jwara i.e. chronic Stage • Drugs for the treatment of the disease • various therapeutic procedures • Signs and symptoms that are manifested when the fever is getting cured, or when it is alleviated – both separately • The duration for which the patient who has become free from a disease has to avoid certain regimens and the reasons for that • The reasons for the reattack of the fever after it has subsided • The therapies which should be administered in order to alleviate this reattack of this fever; After hearing this statement of Agnivesa, the preceptor replied: “ all these will be explained in this chapter on the description of fever. Oh benevolent one, listen to the details.” Shloka - ज्वरो विकारो रोगश्च व्याधिरातङ्क एव च| एकोऽर्थो [१] नामपर्यायैर्विविधैरभिधीयते||११|| Transliteration – jvarō vikārō rōgaśca vyādhirātaṅka ēva ca| ēkō'rthō [1] nāmaparyāyairvividhairabhidhīyatē||11|| jvaro vikAro rogashca vyAdhirAta~gka eva ca| eko~artho [1] nAmaparyAyairvividhairabhidhIyate||11|| Translation in English – Jwara, vikara, roga, vyadhi and atanka – these terms are synonymous and used to indicate this condition. Shloka - तस्य प्रकृतिरुद्दिष्टा दोषाः शारीरमानसाः| देहिनं न हि निर्दोषं ज्वरः समुपसेवते||१२|| क्षयस्तमो ज्वरः पाप्मा मृत्युश्चोक्ता [१] यमात्मकाः| पञ्चत्वप्रत्ययान्नॄणां क्लिश्यतां स्वेन कर्मणा||१३|| इत्यस्य प्रकृतिः प्रोक्ता, ...|१४| Transliteration – tasya prakr̥tiruddiṣṭā dōṣāḥ śārīramānasāḥ| dēhinaṁ na hi nirdōṣaṁ jwaraḥ samupasēvatē||12|| kṣayastamō jwaraḥ pāpmā mr̥tyuścōktā [1] yamātmakāḥ| pañcatvapratyayānnr̥̄ṇāṁ kliśyatāṁ svēna karmaṇā||13|| ityasya prakr̥tiḥ prōktā, ...|14|

tasya prakRutiruddiShTA doShAH shArIramAnasAH| dehinaM na hi nirdoShaM jwaraH samupasevate||12|| kShayastamo jwaraH pApmA mRutyushcoktA [1] yamAtmakAH| pa~jcatvapratyayAnnRUNAM klishyatAM svena karmaNA||13|| ityasya prakRutiH proktA, ...|14| Translation in English – The three physical dośās and the two mānasika dośās are the factors responsible for the manifestation of jwara (prakriti) as jwara cannot originate in a person having the balance of these three dosa (nirdosa – in the state of homeostasis). Therefore, these śāririka and mānasika dośas are the prakriti of jwara. Karshya (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 cause of death (pancatva) in individuals suffering from various grievances, due to their own deeds and hence have been accepted as equivalent to Yama (death lord). In this way the prakṛṭī (basic nature) of jwara has been described. Shloka - ... प्रवृत्तिस्तु परिग्रहात्| निदाने पूर्वमुद्दिष्टा रुद्रकोपाच्च दारुणात्||१४|| द्वितीये हि युगे शर्वमक्रोधव्रतमास्थितम्| दिव्यं सहस्रं वर्षाणामसुरा अभिदुद्रुवुः||१५|| तपोविघ्नाशनाः कर्तुं [३] तपोविघ्नं महात्मनः| पश्यन् समर्थश्चोपेक्षां चक्रे दक्षः प्रजापतिः||१६|| पुनर्माहेश्वरं भागं ध्रुवं दक्षः प्रजापतिः| यज्ञे न कल्पयामास प्रोच्यमानः सुरैरपि||१७|| ऋचः पशुपतेर्याश्च शैव्य आहतयश्च याः| यज्ञसिद्धिप्रदास्ताभिर्हीनं चैव स इष्टवान्||१८|| अथोत्तीर्णव्रतो देवो बुद्ध्वा दक्षव्यतिक्रमम्| रुद्रो रौद्रं पुरस्कृत्य भावमात्मविदात्मनः||१९|| सृष्ट्वा [४] ललाटे चक्षुर्वै दग्ध्वा तानसुरान् प्रभुः| बालं क्रोधाग्निसन्तप्तमसृजत् सत्रनाशनम्||२०|| ततो यज्ञः स विध्वस्तो व्यथिताश्च दिवौकसः| दाहव्यथापरीताश्च भ्रान्ता भूतगणा दिशः||२१|| अथेश्वरं देवगणः सह सप्तर्षिभिर्विभुम्| तमृग्भिरस्तुवन् यावच्छैवे भावे शिवः स्थितः||२२|| शिवं शिवाय भूतानां स्थितं ज्ञात्वा कृताञ्जलिः| भिया भस्मप्रहरणस्त्रिशिरा नवलोचनः||२३|| ज्वालामालाकुलो रौद्रो ह्रस्वजङ्घोदरः क्रमात्| क्रोधाग्निरुक्तवान् देवमहं किं करवाणि ते||२४|| तमुवाचेश्वरः क्रोधं ज्वरो लोके भविष्यसि| जन्मादौ निधने च त्वमपचारान्तरेषु च||२५|| Transliteration –

... pravr̥ttistu parigrahāt| nidānē pūrvamuddiṣṭā rudrakōpācca dāruṇāt||14|| dvitīyē hi yugē śarvamakrōdhavratamāsthitam| divyaṁ sahasraṁ varṣāṇāmasurā abhidudruvuḥ||15|| tapōvighnāśanāḥ kartuṁ [3] tapōvighnaṁ mahātmanaḥ| paśyan samarthaścōpēkṣāṁ cakrē dakṣaḥ prajāpatiḥ||16|| punarmāhēśvaraṁ bhāgaṁ dhruvaṁ dakṣaḥ prajāpatiḥ| yajñē na kalpayāmāsa prōcyamānaḥ surairapi||17|| r̥caḥ paśupatēryāśca śaivya āhatayaśca yāḥ| yajñasiddhipradāstābhirhīnaṁ caiva sa iṣṭavān||18|| athōttīrṇavratō dēvō buddhvā dakṣavyatikramam| rudrō raudraṁ puraskr̥tya bhāvamātmavidātmanaḥ||19|| sr̥ṣṭvā [4] lalāṭē cakṣurvai dagdhvā tānasurān prabhuḥ| bālaṁ krōdhāgnisantaptamasr̥jat satranāśanam||20|| tatō yajñaḥ sa vidhvastō vyathitāśca divaukasaḥ| dāhavyathāparītāśca bhrāntā bhūtagaṇā diśaḥ||21|| athēśvaraṁ dēvagaṇaḥ saha saptarṣibhirvibhum| tamr̥gbhirastuvan yāvacchaivē bhāvē śivaḥ sthitaḥ||22|| śivaṁ śivāya bhūtānāṁ sthitaṁ jñātvā kr̥tāñjaliḥ| bhiyā bhasmapraharaṇastriśirā navalōcanaḥ||23|| jvālāmālākulō raudrō hrasvajaṅghōdaraḥ kramāt| krōdhāgniruktavān dēvamahaṁ kiṁ karavāṇi tē||24|| tamuvācēśvaraḥ krōdhaṁ jvarō lōkē bhaviṣyasi| janmādau nidhanē ca tvamapacārāntarēṣu ca||25||

... pravRuttistu parigrahAt| nidAne pUrvamuddiShTA rudrakopAcca dAruNAt||14|| dvitIye hi yuge sharvamakrodhavratamAsthitam| divyaM sahasraM varShANAmasurA abhidudruvuH||15|| tapovighnAshanAH kartuM [3] tapovighnaM mahAtmanaH| pashyan samarthashcopekShAM cakre dakShaH prajApatiH||16|| punarmAheshvaraM bhAgaM dhruvaM dakShaH prajApatiH| yaj~je na kalpayAmAsa procyamAnaH surairapi||17|| RucaH pashupateryAshca shaivya Ahatayashca yAH| yaj~jasiddhipradAstAbhirhInaM caiva sa iShTavAn||18|| athottIrNavrato devo buddhvA dakShavyatikramam| rudro raudraM puraskRutya bhAvamAtmavidAtmanaH||19|| sRuShTvA [4] lalATe cakShurvai dagdhvA tAnasurAn prabhuH| bAlaM krodhAgnisantaptamasRujat satranAshanam||20|| tato yaj~jaH sa vidhvasto vyathitAshca divaukasaH| dAhavyathAparItAshca bhrAntA bhUtagaNA dishaH||21|| atheshvaraM devagaNaH saha saptarShibhirvibhum| tamRugbhirastuvan yAvacchaive bhAve shivaH sthitaH||22|| shivaM shivAya bhUtAnAM sthitaM j~jAtvA kRutA~jjaliH| bhiyA bhasmapraharaNastrishirA navalocanaH||23|| jvAlAmAlAkulo raudro hrasvaja~gghodaraH kramAt| krodhAgniruktavAn devamahaM kiM karavANi te||24|| tamuvAceshvaraH krodhaM jvaro loke bhaviShyasi| janmAdau nidhane ca tvamapacArAntareShu ca||25|| Translation in English – The origin of jwara is because of the tendency for greed or attachment (parigraha). It has been described earlier in the nidāna section that the origin of jwara resulted from the ferocious wrath of Rudra (lord Shiva). During the Treta yuga (second age) lord Shiva took a vow of not manifesting anger or wrath for one thousand celestial years. During this time the asuras (the demons) indulged in the creating obstruction, playing mischieves and destroying the sacrament and the meditation of the ṛśīs (sages). Daksa Prajapati was capable of combating these demons but he ignored his duties of opposing those demons and further organised a Yajna (ritual of sacrifice) in which he did not offer any share to lord Śiva inspite of being told to do so by the other lords. He even did not chant the hymns (richa) described in the veda of lord Siva which provide fulfilment to the desired objective of yajṅa and even did not offer āhūtī (pouring of ghī in the sacrificial fire) to lord Siva. Lord Siva percieved whole of this situation regarding Daksa Prajapati ‘s non observance of rules and became angry. He then brought forward his Raudra (wrathful) bhava (nature) and opened his third eye, destroying all those demons by burning them and further gave rise to a child like form named ‘Virabhadra’ to his wrath, who was stuffed with his anger and was capable of destroying the yajna of Daksa. That child demolished the yajña of daksa Prajapati as a result of which the gods got afflicted with burning sensation and pain and started running in different directions and became afflicted. Then the gods along with the seven ṛśīs offered those substantial hymns to lord Śiva till he became pleased and switched over to his Śiva (the compassionate or benevolent and auspicious) form. When it was known that lord Śiva is returned to his auspicious disposition, then Virabhadra who was produced from the wrathful fire of lord Śiva, who had three heads and nine eyes, used ash as his weapon, had the flame of his fire as his garland, was wrathful, had frightful and small thighs and stomach approached lord Śiva with folded hands and enquired about his future work. Lord Śiva replied to him that “ you will become jwara in this world and afflict people in the beginning of life – at birth and at the time of death and will also afflict those who will resort to erratic regimen.”

 Shloka  - 

सन्तापः सारुचिस्तृष्णा साङ्गमर्दो हृदि व्यथा| ज्वरप्रभावो, जन्मादौ निधने च महत्तमः||२६|| प्रकृतिश्च प्रवृत्तिश्च प्रभावश्च प्रदर्शितः|२७| Transliteration – santāpaḥ sārucistr̥ṣṇā sāṅgamardō hr̥di vyathā| jwaraprabhāvō, janmādau nidhanē ca mahattamaḥ||26|| prakr̥tiśca pravr̥ttiśca prabhāvaśca pradarśitaḥ|27|

santApaH sArucistRuShNA sA~ggamardo hRudi vyathA| jwaraprabhAvo, janmAdau nidhane ca mahattamaH||26|| prakRutishca pravRuttishca prabhAvashca pradarshitaH|27| Translation in English – Santapa (raised temperature), aruchi (anorexia), trishna (morbid thirst), angamarda (body ache), hrid vyatha (pain in the cardiac region) – these are the invariable manifestations of jwara. The manifestation of jwara is manifested in the form of tamas (feeling of entry into darkness) at the time of beginning of birth and during death. In this way the prakriti (nature), pravritti (origin) and the prabhava (invariable manifestations) of jwara are described. Shloka - निदाने कारणान्यष्टौ पूर्वोक्तानि [२] विभागशः||२७|| Transliteration – nidānē kāraṇānyaṣṭau pūrvōktāni [2] vibhāgaśaḥ||27||

nidAne kAraNAnyaShTau pUrvoktAni [2] vibhAgashaH||27|| Translation in English – Earlier in the Nidana Sthana the etiological factors for each of the eight varieties of jwara have been described separately. Shloka - आलस्यं नयने सास्रे जृम्भणं गौरवं क्रमः| ज्वलनातपवाय्वम्बुभक्तिद्वेषावनिश्चितौ||२८|| अविपाकास्यवैरस्ये हानिश्च बलवर्णयोः| शीलवैकृतमल्पं च ज्वरलक्षणमग्रजम्||२९|| Transliteration – ālasyaṁ nayanē sāsrē jr̥mbhaṇaṁ gauravaṁ kramaḥ| jvalanātapavāyvambubhaktidvēṣāvaniścitau||28|| avipākāsyavairasyē hāniśca balavarṇayōḥ| śīlavaikr̥tamalpaṁ ca jwaralakṣaṇamagrajam||29||

AlasyaM nayane sAsre jRumbhaNaM gauravaM kramaH| jvalanAtapavAyvambubhaktidveShAvanishcitau||28|| avipAkAsyavairasye hAnishca balavarNayoH| shIlavaikRutamalpaM ca jwaralakShaNamagrajam||29|| Premonitory symptoms of Jwara – Laziness, lacrymation, yawning, heaviness, mental fatigue, uncertainity and intolerance about the liking and disliking for the heat, sun, wind and water; indigestion, anorexia, depletion in strength, complexion, and slight change in conduct, are the premonitory signs and symptoms of jwara. Shloka - केवलं समनस्कं च ज्वराधिष्ठानमुच्यते| शरीरं, बलकालस्तु निदाने सम्प्रदर्शितः||३०|| Transliteration – kēvalaṁ samanaskaṁ ca jvarādhiṣṭhānamucyatē| śarīraṁ, balakālastu nidānē sampradarśitaḥ||30||

kevalaM samanaskaM ca jwaradhiShThAnamucyate| sharIraM, balakAlastu nidAne sampradarshitaH||30||

Sites of Jwara – The whole body and the mind are the sites of manifestation of jwara. The strength and the time of manifestation of jwara have been described in Nidana sthana. Shloka - ज्वरप्रत्यात्मिकं लिङ्गं सन्तापो देहमानसः| ज्वरेणाविशता भूतं न हि किञ्चिन्न तप्यते||३१|| Transliteration – jwarapratyātmikaṁ liṅgaṁ santāpō dēhamānasaḥ| jvarēṇāviśatā bhūtaṁ na hi kiñcinna tapyatē||31||

jwarapratyAtmikaM li~ggaM santApo dehamAnasaH| jvareNAvishatA bhUtaM na hi ki~jcinna tapyate||31||

Translation in English – The clinical features invariably associated with jwara are the increased body temperature and discomfort in body and mind. Jwara afflicts the whole body including mind and sensory organs in all living beings. Shloka - द्विविधो विधिभेदेन ज्वरः शारीरमानसः| पुनश्च द्विविधो दृष्टः सौम्यश्चाग्नेय एव वा||३२|| अन्तर्वेगो बहिर्वेगो द्विविधः पुनरुच्यते| प्राकृतो वैकृतश्चैव साध्यश्चासाध्य एव च||३३|| पुनः पञ्चविधो दृष्टो दोषकालबलाबलात्| सन्ततः सततोऽन्येद्युस्तृतीयकचतुर्थकौ||३४|| पुनराश्रयभेदेन धातूनां सप्तधा मतः| भिन्नः कारणभेदेन पुनरष्टविधो ज्वरः||३५|| Transliteration – dvividhō vidhibhēdēna jwaraḥ śārīramānasaḥ| punaśca dvividhō dr̥ṣṭaḥ saumyaścāgnēya ēva vā||32|| antarvēgō bahirvēgō dvividhaḥ punarucyatē| prākr̥tō vaikr̥taścaiva sādhyaścāsādhya ēva ca||33|| punaḥ pañcavidhō dr̥ṣṭō dōṣakālabalābalāt| santataḥ satatō'nyēdyustr̥tīyakacaturthakau||34|| punarāśrayabhēdēna dhātūnāṁ saptadhā mataḥ| bhinnaḥ kāraṇabhēdēna punaraṣṭavidhō jwaraḥ||35||

dvividho vidhibhedena jwaraH shArIramAnasaH| punashca dvividho dRuShTaH saumyashcAgneya eva vA||32|| antarvego bahirvego dvividhaH punarucyate| prAkRuto vaikRutashcaiva sAdhyashcAsAdhya eva ca||33|| punaH pa~jcavidho dRuShTo doShakAlabalAbalAt| santataH satato~anyedyustRutIyakacaturthakau||34|| punarAshrayabhedena dhAtUnAM saptadhA mataH| bhinnaH kAraNabhedena punaraShTavidho jwaraH||35||

Classifications – Jwara is classified into two types each on the basis of the following criterias – • Sarira (physical) and manasa (mental) • Saumya (predominated by cold) and agneya (predominated by heat) • Antarvega ( internal ) and bahirvega (external) • prakrita (according to seasons) and vaikrita ( unseasonal) • sadhya (curable) and asadhya ( incurable) Jwara is again classified into five categories depending upon the strength and weakness of dosa and the time. These are intermittent in nature: 1. Santata 2. Satata 3. Anyeduśka 4. Tṛitiyaka 5. Caturthaka. Depending upon the ashraya (site of manifestation in the body) among the seven dhatu (body tissues) jwara is again classified into seven categories. Jwara is classified into eight types on the basis of eight causes of jwara (dosa predominance). Shloka - शारीरो जायते पूर्वं देहे, मनसि मानसः| वैचित्त्यमरतिर्ग्लानिर्मनसस्तापलक्षणम्||३६|| इन्द्रियाणां च वैकृत्यं ज्ञेयं [१] सन्तापलक्षणम्|३७| वातपित्तात्मकः शीतमुष्णं वातकफात्मकः||३७|| इच्छत्युभयमेतत्तु ज्वरो व्यामिश्रलक्षणः|३८| Transliteration – śārīrō jāyatē pūrvaṁ dēhē, manasi mānasaḥ| vaicittyamaratirglānirmanasastāpalakṣaṇam||36|| indriyāṇāṁ ca vaikr̥tyaṁ jñēyaṁ [1] santāpalakṣaṇam|37| vātapittātmakaḥ śītamuṣṇaṁ vātakaphātmakaḥ||37|| icchatyubhayamētattu jvarō vyāmiśralakṣaṇaḥ|38|

shArIro jAyate pUrvaM dehe, manasi mAnasaH| vaicittyamaratirglAnirmanasastApalakShaNam||36|| indriyANAM ca vaikRutyaM j~jeyaM [1] santApalakShaNam|37| vAtapittAtmakaH shItamuShNaM vAtakaphAtmakaH||37|| icchatyubhayametattu jvaro vyAmishralakShaNaH|38|

Translation in English – The sarira type of jwara first appears in the body and the manasa type of first appears in the mind. Vaicitya (mental unstability), 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. A patient suffering from vatapittaja vareity of jwara desires for cold things, while, a patient suffering from jwara caused by vata and kapha dosa longs for hot things. However, when both of these types of dośās get mixed then such patient manifests both the kinds of symptoms. Shloka - योगवाहः परं वायुः संयोगादुभयार्थकृत्||३८|| दाहकृत्तेजसा युक्तः, शीतकृत् सोमसंश्रयात्|३९| अन्तर्दाहोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||३९|| सन्ध्यस्थिशूलमस्वेदो दोषवर्चोविनिग्रहः| अन्तर्वेगस्य लिङ्गानि ज्वरस्यैतानि लक्षयेत्||४०|| सन्तापोऽभ्यधिको बाह्यस्तृष्णादीनां च मार्दवम्| बहिर्वेगस्य लिङ्गानि सुखसाध्यत्वमेव च||४१||

Transliteration – yōgavāhaḥ paraṁ vāyuḥ saṁyōgādubhayārthakr̥t||38|| dāhakr̥ttējasā yuktaḥ, śītakr̥t sōmasaṁśrayāt|39|

antardāhō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||39|| sandhyasthiśūlamasvēdō dōṣavarcōvinigrahaḥ| antarvēgasya liṅgāni jwarasyaitāni lakṣayēt||40|| santāpō'bhyadhikō bāhyastr̥ṣṇādīnāṁ ca mārdavam| bahirvēgasya liṅgāni sukhasādhyatvamēva ca||41||

yogavAhaH paraM vAyuH saMyogAdubhayArthakRut||38|| dAhakRuttejasA yuktaH, shItakRut somasaMshrayAt|39| antardAho~adhikastRuShNA pralApaH shvasanaM bhramaH||39|| sandhyasthishUlamasvedo doShavarcovinigrahaH| antarvegasya li~ggAni jwarasyaitAni lakShayet||40|| santApo~abhyadhiko bAhyastRuShNAdInAM ca mArdavam| bahirvegasya li~ggAni sukhasAdhyatvameva ca||41|| Translation in English – Vata dosa is exceedingly yogavahi (which accentuates the properties of others) in nature. It produces both the type of effects on combination with the two dośās. On combining with tejas it produces burning sensation while in combination with soma it produces cooling effect. Antarvega(internal) and Bahirvega(external) Jwara – Excessive burning sensation inside the body, thirst, delirium, delirious speech, dyspnoea, giddiness, pain in bones and joints, absence of sweating, non excretion of dośās and the faeces – are the clinical features of antarvegī jwara (internal kind of jwara). Excessive rise in the body temperature and less of thirst etc. are the features of bahirvegi (external type of jwara) and this type of jwara is easily curable. Shloka - प्राकृतः सुखसाध्यस्तु वसन्तशरदुद्भवः| उष्णमुष्णेन संवृद्धं पित्तं शरदि कुप्यति||४२|| चितः शीते कफश्चैवं वसन्ते समुदीर्यते| वर्षास्वम्लविपाकाभिरद्भिरोषधिभिस्तथा||४३|| सञ्चितं पित्तमुद्रिक्तं [१] शरद्यादित्यतेजसा| ज्वरं सञ्जनयत्याशु तस्य चानुबलः कफः||४४|| प्रकृत्यैव [२] विसर्गस्य तत्र नानशनाद्भयम्| अद्भिरोषधिभिश्चैव मधुराभिश्चितः कफः||४५|| हेमन्ते, सूर्यसन्तप्तः स वसन्ते प्रकुप्यति| वसन्ते श्लेष्मणा तस्माज्ज्वरः समुपजायते||४६|| आदानमध्ये तस्यापि वातपित्तं भवेदनु|४७| आदावन्ते च मध्ये च बुद्ध्वा दोषबलाबलम्||४७|| शरद्वसन्तयोर्विद्वाञ्ज्वरस्य प्रतिकारयेत्|४८| कालप्रकृतिमुद्दिश्य निर्दिष्टः प्राकृतो ज्वरः||४८|| प्रायेणानिलजो दुःखः कालेष्वन्येषु वैकृतः| हेतवो विविधास्तस्य निदाने सम्प्रदर्शिताः||४९|| Transliteration – prākr̥taḥ sukhasādhyastu vasantaśaradudbhavaḥ| uṣṇamuṣṇēna saṁvr̥ddhaṁ pittaṁ śaradi kupyati||42|| citaḥ śītē kaphaścaivaṁ vasantē samudīryatē| varṣāsvamlavipākābhiradbhirōṣadhibhistathā||43|| sañcitaṁ pittamudriktaṁ [1] śaradyādityatējasā| jwaraṁ sañjanayatyāśu tasya cānubalaḥ kaphaḥ||44|| prakr̥tyaiva [2] visargasya tatra nānaśanādbhayam| adbhirōṣadhibhiścaiva madhurābhiścitaḥ kaphaḥ||45|| hēmantē, sūryasantaptaḥ sa vasantē prakupyati| vasantē ślēṣmaṇā tasmājjwaraḥ samupajāyatē||46|| ādānamadhyē tasyāpi vātapittaṁ bhavēdanu|47| ādāvantē ca madhyē ca buddhvā dōṣabalābalam||47|| śaradvasantayōrvidvāñjwarasya pratikārayēt|48| kālaprakr̥timuddiśya nirdiṣṭaḥ prākr̥tō jwaraḥ||48|| prāyēṇānilajō duḥkhaḥ kālēṣvanyēṣu vaikr̥taḥ| hētavō vividhāstasya nidānē sampradarśitāḥ||49||

prAkRutaH sukhasAdhyastu vasantasharadudbhavaH| uShNamuShNena saMvRuddhaM pittaM sharadi kupyati||42|| citaH shIte kaphashcaivaM vasante samudIryate| varShAsvamlavipAkAbhiradbhiroShadhibhistathA||43|| sa~jcitaM pittamudriktaM [1] sharadyAdityatejasA| jwaraM sa~jjanayatyAshu tasya cAnubalaH kaphaH||44|| prakRutyaiva [2] visargasya tatra nAnashanAdbhayam| adbhiroShadhibhishcaiva madhurAbhishcitaH kaphaH||45|| hemante, sUryasantaptaH sa vasante prakupyati| vasante shleShmaNA tasmAjjwaraH samupajAyate||46|| AdAnamadhye tasyApi vAtapittaM bhavedanu|47| AdAvante ca madhye ca buddhvA doShabalAbalam||47|| sharadvasantayorvidvA~jjwarasya pratikArayet|48| kAlaprakRutimuddishya nirdiShTaH prAkRuto jwaraH||48|| prAyeNAnilajo duHkhaH kAleShvanyeShu vaikRutaH| hetavo vividhAstasya nidAne sampradarshitAH||49||

Translation in English – Prakrita jwara – Jwara manifesting in the vasanta or spring season and śarata or autumn season is called prakrita (seasonal) jwara and is easily curable. Pitta gets aggravated during autumn season because of hot things, due to its hot nature. 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 dośa 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 (the first part of 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 vāta and pitta dohśa constitute the secondary associates. A patient of jwara should be treated keeping in view the strength of the dośhās 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 – Generally, the jwara caused by vata dosa 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 irrespectable of its season of occurrence • paitika jwara occurring in seasons other than autumn and • kaphaja jwara occurring in seasons other than spring. The causative factors of the different types of jwara have been described in nidana sthana (in jwara). Shloka - बलवत्स्वल्पदोषेषु ज्वरः साध्योऽनुपद्रवः| हेतुभिर्बहुभिर्जातो बलिभिर्बहुलक्षणः||५०|| ज्वरः प्राणान्तकृद्यश्च शीघ्रमिन्द्रियनाशनः|५१| सप्ताहाद्वा दशाहाद्वा द्वादशाहात्तथैव च||५१|| सप्रलापभ्रमश्वासस्तीक्ष्णो हन्याज्ज्वरो नरम्|५२| ज्वरः क्षीणस्य शूनस्य गम्भीरो दैर्घरात्रिकः||५२|| असाध्यो बलवान् यश्च केशसीमन्तकृज्ज्वरः|५३| स्रोतोभिर्विसृता दोषा गुरवो रसवाहिभिः||५३|| सर्वदेहानुगाः स्तब्धा ज्वरं कुर्वन्ति सन्ततम्| दशाहं द्वादशाहं वा सप्ताहं वा सुदुःसहः||५४|| स शीघ्रं शीघ्रकारित्वात् प्रशमं याति हन्ति वा| कालदूष्यप्रकृतिभिर्दोषस्तुल्यो हि सन्ततम्||५५|| निष्प्रत्यनीकः कुरुते तस्माज्ज्ञेयः सुदुःसहः| यथा धातूंस्तथा [५] मूत्रं पुरीषं चानिलादयः||५६|| युगपच्चानुपद्यन्ते नियमात् [६] सन्तते ज्वरे| स शुद्ध्या वाऽप्यशुद्ध्या वा रसादीनामशेषतः||५७|| सप्ताहादिषु कालेषु प्रशमं याति हन्ति वा| यदा तु नातिशुध्यन्ति न वा शुध्यन्ति सर्वशः||५८|| द्वादशैते समुद्दिष्टाः सन्ततस्याश्रयास्तदा| विसर्गं द्वादशे कृत्वा दिवसेऽव्यक्तलक्षणम्||५९|| दुर्लभोपशमः कालं दीर्घमप्यनुवर्तते| इति बुद्ध्वा ज्वरं वैद्य उपक्रामेत्तु सन्ततम् [७] ||६०|| क्रियाक्रमविधौ युक्तः प्रायः प्रागपतर्पणैः|६१| Transliteration – balavatsvalpadōṣēṣu jwaraḥ sādhyō'nupadravaḥ| hētubhirbahubhirjātō balibhirbahulakṣaṇaḥ||50|| jwaraḥ prāṇāntakr̥dyaśca śīghramindriyanāśanaḥ|51| saptāhādvā daśāhādvā dvādaśāhāttathaiva ca||51|| sapralāpabhramaśvāsastīkṣṇō hanyājjvarō naram|52| jwaraḥ kṣīṇasya śūnasya gambhīrō dairgharātrikaḥ||52|| asādhyō balavān yaśca kēśasīmantakr̥jjwaraḥ|53| srōtōbhirvisr̥tā dōṣā guravō rasavāhibhiḥ||53|| sarvadēhānugāḥ stabdhā jwaraṁ kurvanti santatam| daśāhaṁ dvādaśāhaṁ vā saptāhaṁ vā suduḥsahaḥ||54|| sa śīghraṁ śīghrakāritvāt praśamaṁ yāti hanti vā| kāladūṣyaprakr̥tibhirdōṣastulyō hi santatam||55|| niṣpratyanīkaḥ kurutē tasmājjñēyaḥ suduḥsahaḥ| yathā dhātūṁstathā [5] mūtraṁ purīṣaṁ cānilādayaḥ||56|| yugapaccānupadyantē niyamāt [6] santatē jvarē| sa śuddhyā vā'pyaśuddhyā vā rasādīnāmaśēṣataḥ||57|| saptāhādiṣu kālēṣu praśamaṁ yāti hanti vā| yadā tu nātiśudhyanti na vā śudhyanti sarvaśaḥ||58|| dvādaśaitē samuddiṣṭāḥ santatasyāśrayāstadā| visargaṁ dvādaśē kr̥tvā divasē'vyaktalakṣaṇam||59|| durlabhōpaśamaḥ kālaṁ dīrghamapyanuvartatē| iti buddhvā jwaraṁ vaidya upakrāmēttu santatam [7] ||60|| kriyākramavidhau yuktaḥ prāyaḥ prāgapatarpaṇaiḥ|61|

balavatsvalpadoSheShu jwaraH sAdhyo~anupadravaH| hetubhirbahubhirjAto balibhirbahulakShaNaH||50|| jwaraH prANAntakRudyashca shIghramindriyanAshanaH|51| saptAhAdvA dashAhAdvA dvAdashAhAttathaiva ca||51|| sapralApabhramashvAsastIkShNo hanyAjjvaro naram|52| jwaraH kShINasya shUnasya gambhIro dairgharAtrikaH||52|| asAdhyo balavAn yashca keshasImantakRujjwaraH|53| srotobhirvisRutA doShA guravo rasavAhibhiH||53|| sarvadehAnugAH stabdhA jwaraM kurvanti santatam| dashAhaM dvAdashAhaM vA saptAhaM vA suduHsahaH||54|| sa shIghraM shIghrakAritvAt prashamaM yAti hanti vA| kAladUShyaprakRutibhirdoShastulyo hi santatam||55|| niShpratyanIkaH kurute tasmAjj~jeyaH suduHsahaH| yathA dhAtUMstathA [5] mUtraM purIShaM cAnilAdayaH||56|| yugapaccAnupadyante niyamAt [6] santate jvare| sa shuddhyA vA~apyashuddhyA vA rasAdInAmasheShataH||57|| saptAhAdiShu kAleShu prashamaM yAti hanti vA| yadA tu nAtishudhyanti na vA shudhyanti sarvashaH||58|| dvAdashaite samuddiShTAH santatasyAshrayAstadA| visargaM dvAdashe kRutvA divase~avyaktalakShaNam||59|| durlabhopashamaH kAlaM dIrghamapyanuvartate| iti buddhvA jwaraM vaidya upakrAmettu santatam [7] ||60|| kriyAkramavidhau yuktaH prAyaH prAgapatarpaNaiH|61|

Sadhya (curable) jwara – 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 dośhās and if there are no complications. Asadhya (incurable) jwara – Jwara having the following characteristics are incurable and lead to death – • Which is caused by either greater amount of / strong aetiological factors • Which manifests with many clinical features • Which destroys the sense organs immediately. Bad prognosis – Acute fever (tiksna jwara) associated with Incoherent speech, giddiness and breathlessness causes death of the patient either on the seventh, tenth or twelth day. Jwara occurring in a weak and emaciated person (kshina), associated with edema (shunasya), seated in deeper body tissues (gambhira), high grade fevers (balvan) and that occurring for very long durations (dirgha ratrika) are incurable ones. The jwara in which, the hair part to produce a straight parting on the head are also considered incurable (kesa simanta krita). Santata jwara – The aggravated dosha circulate through the channels carrying rasa (the first nutritional dhatu equivalent to plasma) and spread allover 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 of fever the patient either gets cured (on the pacification of dosa) or killed (on the further aggravation of dosa) on the 10th, 12th or 7th day. The dosha involved in the the manifestation of santata jwara is in accordance with season (kala), dhatu (dusya), and the physical constitution of the patient (prakriti) due to which it is nispratyanika (having no opponent / which can’t be inhibited). Thus, it is known to be unbearable. Additionally, the other dhatu and excreta, urine, stool, flatus etc. 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. Shloka - रक्तधात्वाश्रयः प्रायो दोषः सततकं ज्वरम्||६१|| सप्रत्यनीकः कुरुते कालवृद्धिक्षयात्मकम्| अहोरात्रे सततको द्वौ कालावनुवर्तते||६२|| Transliteration – raktadhātvāśrayaḥ prāyō dōṣaḥ satatakaṁ jwaram||61|| sapratyanīkaḥ kurutē kālavr̥ddhikṣayātmakam| ahōrātrē satatakō dvau kālāvanuvartatē||62|| raktadhAtvAshrayaH prAyo doShaH satatakaM jwaram||61|| sapratyanIkaH kurute kAlavRuddhikShayAtmakam| ahorAtre satatako dvau kAlAvanuvartate||62|| Translation in English – 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 dośha aggravation or subsidence. The dosha in this type of jwara can be counteracted. Shloka - कालप्रकृतिदूष्याणां प्राप्यैवान्यतमाद्बलम्| अन्येद्युष्कं ज्वरं दोषो रुद्ध्वा मेदोवहाः सिराः||६३|| सप्रत्यनीको जनयत्येककालमहर्निशि| दोषोऽस्थिमज्जगः कुर्यात्तृतीयकचतुर्थकौ||६४|| गतिर्द्व्येकान्तराऽन्येद्युर्दोषस्योक्ताऽन्यथा [१] परैः| अन्येद्युष्कं ज्वरं कुर्यादपि संश्रित्य शोणितम्||६५|| मांसस्रोतांस्यनुगतो जनयेत्तु तृतीयकम्| संश्रितो मेदसो मार्गं दोषश्चापि चतुर्थकम् [२] ||६६|| अन्येद्युष्कः प्रतिदिनं दिनं हित्वा तृतीयकः| दिनद्वयं यो विश्रम्य प्रत्येति स चतुर्थकः||६७|| Transliteration – kālaprakr̥tidūṣyāṇāṁ prāpyaivānyatamādbalam| anyēdyuṣkaṁ jwaraṁ dōṣō ruddhvā mēdōvahāḥ sirāḥ||63|| sapratyanīkō janayatyēkakālamaharniśi| dōṣō'sthimajjagaḥ kuryāttr̥tīyakacaturthakau||64|| gatirdvyēkāntarā'nyēdyurdōṣasyōktā'nyathā [1] paraiḥ| anyēdyuṣkaṁ jwaraṁ kuryādapi saṁśritya śōṇitam||65|| māṁsasrōtāṁsyanugatō janayēttu tr̥tīyakam| saṁśritō mēdasō mārgaṁ dōṣaścāpi caturthakam [2] ||66|| anyēdyuṣkaḥ pratidinaṁ dinaṁ hitvā tr̥tīyakaḥ| dinadvayaṁ yō viśramya pratyēti sa caturthakaḥ||67||

kAlaprakRutidUShyANAM prApyaivAnyatamAdbalam| anyedyuShkaM jwaraM doSho ruddhvA medovahAH sirAH||63|| sapratyanIko janayatyekakAlamaharnishi| doSho~asthimajjagaH kuryAttRutIyakacaturthakau||64|| gatirdvyekAntarA~anyedyurdoShasyoktA~anyathA [1] paraiH| anyedyuShkaM jwaraM kuryAdapi saMshritya shoNitam||65|| mAMsasrotAMsyanugato janayettu tRutIyakam| saMshrito medaso mArgaM doShashcApi caturthakam [2] ||66|| anyedyuShkaH pratidinaM dinaM hitvA tRutIyakaH| dinadvayaM yo vishramya pratyeti sa caturthakaH||67||

Translation in English – Anyedyushka jwara – Dosha produce anyeduṡyaka type of jwara due to support from any one amongst the kala (time), prakriti (physical constitution) and dusya (the body tissues or the dhatu) by causing obstruction in the channel of circulation (sira) of medasa (fat) or medo vahā sirā. It can be counteracted. This fever occurs only once during day and night. Tratiyaka and Chaturthaka jwara – 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 anyedushyaka, 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. Anyedushka jwara occurs every day, while tritiyaka jwara occurs after a gap of one day and chaurthaka occurs after two days gap. Shloka - अधिशेते यथा भूमिं बीजं काले च रोहति| अधिशेते तथा धातुं दोषः काले च कुप्यति||६८|| स वृद्धिं बलकालं च प्राप्य दोषस्तृतीयकम्| चतुर्थकं च कुरुते प्रत्यनीकबलक्षयात्||६९|| कृत्वा वेगं गतबलाः स्वे स्वे स्थाने व्यवस्थिताः| पुनर्विवृद्धाः स्वे काले ज्वरयन्ति नरं मलाः||७०||

कफपित्तात्त्रिकग्राही पृष्ठाद्वातकफात्मकः| वातपित्ताच्छिरोग्राही त्रिविधः स्यात्तृतीयकः||७१|| चतुर्थको दर्शयति प्रभावं द्विविधं ज्वरः| जङ्घाभ्यां श्लैष्मिकः पूर्वं शिरस्तोऽनिलसम्भवः||७२|| Transliteration – adhiśētē yathā bhūmiṁ bījaṁ kālē ca rōhati| adhiśētē tathā dhātuṁ dōṣaḥ kālē ca kupyati||68|| sa vr̥ddhiṁ balakālaṁ ca prāpya dōṣastr̥tīyakam| caturthakaṁ ca kurutē pratyanīkabalakṣayāt||69|| kr̥tvā vēgaṁ gatabalāḥ svē svē sthānē vyavasthitāḥ| punarvivr̥ddhāḥ svē kālē jwarayanti naraṁ malāḥ||70|| kaphapittāttrikagrāhī pr̥ṣṭhādvātakaphātmakaḥ| vātapittācchirōgrāhī trividhaḥ syāttr̥tīyakaḥ||71|| caturthakō darśayati prabhāvaṁ dvividhaṁ jwaraḥ| jaṅghābhyāṁ ślaiṣmikaḥ pūrvaṁ śirastō'nilasambhavaḥ||72||

adhishete yathA bhUmiM bIjaM kAle ca rohati| adhishete tathA dhAtuM doShaH kAle ca kupyati||68|| sa vRuddhiM balakAlaM ca prApya doShastRutIyakam| caturthakaM ca kurute pratyanIkabalakShayAt||69|| kRutvA vegaM gatabalAH sve sve sthAne vyavasthitAH| punarvivRuddhAH sve kAle jwarayanti naraM malAH||70|| kaphapittAttrikagrAhI pRuShThAdvAtakaphAtmakaH| vAtapittAcchirogrAhI trividhaH syAttRutIyakaH||71|| caturthako darshayati prabhAvaM dvividhaM jwaraH| ja~gghAbhyAM shlaiShmikaH pUrvaM shirasto~anilasambhavaH||72||

Translation in English – As a seed remains dormant in the soil till it gets favourable time when it germinates, similarly the dośhās remain inactive in the dhatu and get aggravated on getting suitable time. These dosha gain strength on appropriate time and when the power of the inhibiting factors has subsided, then the tritiyaka and chaturthaka jwara manifest. The dosha lose their strength after manifestating 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 – • When the kapha and pitta dosha are aggravated then it afflicts the Trika Pradesh (Sacral region) • When the vata and kapha dosa are aggravated then the back (prishtha) region are affected • The head region is affected in the case of aggravation of vata and pitta dosa. Similarly Chaturthaka jwara is also of two types – • 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.

Shloka - विषमज्वर एवान्यश्चतुर्थकविपर्ययः| त्रिविधो धातुरेकैको द्विधातुस्थः करोति यम्||७३|| Transliteration – viṣamajwara ēvānyaścaturthakaviparyayaḥ| trividhō dhāturēkaikō dvidhātusthaḥ karōti yam||73|| viShamajwara evAnyashcaturthakaviparyayaH| trividho dhAturekaiko dvidhAtusthaH karoti yam||73||

Translation in English – Chaturthaka viparyaya jwara is another variety of visama 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). Shloka - प्रायशः सन्निपातेन दृष्टः पञ्चविधो ज्वरः| सन्निपाते तु यो भूयान् स दोषः परिकीर्तितः||७४|| Transliteration – prāyaśaḥ sannipātēna dr̥ṣṭaḥ pañcavidhō jwaraḥ| sannipātē tu yō bhūyān sa dōṣaḥ parikīrtitaḥ||74||

prAyashaH sannipAtena dRuShTaH pa~jcavidho jwaraH| sannipAte tu yo bhUyAn sa doShaH parikIrtitaH||74|| Translation in English – These five types of jwara are mostly caused by sannipāta (simultaneous vitiation of the three dosha), however, the dosha, which is predominant amng the three dośhās is generally attributed as the causative factors. Shloka - ऋत्वहोरात्रदोषाणां [१] मनसश्च बलाबलात्| कालमर्थवशाच्चैव ज्वरस्तं तं प्रपद्यते||७५|| गुरुत्वं दैन्यमुद्वेगः सदनं छर्द्यरोचकौ| रसस्थिते बहिस्तापः साङ्गमर्दो विजृम्भणम्||७६|| रक्तोष्णाः पिडकास्तृष्णा सरक्तं ष्ठीवनं मुहुः| दाहरागभ्रममदप्रलापा रक्तसंस्थिते||७७|| अन्तर्दाहः सतृण्मोहः सग्लानिः सृष्टविट्कता| दौर्गन्ध्यं गात्रविक्षेपो ज्वरे मांसस्थिते भवेत्||७८|| स्वेदस्तीव्रा पिपासा च प्रलापो वम्यभीक्ष्णशः| स्वगन्धस्यासहत्वं च मेदःस्थे ग्लान्यरोचकौ||७९|| विरेकवमने चोभे सास्थिभेदं प्रकूजनम्| विक्षेपणं च गात्राणां श्वासश्चास्थिगते ज्वरे||८०|| हिक्का श्वासस्तथा कासस्तमसश्चातिदर्शनम्| मर्मच्छेदो बहिः शैत्यं दाहोऽन्तश्चैव मज्जगे||८१|| शुक्रस्थानगतः शुक्रमोक्षं कृत्वा विनाश्य च| प्राणं वाय्वग्निसोमैश्च सार्धं गच्छत्यसौ विभुः||८२|| रसरक्ताश्रितः साध्यो मेदोमांसगतश्च यः| अस्थिमज्जगतः कृच्छ्रः शुक्रस्थो नैव सिद्ध्यति||८३|| Transliteration – r̥tvahōrātradōṣāṇāṁ [1] manasaśca balābalāt| kālamarthavaśāccaiva jwarastaṁ taṁ prapadyatē||75|| gurutvaṁ dainyamudvēgaḥ sadanaṁ chardyarōcakau| rasasthitē bahistāpaḥ sāṅgamardō vijr̥mbhaṇam||76|| raktōṣṇāḥ piḍakāstr̥ṣṇā saraktaṁ ṣṭhīvanaṁ muhuḥ| dāharāgabhramamadapralāpā raktasaṁsthitē||77|| antardāhaḥ satr̥ṇmōhaḥ saglāniḥ sr̥ṣṭaviṭkatā| daurgandhyaṁ gātravikṣēpō jvarē māṁsasthitē bhavēt||78|| svēdastīvrā pipāsā ca pralāpō vamyabhīkṣṇaśaḥ| svagandhasyāsahatvaṁ ca mēdaḥsthē glānyarōcakau||79|| virēkavamanē cōbhē sāsthibhēdaṁ prakūjanam| vikṣēpaṇaṁ ca gātrāṇāṁ śvāsaścāsthigatē jvarē||80|| hikkā śvāsastathā kāsastamasaścātidarśanam| marmacchēdō bahiḥ śaityaṁ dāhō'ntaścaiva majjagē||81|| śukrasthānagataḥ śukramōkṣaṁ kr̥tvā vināśya ca| prāṇaṁ vāyvagnisōmaiśca sārdhaṁ gacchatyasau vibhuḥ||82|| rasaraktāśritaḥ sādhyō mēdōmāṁsagataśca yaḥ| asthimajjagataḥ kr̥cchraḥ śukrasthō naiva siddhyati||83||

RutvahorAtradoShANAM [1] manasashca balAbalAt| kAlamarthavashAccaiva jwarastaM taM prapadyate||75|| gurutvaM dainyamudvegaH sadanaM chardyarocakau| rasasthite bahistApaH sA~ggamardo vijRumbhaNam||76|| raktoShNAH piDakAstRuShNA saraktaM ShThIvanaM muhuH| dAharAgabhramamadapralApA raktasaMsthite||77|| antardAhaH satRuNmohaH saglAniH sRuShTaviTkatA| daurgandhyaM gAtravikShepo jvare mAMsasthite bhavet||78|| svedastIvrA pipAsA ca pralApo vamyabhIkShNashaH| svagandhasyAsahatvaM ca medaHsthe glAnyarocakau||79|| virekavamane cobhe sAsthibhedaM prakUjanam| vikShepaNaM ca gAtrANAM shvAsashcAsthigate jvare||80|| hikkA shvAsastathA kAsastamasashcAtidarshanam| marmacchedo bahiH shaityaM dAho~antashcaiva majjage||81|| shukrasthAnagataH shukramokShaM kRutvA vinAshya ca| prANaM vAyvagnisomaishca sArdhaM gacchatyasau vibhuH||82|| rasaraktAshritaH sAdhyo medomAMsagatashca yaH| asthimajjagataH kRucchraH shukrastho naiva siddhyati||83|| Translation in English – Manifestation of jwara at a particular time or a change in the time of manifestation takes place due to following factors – Predominance of dosha in external factors like seasons, and day and night, fluctuate temperature according to supporting and opposite effect on internal dosha Other factors responsible for fluctuating temperature and variation of other symptoms are Artha (sensorial objects sensed injudiciously), Karma (misdeeds) done in the present / past life. Manifestation of jwara in the different dhatu (body tissues) – i. 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. ii. The vitiated dośhās causing jwara are located in the rakta dhatu, the clinical features are – Increase in body temperature, erruptions, thirst, frequent spitting mixed with blood burning sensation, discolouration, giddiness, intoxication and incoherent speech. iii. 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 dośhās causing jwara are lodged in the mansa dhatu. iv. 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 ones own body, wet feeling in the body and anorexia. v. 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) throwing movement of the body and limbs. vi. 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. vii. Vitiated dosha causing jwara located in the sukra dhatu cause ejaculation and destruction of śukra resulting in the extinction of life along with vāyū, agnī and soma of the subtle body (sūkṡma śarīra). The jwara in which the dosha are located in the rasa, rakta, mansa 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 śukra dhātu is incurable.

Shloka - हेतुभिर्लक्षणैश्चोक्तः पूर्वमष्टविधो ज्वरः| समासेनोपदिष्टस्य व्यासतः शृणु लक्षणम्||८४|| शिरोरुक् [१] पर्वणां भेदो दाहो रोम्णां प्रहर्षणम्| कण्ठास्यशोषो वमथुस्तृष्णा मूर्च्छा भ्रमोऽरुचिः||८५|| स्वप्ननाशोऽतिवाग्जृम्भा वातपित्तज्वराकृतिः| शीतको गौरवं तन्द्रा स्तैमित्यं पर्वणां च रुक्||८६|| शिरोग्रहः प्रतिश्यायः कासः स्वेदाप्रवर्तनम्| सन्तापो मध्यवेगश्च वातश्लेष्मज्वराकृतिः||८७|| मुहुर्दाहो मुहुः शीतं स्वेदस्तम्भो [२] मुहुर्मुहुः| मोहः कासोऽरुचिस्तृष्णा श्लेष्मपित्तप्रवर्तनम्||८८|| लिप्ततिक्तास्यता तन्द्रा श्लेष्मपित्तज्वराकृतिः| इत्येते द्वन्द्वजाः प्रोक्ताः ...|८९| Transliteration – hētubhirlakṣaṇaiścōktaḥ pūrvamaṣṭavidhō jwaraḥ| samāsēnōpadiṣṭasya vyāsataḥ śr̥ṇu lakṣaṇam||84|| śirōruk [1] parvaṇāṁ bhēdō dāhō rōmṇāṁ praharṣaṇam| kaṇṭhāsyaśōṣō vamathustr̥ṣṇā mūrcchā bhramō'ruciḥ||85|| svapnanāśō'tivāgjr̥mbhā vātapittajvarākr̥tiḥ| śītakō gauravaṁ tandrā staimityaṁ parvaṇāṁ ca ruk||86|| śirōgrahaḥ pratiśyāyaḥ kāsaḥ svēdāpravartanam| santāpō madhyavēgaśca vātaślēṣmajvarākr̥tiḥ||87|| muhurdāhō muhuḥ śītaṁ svēdastambhō [2] muhurmuhuḥ| mōhaḥ kāsō'rucistr̥ṣṇā ślēṣmapittapravartanam||88|| liptatiktāsyatā tandrā ślēṣmapittajvarākr̥tiḥ| ityētē dvandvajāḥ prōktāḥ ...|89|

hetubhirlakShaNaishcoktaH pUrvamaShTavidho jwaraH| samAsenopadiShTasya vyAsataH shRuNu lakShaNam||84|| shiroruk [1] parvaNAM bhedo dAho romNAM praharShaNam| kaNThAsyashoSho vamathustRuShNA mUrcchA bhramo~aruciH||85|| svapnanAsho~ativAgjRumbhA vAtapittajwarakRutiH| shItako gauravaM tandrA staimityaM parvaNAM ca ruk||86|| shirograhaH pratishyAyaH kAsaH svedApravartanam| santApo madhyavegashca vAtashleShmajwarakRutiH||87|| muhurdAho muhuH shItaM svedastambho [2] muhurmuhuH| mohaH kAso~arucistRuShNA shleShmapittapravartanam||88|| liptatiktAsyatA tandrA shleShmapittajwarakRutiH| ityete dvandvajAH proktAH ...|89|

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. Headache, breaking kind of joint pain, 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. 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. 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 dosa have been described. Shloka - ... सन्निपातज उच्यते||८९|| सन्निपातज्वरस्योर्ध्वं त्रयोदशविधस्य हि| प्राक्सूत्रितस्य वक्ष्यामि लक्षणं वै पृथक् पृथक्||९०|| भ्रमः पिपासा दाहश्च गौरवं शिरसोऽतिरुक्| वातपित्तोल्बणे विद्याल्लिङ्गं मन्दकफे ज्वरे||९१|| शैत्यं कासोऽरुचिस्तन्द्रापिपासादाहरुग्व्यथाः| वातश्लेष्मोल्बणे व्याधौ लिङ्गं पित्तावरे विदुः||९२|| छर्दिः शैत्यं मुहुर्दाहस्तृष्णा मोहोऽस्थिवेदना| मन्दवाते व्यवस्यन्ति लिङ्गं पित्तकफोल्बणे||९३|| सन्ध्यस्थिशिरसः शूलं प्रलापो गौरवं भ्रमः| वातोल्बणे स्याद् द्व्यनुगे तृष्णा कण्ठास्यशुष्कता||९४|| रक्तविण्मूत्रता दाहः स्वेदस्तृड् बलसङ्क्षयः| मूर्च्छा चेति त्रिदोषे स्याल्लिङ्गं पित्ते गरीयसि||९५|| आलस्यारुचिहृल्लासदाहवम्यरतिभ्रमैः| कफोल्बणं सन्निपातं तन्द्राकासेन चादिशेत्||९६|| प्रतिश्या छर्दिरालस्यं तन्द्राऽरुच्यग्निमार्दवम्| हीनवाते पित्तमध्ये लिङ्गं श्लेष्माधिके मतम्||९७|| हारिद्रमूत्रनेत्रत्वं दाहस्तृष्णा भ्रमोऽरुचिः| हीनवाते मध्यकफे लिङ्गं पित्ताधिके मतम्||९८|| शिरोरुग्वेपथुः श्वासः प्रलापश्छर्द्यरोचकौ| हीनपित्ते मध्यकफे लिङ्गं स्यान्मारुताधिके||९९|| शीतको गौरवं तन्द्रा प्रलापोऽस्थिशिरोऽतिरुक्| हीनपित्ते वातमध्ये लिङ्गं श्लेष्माधिके विदुः||१००|| श्वासः कासः प्रतिश्यायो मुखशोषोऽतिपार्श्वरुक्| कफहीने पित्तमध्ये लिङ्गं वाताधिके मतम्||१०१|| वर्चोभेदोऽग्निदौर्बल्यं [३] तृष्णा दाहोऽरुचिर्भ्रमः| कफहीने वातमध्ये लिङ्गं पित्ताधिके विदुः||१०२|| सन्निपातज्वरस्योर्ध्वमतो वक्ष्यामि लक्षणम्| क्षणे दाहः क्षणे शीतमस्थिसन्धिशिरोरुजा||१०३|| सास्रावे कलुषे रक्ते निर्भुग्ने चापि दर्शने [४] | सस्वनौ सरुजौ कर्णौ कण्ठः शूकैरिवावृतः||१०४|| तन्द्रा मोहः प्रलापश्च कासः श्वासोऽरुचिर्भ्रमः| परिदग्धा खरस्पर्शा जिह्वा स्रस्ताङ्गता परम्||१०५|| ष्ठीवनं रक्तपित्तस्य कफेनोन्मिश्रितस्य च| शिरसो लोठनं तृष्णा निद्रानाशो हृदि व्यथा||१०६|| स्वेदमूत्रपुरीषाणां चिराद्दर्शनमल्पशः| कृशत्वं नातिगात्राणां प्रततं कण्ठकूजनम्||१०७|| कोठानां श्यावरक्तानां मण्डलानां च दर्शनम्| मूकत्वं स्रोतसां पाको गुरुत्वमुदरस्य च||१०८|| चिरात् पाकश्च दोषाणां सन्निपातज्वराकृतिः|१०९|

Transliteration –

... sannipātaja ucyatē||89|| sannipātajwarasyōrdhvaṁ trayōdaśavidhasya hi| prāksūtritasya vakṣyāmi lakṣaṇaṁ vai pr̥thak pr̥thak||90|| bhramaḥ pipāsā dāhaśca gauravaṁ śirasō'tiruk| vātapittōlbaṇē vidyālliṅgaṁ mandakaphē jvarē||91|| śaityaṁ kāsō'rucistandrāpipāsādāharugvyathāḥ| vātaślēṣmōlbaṇē vyādhau liṅgaṁ pittāvarē viduḥ||92|| chardiḥ śaityaṁ muhurdāhastr̥ṣṇā mōhō'sthivēdanā| mandavātē vyavasyanti liṅgaṁ pittakaphōlbaṇē||93|| sandhyasthiśirasaḥ śūlaṁ pralāpō gauravaṁ bhramaḥ| vātōlbaṇē syād dvyanugē tr̥ṣṇā kaṇṭhāsyaśuṣkatā||94|| raktaviṇmūtratā dāhaḥ svēdastr̥ḍ balasaṅkṣayaḥ| mūrcchā cēti tridōṣē syālliṅgaṁ pittē garīyasi||95|| ālasyārucihr̥llāsadāhavamyaratibhramaiḥ| kaphōlbaṇaṁ sannipātaṁ tandrākāsēna cādiśēt||96|| pratiśyā chardirālasyaṁ tandrā'rucyagnimārdavam| hīnavātē pittamadhyē liṅgaṁ ślēṣmādhikē matam||97|| hāridramūtranētratvaṁ dāhastr̥ṣṇā bhramō'ruciḥ| hīnavātē madhyakaphē liṅgaṁ pittādhikē matam||98|| śirōrugvēpathuḥ śvāsaḥ pralāpaśchardyarōcakau| hīnapittē madhyakaphē liṅgaṁ syānmārutādhikē||99|| śītakō gauravaṁ tandrā pralāpō'sthiśirō'tiruk| hīnapittē vātamadhyē liṅgaṁ ślēṣmādhikē viduḥ||100|| śvāsaḥ kāsaḥ pratiśyāyō mukhaśōṣō'tipārśvaruk| kaphahīnē pittamadhyē liṅgaṁ vātādhikē matam||101|| varcōbhēdō'gnidaurbalyaṁ [3] tr̥ṣṇā dāhō'rucirbhramaḥ| kaphahīnē vātamadhyē liṅgaṁ pittādhikē viduḥ||102|| sannipātajwarasyōrdhvamatō vakṣyāmi lakṣaṇam| kṣaṇē dāhaḥ kṣaṇē śītamasthisandhiśirōrujā||103|| sāsrāvē kaluṣē raktē nirbhugnē cāpi darśanē [4] | sasvanau sarujau karṇau kaṇṭhaḥ śūkairivāvr̥taḥ||104|| tandrā mōhaḥ pralāpaśca kāsaḥ śvāsō'rucirbhramaḥ| paridagdhā kharasparśā jihvā srastāṅgatā param||105|| ṣṭhīvanaṁ raktapittasya kaphēnōnmiśritasya ca| śirasō lōṭhanaṁ tr̥ṣṇā nidrānāśō hr̥di vyathā||106|| svēdamūtrapurīṣāṇāṁ cirāddarśanamalpaśaḥ| kr̥śatvaṁ nātigātrāṇāṁ pratataṁ kaṇṭhakūjanam||107|| kōṭhānāṁ śyāvaraktānāṁ maṇḍalānāṁ ca darśanam| mūkatvaṁ srōtasāṁ pākō gurutvamudarasya ca||108|| cirāt pākaśca dōṣāṇāṁ sannipātajvarākr̥tiḥ|109| ... sannipAtaja ucyate||89|| sannipAtajwarasyordhvaM trayodashavidhasya hi| prAksUtritasya vakShyAmi lakShaNaM vai pRuthak pRuthak||90|| bhramaH pipAsA dAhashca gauravaM shiraso~atiruk| vAtapittolbaNe vidyAlli~ggaM mandakaphe jvare||91|| shaityaM kAso~arucistandrApipAsAdAharugvyathAH| vAtashleShmolbaNe vyAdhau li~ggaM pittAvare viduH||92|| chardiH shaityaM muhurdAhastRuShNA moho~asthivedanA| mandavAte vyavasyanti li~ggaM pittakapholbaNe||93|| sandhyasthishirasaH shUlaM pralApo gauravaM bhramaH| vAtolbaNe syAd dvyanuge tRuShNA kaNThAsyashuShkatA||94|| raktaviNmUtratA dAhaH svedastRuD balasa~gkShayaH| mUrcchA ceti tridoShe syAlli~ggaM pitte garIyasi||95|| AlasyArucihRullAsadAhavamyaratibhramaiH| kapholbaNaM sannipAtaM tandrAkAsena cAdishet||96|| pratishyA chardirAlasyaM tandrA~arucyagnimArdavam| hInavAte pittamadhye li~ggaM shleShmAdhike matam||97|| hAridramUtranetratvaM dAhastRuShNA bhramo~aruciH| hInavAte madhyakaphe li~ggaM pittAdhike matam||98|| shirorugvepathuH shvAsaH pralApashchardyarocakau| hInapitte madhyakaphe li~ggaM syAnmArutAdhike||99|| shItako gauravaM tandrA pralApo~asthishiro~atiruk| hInapitte vAtamadhye li~ggaM shleShmAdhike viduH||100|| shvAsaH kAsaH pratishyAyo mukhashoSho~atipArshvaruk| kaphahIne pittamadhye li~ggaM vAtAdhike matam||101|| varcobhedo~agnidaurbalyaM [3] tRuShNA dAho~arucirbhramaH| kaphahIne vAtamadhye li~ggaM pittAdhike viduH||102|| sannipAtajwarasyordhvamato vakShyAmi lakShaNam| kShaNe dAhaH kShaNe shItamasthisandhishirorujA||103|| sAsrAve kaluShe rakte nirbhugne cApi darshane [4] | sasvanau sarujau karNau kaNThaH shUkairivAvRutaH||104|| tandrA mohaH pralApashca kAsaH shvAso~arucirbhramaH| paridagdhA kharasparshA jihvA srastA~ggatA param||105|| ShThIvanaM raktapittasya kaphenonmishritasya ca| shiraso loThanaM tRuShNA nidrAnAsho hRudi vyathA||106|| svedamUtrapurIShANAM cirAddarshanamalpashaH| kRushatvaM nAtigAtrANAM pratataM kaNThakUjanam||107|| koThAnAM shyAvaraktAnAM maNDalAnAM ca darshanam| mUkatvaM srotasAM pAko gurutvamudarasya ca||108|| cirAt pAkashca doShANAM sannipAtajwarakRutiH|109|

Description of Sannipataja variety of jwara (caused by combined tridosa) Description of Sannipataja variety of jwara (caused by tridosa) will be made – 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 individually.  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.  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.  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.  Sannipataja jwara in which vitiated vāta predominates over the other two dośhās 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.  Sannipataja jwara in which vitiated pitta predominates over the other two dośās 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.  Sannipataja jwara in which vitiated kapha predominates over the other two dośhās presents with the following signs and symptoms – laziness, anorexia, nausea, burning sensation, vomiting, arati (restlessness), giddiness, drowsiness and cough.  Sannipataja jwara in which vitiated kapha is excessively vitiated, pitta moderately vitiated and vāta is less vitiated presents with the following clinical features – coryza, vomiting, laziness, drowsiness, anorexia and loss of power of digestion.  Sannipataja jwara in which vitiated pitta is excessively vitiated, kapha moderately vitiated and vāta is less vitiated presents with the following clinical features – yellowish discoloration of urine and eyes, burning sensation, thirst, giddiness and anorexia.  Sannipataja jwara in which vitiated vāta is excessively vitiated, kapha moderately vitiated and pitta is less vitiated presents with the following clinical features – headache, trembling, breathlessness, incoherent speech, vomiting and anorexia.  Sannipataja jwara in which vitiated kapha is excessively vitiated, vāta moderately vitiated and pitta is less vitiated presents with the following clinical features – coldness, heaviness, drowsiness, delirium and excessive pain in bones as well as head.  Sannipataja jwara in which vitiated vāta is excessively vitiated, pitta moderately vitiated and kapha is less vitiated presents with the following clinical features – asthma, bronchitis, coryza, dryness of the mouth and excessive pain in the chest.  Sannipataja jwara in which vitiated pitta is excessively vitiated, vāta moderately vitiated and kapha is less vitiated presents with the following clinical features – diarrhea, loss in power of digestion, thirst, burning sensation, anorexia and giddiness.  In sannipataja jwara in which all the three dośās are vitiated to the same extent presents with the following signs and symptoms – • Patient has feeling of burning sensation at times and at other times has feeling of cold • Pain in the bones, joints and head • Eyes are with excessive lacrymation, dull, reddish with eyeballs protruded out. • Ringing sound and pain in the ears • Pricking pain in throat like awn of grain • Drowsiness, delusion, incoherent speech cough, breathlessness, anorexia and giddiness • Tongue as if burnt, and turns rough in touch • Excessive fatigue • Spitting of blood and bile mixed with phlegm (sputum) • Swaying movements of head, thirst, sleeplessness and pain in the cardiac region • Sweat, urine and stool reduced in amount with delayed evacuation. • Body is not excessively emaciated • Constant Kūjana(cooing sound) • Urticaria and bluish – black or reddish patches appear on the skin • Patient is unable to speak due to inflammation of throat. • Heaviness in the abdomen • The dośhās undergo pāka after a very long time (conversion into the healthy state of the dośhās do not occur early). Shloka - दोषे विबद्धे नष्टेऽग्नौ सर्वसम्पूर्णलक्षणः||१०९|| सन्निपातज्वरोऽसाध्यः कृच्छ्रसाध्यस्त्वतोऽन्यथा|११०| निदाने त्रिविधा प्रोक्ता या पृथग्जज्वराकृतिः||११०|| संसर्गसन्निपातानां तया [४] चोक्तं स्वलक्षणम्|१११| Transliteration – dōṣē vibaddhē naṣṭē'gnau sarvasampūrṇalakṣaṇaḥ||109|| sannipātajvarō'sādhyaḥ kr̥cchrasādhyastvatō'nyathā|110| nidānē trividhā prōktā yā pr̥thagjajvarākr̥tiḥ||110|| saṁsargasannipātānāṁ tayā [4] cōktaṁ svalakṣaṇam|111|

doShe vibaddhe naShTe~agnau sarvasampUrNalakShaNaH||109|| sannipAtajvaro~asAdhyaH kRucchrasAdhyastvato~anyathA|110| nidAne trividhA proktA yA pRuthagjajwarakRutiH||110|| saMsargasannipAtAnAM tayA [4] coktaM svalakShaNam|111| Translation in English – Sannipata jwara is incurable if there is obstruction or non – elimination of the dosha, if the agnīs are completely destroyed and if sll the signs and symptoms are fully manifested; while it is difficult to treat otherwise. The clinical features of jwaras caused by the individual dośhās vāta, pitta and kapha have been described separately in the nidāna sthāna. From these sign and symptoms, the features of dwandaja types and the sannipataja typs can be known and determined. Shloka - आगन्तुरष्टमो यस्तु स निर्दिष्टश्चतुर्विधः||१११|| अभिघाताभिषङ्गाभ्यामभिचाराभिशापतः| शस्त्रलोष्टकशाकाष्ठमुष्ट्यरत्नितलद्विजैः||११२|| तद्विधैश्च हते गात्रे ज्वरः स्यादभिघातजः| तत्राभिघातजे वायुः प्रायो रक्तं प्रदूषयन्||११३|| सव्यथाशोफवैवर्ण्यं करोति सरुजं ज्वरम्|११४| Transliteration – āganturaṣṭamō yastu sa nirdiṣṭaścaturvidhaḥ||111|| abhighātābhiṣaṅgābhyāmabhicārābhiśāpataḥ| śastralōṣṭakaśākāṣṭhamuṣṭyaratnitaladvijaiḥ||112|| tadvidhaiśca hatē gātrē jwaraḥ syādabhighātajaḥ| tatrābhighātajē vāyuḥ prāyō raktaṁ pradūṣayan||113|| savyathāśōphavaivarṇyaṁ karōti sarujaṁ jwaram|114|

AganturaShTamo yastu sa nirdiShTashcaturvidhaH||111|| abhighAtAbhiSha~ggAbhyAmabhicArAbhishApataH| shastraloShTakashAkAShThamuShTyaratnitaladvijaiH||112|| tadvidhaishca hate gAtre jwaraH syAdabhighAtajaH| tatrAbhighAtaje vAyuH prAyo raktaM pradUShayan||113|| savyathAshophavaivarNyaM karoti sarujaM jwaram|114| The eighth type of jwara i.e. agantuja variety The eighth type of jwara i.e. agantuja variety (that caused due to external factors) is of four types 1. Abhihataja - The jwara caused by the injury from weapons, stones, hunters, wood, fist, palm of the sole, teeth and such other factors is called abhighataja. Vata gets vitiated by all such injuries resulting in pain, swelling, discoloration and fever. Shloka - कामशोकभयक्रोधैरभिषक्तस्य यो ज्वरः||११४|| सोऽभिषङ्गाज्वरो ज्ञेयो यश्च भूताभिषङ्गजः| कामशोकभयाद्वायुः, क्रोधात् पित्तं, त्रयो मलाः||११५|| भूताभिषङ्गात् कुप्यन्ति भूतसामान्यलक्षणाः| भूताधिकारे व्याख्यातं तदष्टविधलक्षणम्||११६|| विषवृक्षानिलस्पर्शात्तथाऽन्यैर्विषसम्भवैः| अभिषक्तस्य चाप्याहुर्ज्वरमेकेऽभिषङ्गजम्||११७|| चिकित्सया विषघ्न्यैव स शमं लभते नरः| अभिचाराभिशापाभ्यां सिद्धानां यः प्रवर्तते||११८|| सन्निपातज्वरो घोरः स विज्ञेयः सुदुःसहः| सन्निपातज्वरस्योक्तं लिङ्गं यत्तस्य तत् स्मृतम्||११९|| चित्तोन्द्रियशरीराणामर्तयोऽन्याश्च नैकशः| प्रयोगं त्वभिचारस्य दृष्ट्वा शापस्य चैव हि||१२०|| स्वयं श्रुत्वाऽनुमानेन लक्ष्यते [२] प्रशमेन वा| वैविध्यादभिचारस्य शापस्य च तदात्मके||१२१|| यथाकर्मप्रयोगेण लक्षणं स्यात् पृथग्विधम्| ध्याननिःश्वासबहुलं लिङ्गं कामज्वरे स्मृतम्||१२२|| शोकजे बाष्पबहुलं त्रासप्रायं भयज्वरे| क्रोधजे बहुसंरम्भं भूतावेशे त्वमानुषम्||१२३|| मूर्च्छामोहमदग्लानिभूयिष्ठं विषसम्भवे| केषाञ्चिदेषां लिङ्गानां सन्तापो जायते पुरः||१२४|| पश्चात्तुल्यं तु केषाञ्चिदेषु कामज्वरादिषु| कामादिजानामुद्दिष्टं ज्वराणां यद्विशेषणम्||१२५|| कामादिजानां रोगाणामन्येषामपि तत् स्मृतम्| मनस्यभिहते पूर्वं कामाद्यैर्न तथा बलम्||१२६|| ज्वरः प्राप्नोति वाताद्यैर्देहो यावन्न दूष्यति| देहे चाभिह(द्रु)ते पूर्वं वाताद्यैर्न तथा बलम्||१२७|| ज्वरः प्राप्नोति कामाद्यैर्मनो यावन्न दूष्यति|१२८| ते पूर्वं केवलाः पश्चान्निजैर्व्यामिश्रलक्षणाः||१२८|| हेत्वौषधविशिष्टाश्च भवन्त्यागन्तवो ज्वराः|१२९|

Transliteration – kāmaśōkabhayakrōdhairabhiṣaktasya yō jwaraḥ||114|| sō'bhiṣaṅgājvarō jñēyō yaśca bhūtābhiṣaṅgajaḥ| kāmaśōkabhayādvāyuḥ, krōdhāt pittaṁ, trayō malāḥ||115|| bhūtābhiṣaṅgāt kupyanti bhūtasāmānyalakṣaṇāḥ| bhūtādhikārē vyākhyātaṁ tadaṣṭavidhalakṣaṇam||116|| viṣavr̥kṣānilasparśāttathā'nyairviṣasambhavaiḥ| abhiṣaktasya cāpyāhurjwaramēkē'bhiṣaṅgajam||117|| cikitsayā viṣaghnyaiva sa śamaṁ labhatē naraḥ| abhicārābhiśāpābhyāṁ siddhānāṁ yaḥ pravartatē||118|| sannipātajvarō ghōraḥ sa vijñēyaḥ suduḥsahaḥ| sannipātajwarasyōktaṁ liṅgaṁ yattasya tat smr̥tam||119|| cittōndriyaśarīrāṇāmartayō'nyāśca naikaśaḥ| prayōgaṁ tvabhicārasya dr̥ṣṭvā śāpasya caiva hi||120|| svayaṁ śrutvā'numānēna lakṣyatē [2] praśamēna vā| vaividhyādabhicārasya śāpasya ca tadātmakē||121|| yathākarmaprayōgēṇa lakṣaṇaṁ syāt pr̥thagvidham| dhyānaniḥśvāsabahulaṁ liṅgaṁ kāmajvarē smr̥tam||122|| śōkajē bāṣpabahulaṁ trāsaprāyaṁ bhayajvarē| krōdhajē bahusaṁrambhaṁ bhūtāvēśē tvamānuṣam||123|| mūrcchāmōhamadaglānibhūyiṣṭhaṁ viṣasambhavē| kēṣāñcidēṣāṁ liṅgānāṁ santāpō jāyatē puraḥ||124|| paścāttulyaṁ tu kēṣāñcidēṣu kāmajvarādiṣu| kāmādijānāmuddiṣṭaṁ jvarāṇāṁ yadviśēṣaṇam||125|| kāmādijānāṁ rōgāṇāmanyēṣāmapi tat smr̥tam| manasyabhihatē pūrvaṁ kāmādyairna tathā balam||126|| jwaraḥ prāpnōti vātādyairdēhō yāvanna dūṣyati| dēhē cābhiha(dru)tē pūrvaṁ vātādyairna tathā balam||127|| jwaraḥ prāpnōti kāmādyairmanō yāvanna dūṣyati|128|

kAmashokabhayakrodhairabhiShaktasya yo jwaraH||114|| so~abhiSha~ggAjvaro j~jeyo yashca bhUtAbhiSha~ggajaH| kAmashokabhayAdvAyuH, krodhAt pittaM, trayo malAH||115|| bhUtAbhiSha~ggAt kupyanti bhUtasAmAnyalakShaNAH| bhUtAdhikAre vyAkhyAtaM tadaShTavidhalakShaNam||116|| viShavRukShAnilasparshAttathA~anyairviShasambhavaiH| abhiShaktasya cApyAhurjwarameke~abhiSha~ggajam||117|| cikitsayA viShaghnyaiva sa shamaM labhate naraH| abhicArAbhishApAbhyAM siddhAnAM yaH pravartate||118|| sannipAtajvaro ghoraH sa vij~jeyaH suduHsahaH| sannipAtajwarasyoktaM li~ggaM yattasya tat smRutam||119|| cittondriyasharIrANAmartayo~anyAshca naikashaH| prayogaM tvabhicArasya dRuShTvA shApasya caiva hi||120|| svayaM shrutvA~anumAnena lakShyate [2] prashamena vA| vaividhyAdabhicArasya shApasya ca tadAtmake||121|| yathAkarmaprayogeNa lakShaNaM syAt pRuthagvidham| dhyAnaniHshvAsabahulaM li~ggaM kAmajvare smRutam||122|| shokaje bAShpabahulaM trAsaprAyaM bhayajvare| krodhaje bahusaMrambhaM bhUtAveshe tvamAnuSham||123|| mUrcchAmohamadaglAnibhUyiShThaM viShasambhave| keShA~jcideShAM li~ggAnAM santApo jAyate puraH||124|| pashcAttulyaM tu keShA~jcideShu kAmajwaradiShu| kAmAdijAnAmuddiShTaM jwaraNAM yadvisheShaNam||125|| kAmAdijAnAM rogANAmanyeShAmapi tat smRutam| manasyabhihate pUrvaM kAmAdyairna tathA balam||126|| jwaraH prApnoti vAtAdyairdeho yAvanna dUShyati| dehe cAbhiha(dru)te pUrvaM vAtAdyairna tathA balam||127|| jwaraH prApnoti kAmAdyairmano yAvanna dUShyati|128| tē pūrvaṁ kēvalāḥ paścānnijairvyāmiśralakṣaṇāḥ||128|| hētvauṣadhaviśiṣṭāśca bhavantyāgantavō jvarāḥ|129|

Translation in English – 2. Abhishangaja jwara. - Jwara caused by the affliction of passion, grief,fear, anger and evil spirits including germs is called abhiśangaja jwara. Vata gets aggrevated by passion, grief and fear, while pitta is aggravated by anger and all the three dośhās are afflicted by bhutās (evil spirits or germs). Simultaneosly, the signs and symptoms of the respective type of bhuta are described here. In the bhutādhikār section, the characteristic features of eight types of bhuta are described.

 Some āchāryās opine that the jwara caused by the contact of the poisonous air of the toxic plants and other such toxins is called abhiśanagaja jwara. This type of jwara gets cured by the administration of antidotes of this poison.

3. Abhicharaj jwara - The activities such as abhicāra (evil tāntric rituals) and abhiśāpa of siddhās (saints who have attained spiritual perfection) results in the manifestation of sannipātaja jwara, which are respectively called abhicāraja and abhiśāpaja jwara respectively. These types of jwara are intolerable and the clinical features of sannipāta jwara manifest in them accompanied by other clinical features of the mind, sense organs and body due to the cause afflicting. 4. Abhishapaja jwara - Abhicāraja and Abhiśāpdaja jwara can be ascertained from the following clinical features – • Either by the direct observation of the performance of the tāntric rituals and śāpa (curse) • By hearing from others about it • By inference (anumāna) about it fom some feature and • By the alleviation of jwara after counteracting their effects. Depending upon the varieties of abhicāra and abhiśāpa, tantric and disease occurred by curse are there, clinical features also vary. A through understanding is essential for the diagnosis of such varieties of diseases. Jwara of psychological origin are further described as:- Kamaj jwara - Dhyana (constantly thinking of same object), frequent sighs of lament are the clinical features of jwara caused by kama (passion) Shokaj jwara - Excessive crying is the clinical presentation of jwara caused by grief. Bhayaj jwara - Patient is generally feel himself threatened in the jwara caused by fear. Krodhaj jwara - Patient is agitated excessively in the jwara caused by anger. Para psychic manifestations are also presented in the jwara due to affliction by the bhutas (evil spirits) Jwara caused by visha (intoxications) is associated with the features of fainting, unconsciousness, intoxication and fatigue. In some jwara, fever appears first and then the signs and symptoms of kama etc. as described above are manifested, and it may happen the other way also. The specific features of kāma etc. as described in the context of jwara are also applicable to other diseases caused by these factors (as unmāda etc.). In kama jwara etc. the mind is first afflicted by passion etc. but the jwara does not manifest until the dośhās as vāta, pitta, kapha of the body are not vitiated. Similarly, the vitiation of the dośhās in the body also does not gain enough strength to produce jwara unless the mind is afflicted by these factors (kāma, cintā etc.) The jwara caused by external causes are at first independent but later they get mixed up with the signs and symptoms of nija jwara (endogenous fevers). However, these āgantuja jwaras have their own aetiological factors and treatments.

Shloka  - 

संसृष्टाः सन्निपतिताः पृथग्वा कुपिता मलाः||१२९|| रसाख्यं धातुमन्वेत्य पक्तिं [२] स्थानान्निरस्य च| स्वेन तेनोष्मण चैव कृत्वा देहोष्मणो बलम्||१३०|| स्रोतांसि रुद्ध्वा सम्प्राप्ताः केवलं देहमुल्बणाः| सन्तापमधिकं देहे जनयन्ति नरस्तदा||१३१|| भवत्यत्युष्णसर्वाङ्गो ज्वरितस्तेन चोच्यते|१३२| Transliteration – saṁsr̥ṣṭāḥ sannipatitāḥ pr̥thagvā kupitā malāḥ||129|| rasākhyaṁ dhātumanvētya paktiṁ [2] sthānānnirasya ca| svēna tēnōṣmaṇa caiva kr̥tvā dēhōṣmaṇō balam||130|| srōtāṁsi ruddhvā samprāptāḥ kēvalaṁ dēhamulbaṇāḥ| santāpamadhikaṁ dēhē janayanti narastadā||131|| bhavatyatyuṣṇasarvāṅgō jvaritastēna cōcyatē|132|

te pUrvaM kevalAH pashcAnnijairvyAmishralakShaNAH||128|| hetvauShadhavishiShTAshca bhavantyAgantavo jwaraH|129| saMsRuShTAH sannipatitAH pRuthagvA kupitA malAH||129|| rasAkhyaM dhAtumanvetya paktiM [2] sthAnAnnirasya ca| svena tenoShmaNa caiva kRutvA dehoShmaNo balam||130|| srotAMsi ruddhvA samprAptAH kevalaM dehamulbaNAH| santApamadhikaM dehe janayanti narastadA||131|| bhavatyatyuShNasarvA~ggo jvaritastena cocyate|132|

Translation in English – These aggravated dosha either singly or in the combination of two or three, spread along with the rasa dhatu (the first dhatu responsible for nourishment of the body) and displace the jatharagni from its own place. Supplemented by the heat of the dosha them selves and the heat of the jatharagni, the heat of the body gets accentuated and they are further aggravated by the blockage of the circulatory channels. It then pervades the entire body to produce excessive heat. Therefore, the temperature increases all over the body and this condition is called jwara. Shloka - स्रोतसां सन्निरुद्धत्वात् स्वेदं ना नाधिगच्छति||१३२|| स्वस्थानात् प्रच्युते चाग्नौ प्रायशस्तरुणेज्वरे|१३३| Transliteration – srōtasāṁ sanniruddhatvāt svēdaṁ nā nādhigacchati||132|| svasthānāt pracyutē cāgnau prāyaśastaruṇējvarē|133|

srotasAM sanniruddhatvAt svedaM nA nAdhigacchati||132|| svasthAnAt pracyute cAgnau prAyashastaruNejvare|133| Translation in English – A person suffering from taruna jwara (the first stage of jwara) does not sweat because of the obstruction of the channels of circulation and the displacement of agni.

Shloka - अरुचिश्चाविपाकश्च गुरुत्वमुदरस्य च||१३३|| हृदयस्याविशुद्धिश्च तन्द्रा चालस्यमेव च| ज्वरोऽविसर्गी बलवान् दोषाणामप्रवर्तनम्||१३४|| लालाप्रसेको हृल्लासः क्षुन्नाशो विरसं [१] मुखम्| स्तब्धसुप्तगुरुवं च गात्राणां बहुमूत्रता||१३५|| न विड् जीर्णा न च ग्लानिर्ज्वरस्यामस्य लक्षणम्| ज्वरवेगोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||१३६|| मलप्रवृत्तिरुत्क्लेशः पच्यमानस्य लक्षणम्|१३७| Transliteration – aruciścāvipākaśca gurutvamudarasya ca||133|| hr̥dayasyāviśuddhiśca tandrā cālasyamēva ca| jvarō'visargī balavān dōṣāṇāmapravartanam||134|| lālāprasēkō hr̥llāsaḥ kṣunnāśō virasaṁ [1] mukham| stabdhasuptaguruvaṁ ca gātrāṇāṁ bahumūtratā||135|| na viḍ jīrṇā na ca glānirjwarasyāmasya lakṣaṇam| jwaravēgō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||136|| malapravr̥ttirutklēśaḥ pacyamānasya lakṣaṇam|137|

arucishcAvipAkashca gurutvamudarasya ca||133|| hRudayasyAvishuddhishca tandrA cAlasyameva ca| jvaro~avisargI balavAn doShANAmapravartanam||134|| lAlApraseko hRullAsaH kShunnAsho virasaM [1] mukham| stabdhasuptaguruvaM ca gAtrANAM bahumUtratA||135|| na viD jIrNA na ca glAnirjwarasyAmasya lakShaNam| jwaravego~adhikastRuShNA pralApaH shvasanaM bhramaH||136|| malapravRuttirutkleshaH pacyamAnasya lakShaNam|137|

Translation in English – The ama jwara (first stage of jwara) presents with the following clinical features – • Anorexia, indigestion, heaviness in the stomach • Feeling of heaviness and accumulation of impurities in heart, drowsiness and laziness • Continuous fever. • Acuteness of the attack. • Non elimination of the dosha along with mala or waste products • Salivation, nausea, loss of apetite, and tastelessness in the mouth • Rigidity, numbness and heaviness of the body. • Excessive urination • Improper formation of stool • Sudden absence of weakness The features of pachyamana jwara (Second stage of fever) are as follows – high fever and thirst, incoherent speech, dyspnoea, giddiness and the painful evacuation. Shloka - क्षुत् क्षामता लघुत्वं च गात्राणां ज्वरमार्दवम्||१३७|| दोषप्रवृत्तिरष्टाहो निरामज्वरलक्षणम्|१३८| Transliteration – kṣut kṣāmatā laghutvaṁ ca gātrāṇāṁ jwaramārdavam||137|| dōṣapravr̥ttiraṣṭāhō nirāmajwaralakṣaṇam|138| kShut kShAmatA laghutvaM ca gAtrANAM jwaramArdavam||137|| doShapravRuttiraShTAho nirAmajwaralakShaNam|138| Translation in English – clinical features of nirama jwara (becomes free from the ama). restoration of hunger, debility, lightness in the body, reduced fever, elimination of the dosa along with the waste products from the body – are all the clinical features of nirama jwara (condition when the patient’s body becomes free from the ama). These features generally appear on the 8th day. Shloka - नवज्वरे दिवास्वप्नस्नानाभ्यङ्गान्नमैथुनम्||१३८|| क्रोधप्रवातव्यायामान् कषायांश्च विवर्जयेत्|१३९| Transliteration – navajvarē divāsvapnasnānābhyaṅgānnamaithunam||138|| krōdhapravātavyāyāmān kaṣāyāṁśca vivarjayēt|139|

navajvare divAsvapnasnAnAbhya~ggAnnamaithunam||138|| krodhapravAtavyAyAmAn kaShAyAMshca vivarjayet|139| Translation in English – Precaution at first stage of fever:- The patient, in the state of nava jwara (first stage fever) should avoid certain things as – daytime sleep, bath, massage, heavy food, sexual intercourse, anger, exposure to wind, exercise, and kashaya (astringent foods). Shloka - ज्वरे लङ्घनमेवादावुपदिष्टमृते ज्वरात्||१३९|| क्षयानिलभयक्रोधकामशोकश्रमोद्भवात् [२] |१४०| लङ्घनेन क्षयं नीते दोषे सन्धुक्षितेऽनले||१४०|| विज्वरत्वं लघुत्वं च क्षुच्चैवास्योपजायते [५] | प्राणाविरोधिना चैनं लङ्घनेनोपपादयेत्||१४१|| बलाधिष्ठानमारोग्यं यदर्थोऽयं क्रियाक्रमः|१४२| Transliteration – jvarē laṅghanamēvādāvupadiṣṭamr̥tē jvarāt||139|| kṣayānilabhayakrōdhakāmaśōkaśramōdbhavāt [2] |140| laṅghanēna kṣayaṁ nītē dōṣē sandhukṣitē'nalē||140|| vijwaratvaṁ laghutvaṁ ca kṣuccaivāsyōpajāyatē [5] | prāṇāvirōdhinā cainaṁ laṅghanēnōpapādayēt||141|| balādhiṣṭhānamārōgyaṁ yadarthō'yaṁ kriyākramaḥ|142|

jvare la~gghanamevAdAvupadiShTamRute jwarat||139|| kShayAnilabhayakrodhakAmashokashramodbhavAt [2] |140| la~gghanena kShayaM nIte doShe sandhukShite~anale||140|| vijwaratvaM laghutvaM ca kShuccaivAsyopajAyate [5] | prANAvirodhinA cainaM la~gghanenopapAdayet||141|| balAdjhiShThAnamArogyaM yadartho~ayaM kriyAkramaH|142| Translation in English – Langhana or fasting is prescribed in the initial stage of jwara except those caused by kshaya (consumption), vatic jwara , fear, anger, passion, grief and physical exertion. Langhana alleviates the aggravated dosha and stimulates the agni, as a result of which jwara subsides and the body becomes light and the person’s appetite is restored. Langhana should be performed to the extent that it does not hamper the vitality of the individual. The aim of all these measures is to regain the health of the body which also depends on the physical, mental and spiritual strength. Shloka - लङ्घनं स्वेदनं कालो यवाग्वस्तिक्तको रसः||१४२|| पाचनान्यविपक्वानां दोषाणां तरुणे ज्वरे|१४३| Transliteration – laṅghanaṁ svēdanaṁ kālō yavāgvastiktakō rasaḥ||142|| pācanānyavipakvānāṁ dōṣāṇāṁ taruṇē jvarē|143|

la~gghanaM svedanaM kAlo yavAgvastiktako rasaH||142|| pAcanAnyavipakvAnAM doShANAM taruNe jvare|143| Translation in English – Langhana (fasting), swedana (fomentation), kala (passage of time), yavagu (medicated gruels) and tikta rasa drugs (drugs having bitter taste) and all digestive enhancers of avipakwa dosa (untransformed) in the taruna jwara (the initial stage of jwara).

Shloka -

तृष्यते सलिलं चोष्णं दद्याद्वातकफज्वरे [२] ||१४३|| 

मद्योत्थे पैत्तिके चाथ शीतलं तिक्तकैः शृतम्| दीपनं पाचनं चैव ज्वरघ्नमुभयं हि तत्||१४४|| स्रोतसां शोधनं बल्यं रुचिस्वेदकरं शिवम्|१४५| Transliteration – tr̥ṣyatē salilaṁ cōṣṇaṁ dadyādvātakaphajvarē [2] ||143|| madyōtthē paittikē cātha śītalaṁ tiktakaiḥ śr̥tam| dīpanaṁ pācanaṁ caiva jwaraghnamubhayaṁ hi tat||144|| srōtasāṁ śōdhanaṁ balyaṁ rucisvēdakaraṁ śivam|145|

tRuShyate salilaM coShNaM dadyAdvAtakaphajvare [2] ||143|| madyotthe paittike cAtha shItalaM tiktakaiH shRutam| dIpanaM pAcanaM caiva jwaraghnamubhayaM hi tat||144|| srotasAM shodhanaM balyaM rucisvedakaraM shivam|145| Translation in English – If the patient of jwara feels thirsty, he should be given – hot water to drink if the jwara caused by vāta or kapha or by the simultaneous aggravation of vāta and kapha If the jwara is paittika or if it occurs as a result of intake of alcohol, water boiled with bitter drugs and then cooled, is given. Both of these are dipana, (digestive stimulant), pachana (carminative), and jwaraghna (alleviators of jwara). They help in cleansing the channels of circulation and promote strength, appetitie, sweating and auspiciousness.

Shloka - मुस्तपर्पटकोशीरचन्दनोदीच्यनागरैः||१४५|| शृतशीतं जलं दद्यात् पिपासाज्वरशान्तये|१४६| Transliteration – mustaparpaṭakōśīracandanōdīcyanāgaraiḥ||145|| śr̥taśītaṁ jalaṁ dadyāt pipāsājwaraśāntayē|146|

mustaparpaTakoshIracandanodIcyanAgaraiH||145|| shRutashItaM jalaM dadyAt pipAsAjwarashAntaye|146|

Translation in English – Patient should be given water cooled after boiling it with musta, parpata, ushira, chandana, udichya and nagara for the alleviation of thirst and jwara. Shloka - कफप्रधानानुत्क्लिष्टान् दोषानामाशयस्थितान्||१४६|| बुद्ध्वा ज्वरकरान् काले वम्यानां वमनैर्हरेत्|१४७|

Transliteration – kaphapradhānānutkliṣṭān dōṣānāmāśayasthitān||146|| buddhvā jwarakarān kālē vamyānāṁ vamanairharēt|147|

kaphapradhAnAnutkliShTAn doShAnAmAshayasthitAn||146|| buddhvA jwarakarAn kAle vamyAnAM vamanairharet|147|

Translation in English – If the jwara is caused by kapha pradhana dosa, which is located in the amashaya (stomach) and is in a stage of utklesha (in a stage of being on the verge of coming out of its place) then it should be eliminated by the administration of emetics. The status of kapha should be ascertained clearly before the administration of drug and emetics should be given only to those patients who are found suitable for emesis. Shloka - अनुपस्थितदोषाणां वमनं तरुणेज्वरे||१४७|| हृद्रोगं श्वासमानाहं मोहं [१] च जनयेद्भृशम्| सर्वदेहानुगाः सामा धातुस्था असुनिर्हराः [२] ||१४८|| दोषाः फलानामामानां [३] स्वरसा इव सात्ययाः|१४९| Transliteration – anupasthitadōṣāṇāṁ vamanaṁ taruṇējvarē||147|| hr̥drōgaṁ śvāsamānāhaṁ mōhaṁ [1] ca janayēdbhr̥śam| sarvadēhānugāḥ sāmā dhātusthā asunirharāḥ [2] ||148|| dōṣāḥ phalānāmāmānāṁ [3] svarasā iva sātyayāḥ|149|

anupasthitadoShANAM vamanaM taruNejvare||147|| hRudrogaM shvAsamAnAhaM mohaM [1] ca janayedbhRusham| sarvadehAnugAH sAmA dhAtusthA asunirharAH [2] ||148|| doShAH phalAnAmAmAnAM [3] svarasA iva sAtyayAH|149|

Translation in English – If vamana (emesis) is administered to a jwara patient in whom the dosha have not attained the stage of utklesha (verge of coming out), then they may cause acute form of heart disease, breathlessness, anaha (obstruction to the movement of flatus and feces) and illusion. Attempting to take out the anupasthita dosa (unprepared to be eliminated) from the body of a person bring complications for the person and is just like attempting to take out juice from a raw fruit which is nearly impossible. Shloka - वमितं लङ्घितं काले यवागूभिरुपाचरेत्||१४९|| यथास्वौषधसिद्धाभिर्मण्डपूर्वाभिरादितः| यावज्ज्वरमृदूभावात् षडहं वा विचक्षणः||१५०|| तस्याग्निर्दीप्यते ताभिः समिद्भिरिव पावकः| ताश्च भेषजसंयोगाल्लघुत्वाच्चाग्निदीपनाः||१५१|| वातमूत्रपुरीषाणां दोषाणां [६] चानुलोमनाः| स्वेदनाय द्रवोष्णत्वाद्द्रवत्वात्तृट्प्रशान्तये||१५२|| आहारभावात् प्राणाय सरत्वाल्लाघवाय च| ज्वरघ्न्यो ज्वरसात्म्यत्वात्तस्मात् [७] पेयाभिरादितः||१५३|| ज्वरानुपचरेद्धीमानृते [८] मद्यसमुत्थितात्| मदात्यये मद्यनित्ये ग्रीष्मे पित्तकफाधिके||१५४|| ऊर्ध्वगे रक्तपित्ते च यवागूर्न हिता ज्वरे|१५५| Transliteration – vamitaṁ laṅghitaṁ kālē yavāgūbhirupācarēt||149|| yathāsvauṣadhasiddhābhirmaṇḍapūrvābhirāditaḥ| yāvajjwaramr̥dūbhāvāt ṣaḍahaṁ vā vicakṣaṇaḥ||150|| tasyāgnirdīpyatē tābhiḥ samidbhiriva pāvakaḥ| tāśca bhēṣajasaṁyōgāllaghutvāccāgnidīpanāḥ||151|| vātamūtrapurīṣāṇāṁ dōṣāṇāṁ [6] cānulōmanāḥ| svēdanāya dravōṣṇatvāddravatvāttr̥ṭpraśāntayē||152|| āhārabhāvāt prāṇāya saratvāllāghavāya ca| jwaraghnyō jwarasātmyatvāttasmāt [7] pēyābhirāditaḥ||153|| jvarānupacarēddhīmānr̥tē [8] madyasamutthitāt| madātyayē madyanityē grīṣmē pittakaphādhikē||154|| ūrdhvagē raktapittē ca yavāgūrna hitā jvarē|155|

vamitaM la~gghitaM kAle yavAgUbhirupAcaret||149|| yathAsvauShadhasiddhAbhirmaNDapUrvAbhirAditaH| yAvajjwaramRudUbhAvAt ShaDahaM vA vicakShaNaH||150|| tasyAgnirdIpyate tAbhiH samidbhiriva pAvakaH| tAshca bheShajasaMyogAllaghutvAccAgnidIpanAH||151|| vAtamUtrapurIShANAM doShANAM [6] cAnulomanAH| svedanAya dravoShNatvAddravatvAttRuTprashAntaye||152|| AhArabhAvAt prANAya saratvAllAghavAya ca| jwaraghnyo jwarasAtmyatvAttasmAt [7] peyAbhirAditaH||153|| jwaranupacareddhImAnRute [8] madyasamutthitAt| madAtyaye madyanitye grIShme pittakaphAdhike||154|| Urdhvage raktapitte ca yavAgUrna hitA jvare|155|

Translation in English – The patient after being given emesis and kept on fasting should be administered yavagu (a gruel preperation) prepared by boiling with the drugs mentioned further, in appropriate time. Before administering yavagu, the patient should be given manda (extremely thin gruel). This should be continued by the wise for either six days or till the jwara becomes mild.

As the addition of samidha (fuel) accelaerates the fire, similarly the digestive fire also becomes stimulated by the addition of gruels. These gruels are themselves light for digestion and they further stimulate the agnī due to the addition of drugs to it. 

These help in anulomana (elimination through the downward movement) of flatus, urine, faeces and dośhās. Being liquid and hot they also cause sweating. Being watery in nature they also alleviate thirst. Due to their nourishing property as a diet, they sustain the prāṇa (vitaliy) and cause lightness of the body because of their laxative property. They bring down the jwara and are also wholesome for the jwara patients. In view of above, a jwara patient should in the beginning be administered with different types of peya (thin gruels). However, these gruels are contraindicated in the fevers caused by intake of of alcohol, in alcoholism, for persons addicted to alcohol, in summer seasons, when there is predominance of pitta and kapha and in urdhwaga rakta – pitta (a disease characterized by bleeding from the different upper channels of the body). Shloka - तत्र तर्पणमेवाग्रे प्रयोज्यं [८] लाजसक्तुभिः||१५५|| ज्वरापहैः फलरसैर्युक्तं समधुशर्करम्|१५६| Transliteration – tatra tarpaṇamēvāgrē prayōjyaṁ [8] lājasaktubhiḥ||155|| jvarāpahaiḥ phalarasairyuktaṁ samadhuśarkaram|156|

tatra tarpaNamevAgre prayojyaM [8] lAjasaktubhiH||155|| jwarapahaiH phalarasairyuktaM samadhusharkaram|156|

Translation in English – In cases where yavagu administration is prohibited, the physician should administer in the beginning tarpaṇa (nutritional diet) prepared from laja saktu (Powder of roasted grains) mixed with honey, sugar and fruit juices, which have jwara alleviating properties. Shloka - ततः सात्म्यबलापेक्षी भोजयेज्जीर्णतर्पणम्||१५६|| तनुना मुद्गयूषेण जाङ्गलानां रसेन वा| अन्नकालेषु चाप्यस्मै विधेयं दन्तधावनम्||१५७|| योऽस्य वक्त्ररसस्तस्माद्विपरीतं प्रियं च यत्| तदस्य मुखवैशद्यं प्रकाङ्क्षां चान्नपानयोः||१५८|| धत्ते रसविशेषाणामभिज्ञत्वं करोति यत्| विशोध्य द्रुमशाखाग्रैरास्यं प्रक्षाल्य चासकृत्||१५९|| मस्त्विक्षुरसमद्याद्यैर्यथाहारमवाप्नुयात्|१६०| Transliteration – tataḥ sātmyabalāpēkṣī bhōjayējjīrṇatarpaṇam||156|| tanunā mudgayūṣēṇa jāṅgalānāṁ rasēna vā| annakālēṣu cāpyasmai vidhēyaṁ dantadhāvanam||157|| yō'sya vaktrarasastasmādviparītaṁ priyaṁ ca yat| tadasya mukhavaiśadyaṁ prakāṅkṣāṁ cānnapānayōḥ||158|| dhattē rasaviśēṣāṇāmabhijñatvaṁ karōti yat| viśōdhya drumaśākhāgrairāsyaṁ prakṣālya cāsakr̥t||159|| mastvikṣurasamadyādyairyathāhāramavāpnuyāt|160|

tataH sAtmyabalApekShI bhojayejjIrNatarpaNam||156|| tanunA mudgayUSheNa jA~ggalAnAM rasena vA| annakAleShu cApyasmai vidheyaM dantadhAvanam||157|| yo~asya vaktrarasastasmAdviparItaM priyaM ca yat| tadasya mukhavaishadyaM prakA~gkShAM cAnnapAnayoH||158|| dhatte rasavisheShANAmabhij~jatvaM karoti yat| vishodhya drumashAkhAgrairAsyaM prakShAlya cAsakRut||159|| mastvikShurasamadyAdyairyathAhAramavApnuyAt|160|

Translation in English – Depending upon the habituation (satmya) and the strength of the patient, after digestion of the tarpaṇa, patient is administered thin soup of mudga (green gram) or meat of wild animals. During food time, the patient’s teeth should be cleaned with the twig of plants, which should be such that their taste can counteract the taste of the patient’s mouth and is relishing to the patient. Such kind of cleaning of teeth makes the patient feel freshness in his mouth, develops appetite for food and drinks and becomes capable of appreciating the taste of food to be taken. The mouth should be cleaned several times with water after cleaning with twigs. Thereafter the patient should be given mastu (thin butter milk), sugarcane juice, alcoholic drinks etc. with suitable and appropriate diet. Shloka - पाचनं शमनीयं वा कषायं पाययेद्भिषक्||१६०|| ज्वरितं षडहेऽतीते लघ्वन्नप्रतिभोजितम्|१६१| Transliteration – pācanaṁ śamanīyaṁ vā kaṣāyaṁ pāyayēdbhiṣak||160|| jvaritaṁ ṣaḍahē'tītē laghvannapratibhōjitam|161|

pAcanaM shamanIyaM vA kaShAyaM pAyayedbhiShak||160|| jvaritaM ShaDahe~atIte laghvannapratibhojitam|161| Translation in English – The jwara patient, after six days and having been given light diet to eat, should be administered decoctions, which are either pachana (stimulant of digestion) or shamana (alleviator of dośhās). Shloka - स्तभ्यन्ते न [९] विपच्यन्ते कुर्वन्ति विषमज्वरम्||१६१|| दोषा बद्धाः कषायेण स्तम्भित्वात्तरुणे ज्वरे| न तु कल्पनमुद्दिश्य कषायः प्रतिषिध्यते||१६२|| यः कषायकषायः [१०] स्यात् स वर्ज्यस्तरुणज्वरे|१६३|

Transliteration – stabhyantē na [9] vipacyantē kurvanti viṣamajwaram||161|| dōṣā baddhāḥ kaṣāyēṇa stambhitvāttaruṇē jvarē| na tu kalpanamuddiśya kaṣāyaḥ pratiṣidhyatē||162|| yaḥ kaṣāyakaṣāyaḥ [10] syāt sa varjyastaruṇajvarē|163|

stabhyante na [9] vipacyante kurvanti viShamajwaram||161|| doShA baddhAH kaShAyeNa stambhitvAttaruNe jvare| na tu kalpanamuddishya kaShAyaH pratiShidhyate||162|| yaH kaShAyakaShAyaH [10] syAt sa varjyastaruNajvare|163| Translation in English – If, decoctions of astringent drugs are administered to the patient in taruna jwara (first stage of jwara) stage, then the dośhās do not undergo paka and get adhered due to stickiness. This leads to the onset of vishama jwara (irregular fevers). The term kaśāya has two meanings i.e. the decoction prepared by boiling the drugs and astringent taste. In the first stage of jwara (taruṇa jwara), the astringent tasted drugs are prohibited. Shloka - यूषैरम्लैरनम्लैर्वा जाङ्गलैर्वा रसैर्हितैः||१६३|| दशाहं यावदश्नीयाल्लघ्वन्नं ज्वरशान्तये|१६४| Transliteration – yūṣairamlairanamlairvā jāṅgalairvā rasairhitaiḥ||163|| daśāhaṁ yāvadaśnīyāllaghvannaṁ jwaraśāntayē|164|

yUShairamlairanamlairvA jA~ggalairvA rasairhitaiH||163|| dashAhaM yAvadashnIyAllaghvannaM jwarashAntaye|164|

Translation in English – The patient should be given light diet along with yusha (soup) prepared from vegetables and pulses and rasa (soup) of the meat of animals inhabiting arid regions, for the alleviation of jwara, upto the tenth day. Amla (sour) things may or may not be added to these yusha. Shloka - अत ऊर्ध्वं कफे मन्दे वातपित्तोत्तरे ज्वरे||१६४|| परिपक्वेषु दोषेषु सर्पिष्पानं यथाऽमृतम्|१६५| निर्दशाहमपि ज्ञात्वा कफोत्तरमलङ्घितम्||१६५|| न सर्पिः पाययेद्वैद्यः कषायैस्तमुपाचरेत् [३] | यावल्लघुत्वादशनं दद्यान्मांसरसेन च||१६६|| बलं ह्यलं निग्रहाय दोषाणां, बलकृच्च तत् [४] |१६७| Transliteration – ata ūrdhvaṁ kaphē mandē vātapittōttarē jvarē||164|| paripakvēṣu dōṣēṣu sarpiṣpānaṁ yathā'mr̥tam|165| nirdaśāhamapi jñātvā kaphōttaramalaṅghitam||165|| na sarpiḥ pāyayēdvaidyaḥ kaṣāyaistamupācarēt [3] | yāvallaghutvādaśanaṁ dadyānmāṁsarasēna ca||166|| balaṁ hyalaṁ nigrahāya dōṣāṇāṁ, balakr̥cca tat [4] |167|

ata UrdhvaM kaphe mande vAtapittottare jvare||164|| paripakveShu doSheShu sarpiShpAnaM yathA~amRutam|165| nirdashAhamapi j~jAtvA kaphottaramala~gghitam||165|| na sarpiH pAyayedvaidyaH kaShAyaistamupAcaret [3] | yAvallaghutvAdashanaM dadyAnmAMsarasena ca||166|| balaM hyalaM nigrahAya doShANAM, balakRucca tat [4] |167| Translation in English – Therafter, ghee should be given to the patients who have more aggravation of vata and pitta and less aggravation of kapha and in whom the dosha have reached the pakwa stage (having no ama ansha) it is like amritt (nectar) for them. Ghī should not be given to jwara patient even after the tenth day, if the kapha dośha still predominates and if the signs and symptoms of well accomplished langhana have not appeared. In such case kashaya should be administered to the patient till the body becomes light. Till the features of langhana appear in the body, the patient should be given light to digest food along with the meat soup of wild animals and birds. This destroys the strength of the dośhās and promotes the strength of the body.

Shloka - दाहतृष्णापरीतस्य वातपित्तोत्तरं ज्वरम्||१६७|| बद्धप्रच्युतदोषं वा निरामं पयसा जयेत्|१६८| Transliteration – dāhatr̥ṣṇāparītasya vātapittōttaraṁ jwaram||167|| baddhapracyutadōṣaṁ vā nirāmaṁ payasā jayēt|168|

dAhatRuShNAparItasya vAtapittottaraM jwaram||167|| baddhapracyutadoShaM vA nirAmaM payasA jayet|168|

Translation in English – A patient with the following conditions should be given milk in nirama stage in the body – • When the patient has excessive burning sensation and thirst • If vāta and pitta dośha predominate the patient suffering from jwara • If the dosha are either baddha ( static), or pracyuta (slightly dislodged).

Shloka  - 

क्रियाभिराभिः प्रशमं न प्रयाति यदा ज्वरः||१६८|| अक्षीणबलमांसाग्नेः [१] शमयेत्तं विरेचनैः|१६९| Transliteration – kriyābhirābhiḥ praśamaṁ na prayāti yadā jwaraḥ||168|| akṣīṇabalamāṁsāgnēḥ [1] śamayēttaṁ virēcanaiḥ|169|

kriyAbhirAbhiH prashamaM na prayAti yadA jwaraH||168|| akShINabalamAMsAgneH [1] shamayettaM virecanaiH|169| Translation in English – If the jwara does not subside by the the therapies described before, then virecana (purgatives) should be given for its alleviation, provided the patient is neither emaciated, weak, depleted of muscle tissue nor has reduced digestive power. Shloka - ज्वरक्षीणस्य न हितं वमनं न विरेचनम्||१६९|| कामं तु पयसा तस्य निरूहैर्वा हरेन्मलान्| निरूहो बलमग्निं च विज्वरत्वं मुदं रुचिम्||१७०|| परिपक्वेषु दोषेषु प्रयुक्तः शीघ्रमावहेत्|१७१| पित्तं वा कफपित्तं वा पित्ताशयगतं हरेत्||१७१|| स्रंसनं त्रीन्मलान् बस्तिर्हरेत् पक्वाशयस्थितान्|१७२| Transliteration –

jwarakṣīṇasya na hitaṁ vamanaṁ na virēcanam||169|| kāmaṁ tu payasā tasya nirūhairvā harēnmalān| nirūhō balamagniṁ ca vijwaratvaṁ mudaṁ rucim||170|| paripakvēṣu dōṣēṣu prayuktaḥ śīghramāvahēt|171| pittaṁ vā kaphapittaṁ vā pittāśayagataṁ harēt||171|| sraṁsanaṁ trīnmalān bastirharēt pakvāśayasthitān|172|

jwarakShINasya na hitaM vamanaM na virecanam||169|| kAmaM tu payasA tasya nirUhairvA harenmalAn| nirUho balamagniM ca vijwaratvaM mudaM rucim||170|| paripakveShu doSheShu prayuktaH shIghramAvahet|171| pittaM vA kaphapittaM vA pittAshayagataM haret||171|| sraMsanaM trInmalAn bastirharet pakvAshayasthitAn|172|

Translation in English – Neither vamana (emesis) nor virecana (purgation) is useful for patients emaciated by fever. It is thus desirable to remove their malās by the administration of milk or niruha (ununctuous type of medicated enema prepared by decoctions etc.) Niruha basti administered when the dosha are in paripakwa stage immediately promotes the strength and the power of digestion, alleviates fever and causes happiness and brings relish for food. Purgation (sransana) eliminates kapha or kapha pitta dosa from the pittashaya (lower portion of the stomach and small intestine). Basti eliminates all the three dosa lodged in the pakwashaya. Shloka - ज्वरे पुराणे सङ्क्षीणे कफपित्ते दृढाग्नये||१७२|| रूक्षबद्धपुरीषाय प्रदद्यादनुवासनम्|१७३| Transliteration – jvarē purāṇē saṅkṣīṇē kaphapittē dr̥ḍhāgnayē||172|| rūkṣabaddhapurīṣāya pradadyādanuvāsanam|173|

jvare purANe sa~gkShINe kaphapitte dRuDhAgnaye||172|| rUkShabaddhapurIShAya pradadyAdanuvAsanam|173|

Translation in English – In chronic types of fever (jirna jwara) anuvasana type of basti (medicated enema with oils) should be given in the following conditions – • When kapha and pitta are alleviated • When there is strong power of digestion • When there is ununctuousness (rukshata) and bandhatwa (obstruction, compactness) in the feces.

Shloka - गौरवे शिरसः शूले विबद्धेष्विन्द्रियेषु च||१७३|| जीर्णज्वरे रुचिकरं कुर्यान्मूर्धविरेचनम्|१७४| Transliteration – gauravē śirasaḥ śūlē vibaddhēṣvindriyēṣu ca||173|| jīrṇajvarē rucikaraṁ kuryānmūrdhavirēcanam|174|

gaurave shirasaH shUle vibaddheShvindriyeShu ca||173|| jIrNajvare rucikaraM kuryAnmUrdhavirecanam|174|

Translation in English – Murdha virecana should be done in patients suffering from chronic type of fevers who have heaviness and pain in head, impaired sensoria. This develops relish for food and also the objects. Shloka - अभ्यङ्गांश्च प्रदेहांश्च परिषेकावगाहने||१७४|| विभज्य शीतोष्णकृतं [१] कुर्याज्जीर्णे ज्वरे भिषक्| तैराशु प्रशमं याति बहिर्मार्गगतो ज्वरः||१७५|| लभन्ते सुखमङ्गानि बलं वर्णश्च वर्धते|१७६| धूपनाञ्जनयोगैश्च यान्ति जीर्णज्वराः शमम्||१७६|| त्वङ्मात्रशेषा येषां च भवत्यागन्तुरन्वयः|१७७| Transliteration – abhyaṅgāṁśca pradēhāṁśca pariṣēkāvagāhanē||174|| vibhajya śītōṣṇakr̥taṁ [1] kuryājjīrṇē jvarē bhiṣak| tairāśu praśamaṁ yāti bahirmārgagatō jwaraḥ||175|| labhantē sukhamaṅgāni balaṁ varṇaśca vardhatē|176| dhūpanāñjanayōgaiśca yānti jīrṇajvarāḥ śamam||176|| tvaṅmātraśēṣā yēṣāṁ ca bhavatyāganturanvayaḥ|177|

abhya~ggAMshca pradehAMshca pariShekAvagAhane||174|| vibhajya shItoShNakRutaM [1] kuryAjjIrNe jvare bhiShak| tairAshu prashamaM yAti bahirmArgagato jwaraH||175|| labhante sukhama~ggAni balaM varNashca vardhate|176| dhUpanA~jjanayogaishca yAnti jIrNajwaraH shamam||176|| tva~gmAtrasheShA yeShAM ca bhavatyAganturanvayaH|177| Translation in English – Abhyanga (massage), pradeha (unguentum), parisheka (sprinkling of water), and avagahana (bathing) should be done in patients of jirna jwara (chronic fevers) considering the types of jwara with their hot and cold types. By these measures the bahirmargagata (located in the external tissues) jwara gets alleviated instantaneously. There is a feeling of ease in the body along with the promotion of strength and complexion. jirna jwara also gets alleviated by the administration of dhupana (fumigation) and anjana (collyrium). Jwara located in skin and of exogenous nature or types can be treated with same Shloka - इति क्रियाक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१७७|| येषां त्वेष क्रमस्तानि द्रव्याण्यूर्ध्वमतः शृणु| रक्तशाल्यादयः शस्ताः पुराणाः षष्टिकैः सह||१७८|| यवाग्वोदनलाजार्थे ज्वरितानां ज्वरापहाः|१७९| Transliteration – iti kriyākramaḥ siddhō jwaraghnaḥ samprakāśitaḥ||177|| yēṣāṁ tvēṣa kramastāni dravyāṇyūrdhvamataḥ śr̥ṇu| raktaśālyādayaḥ śastāḥ purāṇāḥ ṣaṣṭikaiḥ saha||178|| yavāgvōdanalājārthē jvaritānāṁ jvarāpahāḥ|179|

iti kriyAkramaH siddho jwaraghnaH samprakAshitaH||177|| yeShAM tveSha kramastAni dravyANyUrdhvamataH shRuNu| raktashAlyAdayaH shastAH purANAH ShaShTikaiH saha||178|| yavAgvodanalAjArthe jvaritAnAM jwarapahAH|179| Translation in English – Proper line of treatment for the alleviation of jwara has been described above, the ingredients used for therapies in accordance with the above stated line of treatment has been described further. For this purpose rakta sali, sashtika type of purana (preserved for over an year) rice are the best and should be given in the form of yavagu (gruel), odana (boiled rice), laja (fried paddy) as these mitigate jwara of the patient. Shloka - लाजपेयां सुखजरां पिप्पलीनागरैः शृताम्||१७९|| पिबेज्ज्वरी ज्वरहरां क्षुद्वानल्पाग्निरादितः| अम्लाभिलाषी तामेव दाडिमाम्लां सनागराम्||१८०|| सृष्टविट् पैत्तिको वाऽथ शीतां मधुयुतां पिबेत्| पेयां वा रक्तशालीनां पार्श्वबस्तिशिरोरुजि||१८१|| श्वदंष्ट्राकण्टकारिभ्यां सिद्धां ज्वरहरां पिबेत्| ज्वरातिसारी पेयां वा पिबेत् साम्लां शृतां नरः||१८२|| पृश्निपर्णीबलाबिल्वनागरोत्पलधान्यकैः| शृतां विदारीगन्धाद्यैर्दीपनीं स्वेदनीं नरः||१८३|| कासी श्वासी च हिक्की च यवागूं ज्वरितः पिबेत्| विबद्धवर्चाः सयवां पिप्पल्यामलकैः शृताम्||१८४|| सर्पिष्मतीं पिबेत् पेयां ज्वरी दोषानुलोमनीम्| कोष्ठे विबद्धे सरुजि पिबेत् पेयां शृतां ज्वरी||१८५|| मृद्वीकापिप्पलीमूलचव्यामलकनागरैः| पिबेत् सबिल्वां पेयां वा ज्वरे सपरिकर्तिके||१८६|| बलावृक्षाम्लकोलाम्लकलशीधावनीशृताम्| अस्वेदनिद्रस्तृष्णार्तः पिबेत् पेयां सशर्कराम्||१८७|| नागरामलकैः सिद्धां घृतभृष्टां ज्वरापहाम्|१८८| Transliteration – lājapēyāṁ sukhajarāṁ pippalīnāgaraiḥ śr̥tām||179|| pibējjvarī jwaraharāṁ kṣudvānalpāgnirāditaḥ| amlābhilāṣī tāmēva dāḍimāmlāṁ sanāgarām||180|| sr̥ṣṭaviṭ paittikō vā'tha śītāṁ madhuyutāṁ pibēt| pēyāṁ vā raktaśālīnāṁ pārśvabastiśirōruji||181|| śvadaṁṣṭrākaṇṭakāribhyāṁ siddhāṁ jwaraharāṁ pibēt| jvarātisārī pēyāṁ vā pibēt sāmlāṁ śr̥tāṁ naraḥ||182|| pr̥śniparṇībalābilvanāgarōtpaladhānyakaiḥ| śr̥tāṁ vidārīgandhādyairdīpanīṁ svēdanīṁ naraḥ||183|| kāsī śvāsī ca hikkī ca yavāgūṁ jvaritaḥ pibēt| vibaddhavarcāḥ sayavāṁ pippalyāmalakaiḥ śr̥tām||184|| sarpiṣmatīṁ pibēt pēyāṁ jvarī dōṣānulōmanīm| kōṣṭhē vibaddhē saruji pibēt pēyāṁ śr̥tāṁ jvarī||185|| mr̥dvīkāpippalīmūlacavyāmalakanāgaraiḥ| pibēt sabilvāṁ pēyāṁ vā jvarē saparikartikē||186|| balāvr̥kṣāmlakōlāmlakalaśīdhāvanīśr̥tām| asvēdanidrastr̥ṣṇārtaḥ pibēt pēyāṁ saśarkarām||187|| nāgarāmalakaiḥ siddhāṁ ghr̥tabhr̥ṣṭāṁ jvarāpahām|188|

lAjapeyAM sukhajarAM pippalInAgaraiH shRutAm||179|| pibejjvarI jwaraharAM kShudvAnalpAgnirAditaH| amlAbhilAShI tAmeva dADimAmlAM sanAgarAm||180|| sRuShTaviT paittiko vA~atha shItAM madhuyutAM pibet| peyAM vA raktashAlInAM pArshvabastishiroruji||181|| shvadaMShTrAkaNTakAribhyAM siddhAM jwaraharAM pibet| jwaratisArI peyAM vA pibet sAmlAM shRutAM naraH||182|| pRushniparNIbalAbilvanAgarotpaladhAnyakaiH| shRutAM vidArIgandhAdyairdIpanIM svedanIM naraH||183|| kAsI shvAsI ca hikkI ca yavAgUM jvaritaH pibet| vibaddhavarcAH sayavAM pippalyAmalakaiH shRutAm||184|| sarpiShmatIM pibet peyAM jvarI doShAnulomanIm| koShThe vibaddhe saruji pibet peyAM shRutAM jvarI||185|| mRudvIkApippalImUlacavyAmalakanAgaraiH| pibet sabilvAM peyAM vA jvare saparikartike||186|| balAvRukShAmlakolAmlakalashIdhAvanIshRutAm| asvedanidrastRuShNArtaH pibet peyAM sasharkarAm||187|| nAgarAmalakaiH siddhAM ghRutabhRuShTAM jwarapahAm|188|

Translation in English – Ten types of yavagu in jwara – • The peya prepared with laja (fried paddy) and boiled with pippali and nagara is light to digest and should be given to the patient in the beginning of the jwara when the digestive power is reduced. However, it should be ascertained before administration that the patient is desirous for food before administration. • If there is movement of bowel and the patient is desirous of sour things, then the peya described above should be made sour by adding daḍima and should be given along with nagara. • The above mentioned peya should be cooled and added with honey before administration in paittika type of patient. • A patient suffering from shula (pain) in the parshva (flanks), basti (urinary bladder) and shira (head) regions should be given peya prepared from red variety of shali rice and boiled with shvadashṭra and kanṭakari as this alleviates jwara. • A person suffering from jwaratisara (fever associated with diarrhoea) should be given peyā which is sour and is boiled with prishniparni, bala, bilva, nagara, utpala and dhanyaka. • Patients suffering from jwara associated with kasa (bronchitis), swasa (difficulty in breathing) and hikka (hiccups) should be given yavagu prepared by boiling with the group of drugs belonging to vidarigandhadi gana, which acts as a stimulant of digestion and promotes sweating. • Peya prepared of yava (barley) boiled with pippali and amalaki should be given to a patient suffering from jwara associated with koshthabaddhata(Constipation). It causes anulomana (downward movement) of dosa. This peya mixed with ghee should be taken by the patient suffering from jwara associated with constipation. • The peya prepared by boiling with mridvika, pippalī mula, chavya, amalaka and nagara should be taken by the patient suffering from jwara associated with constipation and pain. • Peya boiled with bala, vrikshamla, kolamla, kalasi (siṁha pucchi), dhavani (kantakari) and bilva should be given to a patient suffering from jwara associated with sawing pain. (cutting pain). • Peya prepared by boiling with nagara and amalaka fried with ghee and mixed with sugar is jwaraghna (alleviates jwara). It should be given to a patient suffering from asweda (absence of sweating), anidra (sleeplessness) and trishna (morbid thirst).

Shloka  - 

मुद्गान्मसूरांश्चणकान् कुलत्थान् समकुष्टकान्||१८८|| यूषार्थे यूषसात्म्यानां [७] ज्वरितानां प्रदापयेत्|१८९| Transliteration – mudgānmasūrāṁścaṇakān kulatthān samakuṣṭakān||188|| yūṣārthē yūṣasātmyānāṁ [7] jvaritānāṁ pradāpayēt|189|

mudgAnmasUrAMshcaNakAn kulatthAn samakuShTakAn||188|| yUShArthe yUShasAtmyAnAM [7] jvaritAnAM pradApayet|189|

Translation in English – yusha is wholesome for some patients of jwara. This yusha may be prepared from mudga, masura, canaka, kulattha and makushtha. Shloka - पटोलपत्रं सफलं कुलकं पापचेलिकम्||१८९|| कर्कोटकं कठिल्लं च विद्याच्छाकं ज्वरे हितम्|१९०| Transliteration – paṭōlapatraṁ saphalaṁ kulakaṁ pāpacēlikam||189|| karkōṭakaṁ kaṭhillaṁ ca vidyācchākaṁ jvarē hitam|190|

paTolapatraM saphalaM kulakaM pApacelikam||189|| karkoTakaM kaThillaM ca vidyAcchAkaM jvare hitam|190| vegetables useful in jwara The leaves and fruits of patola, kulaka (karvellaka), papacellika (paṭha), karkotaka, kathilla (red variety of punarnava) shakas are useful in the patients of jwara. Shloka - लावान् कपिञ्जलानेणांश्चकोरानुपचक्रकान्||१९०|| कुरङ्गान् कालपुच्छांश्च हरिणान् पृषताञ्छशान्| प्रदद्यान्मांससात्म्याय ज्वरिताय ज्वरापहान्||१९१|| ईषदम्लाननम्लान् वा रसान् काले विचक्षणः| कुक्कुटांश्च मयूरांश्च तित्तिरिक्रौञ्चवर्तकान्||१९२|| गुरूष्णत्वान्न शंसन्ति ज्वरे केचिच्चिकित्सकाः| लङ्घनेनानिलबलं ज्वरे यद्यधिकं भवेत्||१९३|| भिषङ्मात्राविकल्पज्ञो [१] दद्यात्तानपि कालवित्|१९४| Transliteration – lāvān kapiñjalānēṇāṁścakōrānupacakrakān||190|| kuraṅgān kālapucchāṁśca hariṇān pr̥ṣatāñchaśān| pradadyānmāṁsasātmyāya jvaritāya jvarāpahān||191|| īṣadamlānanamlān vā rasān kālē vicakṣaṇaḥ| kukkuṭāṁśca mayūrāṁśca tittirikrauñcavartakān||192|| gurūṣṇatvānna śaṁsanti jvarē kēciccikitsakāḥ| laṅghanēnānilabalaṁ jvarē yadyadhikaṁ bhavēt||193|| bhiṣaṅmātrāvikalpajñō [1] dadyāttānapi kālavit|194|

lAvAn kapi~jjalAneNAMshcakorAnupacakrakAn||190|| kura~ggAn kAlapucchAMshca hariNAn pRuShatA~jchashAn| pradadyAnmAMsasAtmyAya jvaritAya jwarapahAn||191|| IShadamlAnanamlAn vA rasAn kAle vicakShaNaH| kukkuTAMshca mayUrAMshca tittirikrau~jcavartakAn||192|| gurUShNatvAnna shaMsanti jvare keciccikitsakAH| la~gghanenAnilabalaM jvare yadyadhikaM bhavet||193|| bhiSha~gmAtrAvikalpaj~jo [1] dadyAttAnapi kAlavit|194| Meat soups advisable in Jwara The soup prepared from lava, kapinjala (white variety of tittiri), ena (kṛśṇa sāra), chakora, upacakraka (a variety of cakora), kuranga, kala puccha (a type of hariṇa), hariṇa (coppery coloured dear), priashata (spotted dear) and shasha (rabbit) are alleviators of jwara and hence should be given to the patients of jwara for whom meat is wholesome. These meat soups may be made slightly sour or taken as such. The wise physician should administer these soups at appropriate time. Some physicians do not advise the meat soups of animals such as kukkuṭa, mayūra, tittiri, kraunca and vartaka as they are heavy and hot. In jwara if vāyu gets aggravated because of langhana, then the physician acquainted with the signs of the dośhās should give the meat soup of these animals also at appropriate time. Shloka - घर्माम्बु चानुपानार्थं तृषिताय प्रदापयेत्||१९४|| मद्यं वा मद्यसात्म्याय यथादोषं यथाबलम्|१९५| Transliteration – gharmāmbu cānupānārthaṁ tr̥ṣitāya pradāpayēt||194|| madyaṁ vā madyasātmyāya yathādōṣaṁ yathābalam|195|

gharmAmbu cAnupAnArthaM tRuShitAya pradApayet||194|| madyaM vA madyasAtmyAya yathAdoShaM yathAbalam|195|

Translation in English – Hot water should be given to drink to a thirsty person. Depending upon the dośhās involved and the strength of the patient madya (wines) may be given to those patients for whom it is wholesome. Shloka - गुरूष्णस्निग्धमधुरान् कषायांश्च नवज्वरे||१९५|| आहारान् दोषपक्त्यर्थं प्रायशः परिवर्जयेत्| अन्नपानक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१९६|| Transliteration – gurūṣṇasnigdhamadhurān kaṣāyāṁśca navajvarē||195|| āhārān dōṣapaktyarthaṁ prāyaśaḥ parivarjayēt| annapānakramaḥ siddhō jwaraghnaḥ samprakāśitaḥ||196||

gurUShNasnigdhamadhurAn kaShAyAMshca navajvare||195|| AhArAn doShapaktyarthaM prAyashaH parivarjayet| annapAnakramaH siddho jwaraghnaH samprakAshitaH||196||

Not advisable foods Food ingredients, which are heavy to digest, hot, unctuous, sweet and astringent should mostly be avoided in a patient suffering from nava jwara (the patient of first stage of jwara) in order to facilitate the pāka of the dośhās. So, here the diet and drinks, which are wholesome to the patient of jwara have been described here. Shloka - अत ऊर्ध्वं प्रवक्ष्यन्ते कषाया ज्वरनाशनाः| पाक्यं शीतकषायं वा मुस्तपर्पटकं पिबेत्||१९७|| सनागरं पर्पटकं पिबेद्वा सदुरालभम्| किराततिक्तकं मुस्तं गुडूचीं विश्वभेषजम्||१९८|| पाठामुशीरं सोदीच्यं पिबेद्वा ज्वरशान्तये| ज्वरघ्ना दीपनाश्चैते कषाया दोषपाचनाः||१९९|| तृष्णारुचिप्रशमना मुखवैरस्यनाशनाः|२००| Transliteration – ata ūrdhvaṁ pravakṣyantē kaṣāyā jwaranāśanāḥ| pākyaṁ śītakaṣāyaṁ vā mustaparpaṭakaṁ pibēt||197|| sanāgaraṁ parpaṭakaṁ pibēdvā sadurālabham| kirātatiktakaṁ mustaṁ guḍūcīṁ viśvabhēṣajam||198|| pāṭhāmuśīraṁ sōdīcyaṁ pibēdvā jwaraśāntayē| jwaraghnā dīpanāścaitē kaṣāyā dōṣapācanāḥ||199|| tr̥ṣṇārucipraśamanā mukhavairasyanāśanāḥ|200|

ata UrdhvaM pravakShyante kaShAyA jwaranAshanAH| pAkyaM shItakaShAyaM vA mustaparpaTakaM pibet||197|| sanAgaraM parpaTakaM pibedvA sadurAlabham| kirAtatiktakaM mustaM guDUcIM vishvabheShajam||198|| pAThAmushIraM sodIcyaM pibedvA jwarashAntaye| jwaraghnA dIpanAshcaite kaShAyA doShapAcanAH||199|| tRuShNAruciprashamanA mukhavairasyanAshanAH|200|

Advisable drugs – Now, we will describe the kashayas, which alleviate jwara. These are as follows – 1-2. Musta and parpaṭaka can be taken either in the form of decoction (pākya) or śīta kaṡāya (soaking the drugs for overnight period in water and then filtering the content and using the filtrate). 3. Parpaṭaka decoction may be given to the patient along with nagara and durālabhā. 4. The decoction made from kirāta tikta, mustā, guḍucī and viśva bheṡaja. 5. The decoction of pāthā and uśīra alongwith udīcya. The above mentioned decoctions which are used for the alleviation of jwara are jwaraghna. They stimulate the power of digestion, help in the pācana (metabolic transformation) of the dośhās; alleviate thirst, anorexia and cure mukha vairasya (bad taste of the mouth). Shloka - कलिङ्गकाः पटोलस्य पत्रं कटुकरोहिणी||२००|| पटोलः सारिवा मुस्तं पाठा कटुकरोहिणी| निम्बः पटोलस्त्रिफला मृद्वीका मुस्तवत्सकौ|| २०१|| किराततिक्तममृता चन्दनं विश्वभेषजम्| गुडूच्यामलकं मुस्तमर्धश्लोकसमापनाः||c०२|| कषायाः शमयन्त्याशु पञ्च पञ्चविधाञ्ज्वरान्| सन्ततं सततान्येद्युस्तृतीयकचतुर्थकान्||२०३|| Transliteration – kaliṅgakāḥ paṭōlasya patraṁ kaṭukarōhiṇī||200|| paṭōlaḥ sārivā mustaṁ pāṭhā kaṭukarōhiṇī| nimbaḥ paṭōlastriphalā mr̥dvīkā mustavatsakau||101|| kirātatiktamamr̥tā candanaṁ viśvabhēṣajam| guḍūcyāmalakaṁ mustamardhaślōkasamāpanāḥ||202|| kaṣāyāḥ śamayantyāśu pañca pañcavidhāñjvarān| santataṁ satatānyēdyustr̥tīyakacaturthakān||203||

kali~ggakAH paTolasya patraM kaTukarohiNI||200|| paTolaH sArivA mustaM pAThA kaTukarohiNI| nimbaH paTolastriphalA mRudvIkA mustavatsakau||201|| kirAtatiktamamRutA candanaM vishvabheShajam| guDUcyAmalakaM mustamardhashlokasamApanAH||202|| kaShAyAH shamayantyAshu pa~jca pa~jcavidhA~jjwaran| santataM satatAnyedyustRutIyakacaturthakAn||203|| Translation in English – The five types of jwara named the santata, satata, anyeduṡka, tṛtīyaka and caturthaka are quickly cured by the five types of decoctions made from drugs described below – 1. Kalingakā, paṭola leaves and katuka rohiṇī 2. paṭola, sārivā, mustā, pāthā and katuka rohiṇī 3. nimbi, paṭola, triphalā, mṛdvīkā, mustā and vatsaka 4. kirātatikta, amṛtā, candana, viśva bheṡaja; and 5. guḍūcī, āmalaka and mustā Shloka - वत्सकारग्वधौ पाठां षड्ग्रन्थां कटुरोहिणीम्| मूर्वां सातिविषां निम्बं पटोलं धन्वयासकम्||२०४|| वचां मुस्तमुशीरं च मधुकं त्रिफलां बलाम्| पाक्यं शीतकषायं वा पिबेज्ज्वरहरं नरः||२०५|| मधूकमुस्तमृद्वीकाकाश्मर्याणि परूषकम्| त्रायमाणामुशीरं च त्रिफलां कटुरोहिणीम्||२०६|| पीत्वा निशिस्थितं जन्तुर्ज्वराच्छीघ्रं विमुच्यते|२०७| Transliteration – vatsakāragvadhau pāṭhāṁ ṣaḍgranthāṁ kaṭurōhiṇīm| mūrvāṁ sātiviṣāṁ nimbaṁ paṭōlaṁ dhanvayāsakam||204|| vacāṁ mustamuśīraṁ ca madhukaṁ triphalāṁ balām| pākyaṁ śītakaṣāyaṁ vā pibējjwaraharaṁ naraḥ||205|| madhūkamustamr̥dvīkākāśmaryāṇi parūṣakam| trāyamāṇāmuśīraṁ ca triphalāṁ kaṭurōhiṇīm||206|| pītvā niśisthitaṁ janturjvarācchīghraṁ vimucyatē|207|

vatsakAragvadhau pAThAM ShaDgranthAM kaTurohiNIm| mUrvAM sAtiviShAM nimbaM paTolaM dhanvayAsakam||204|| vacAM mustamushIraM ca madhukaM triphalAM balAm| pAkyaM shItakaShAyaM vA pibejjwaraharaM naraH||205|| madhUkamustamRudvIkAkAshmaryANi parUShakam| trAyamANAmushIraM ca triphalAM kaTurohiNIm||206|| pItvA nishisthitaM janturjwaracchIghraM vimucyate|207|

Translation in English – The decoction or śīta kaṡāya of the following drugs should be taken by a person for curing jwara – 1. vatsaka, āragavadha, pāthā, ṡaḍ granthā and katurohiṇī 2. mūrvā along with ativiṡā, nimbi, paṭola and dhanavayāsaka 3. vacā, mustā, uśīra, madhūka, triphalā and balā the śita kaṡāya of madhūka, mustā, mṛdvīkā, kaśmarya, paruśaka, trāyamāṇā, uśīra, triphalā, and kaṭu rohiṇī, prepared by keeping overnight, immediately cures the jwara of living beings. Shloka - जात्यामलकमुस्तानि तद्वद्धन्वयवासकम्||२०७|| विबद्धदोषो ज्वरितः कषायं सगुडं पिबेत्| त्रिफलां त्रायमाणां च मृद्वीकां कटुरोहिणीम्||२०८|| पित्तश्लेष्महरस्त्वेष कषायो ह्यानुलोमिकः| त्रिवृताशर्करायुक्तः पित्तश्लेष्मज्वरापहः||२०९|| Transliteration – jātyāmalakamustāni tadvaddhanvayavāsakam||207|| vibaddhadōṣō jvaritaḥ kaṣāyaṁ saguḍaṁ pibēt| triphalāṁ trāyamāṇāṁ ca mr̥dvīkāṁ kaṭurōhiṇīm||208|| pittaślēṣmaharastvēṣa kaṣāyō hyānulōmikaḥ| trivr̥tāśarkarāyuktaḥ pittaślēṣmajvarāpahaḥ||209||

jAtyAmalakamustAni tadvaddhanvayavAsakam||207|| vibaddhadoSho jvaritaH kaShAyaM saguDaM pibet| triphalAM trAyamANAM ca mRudvIkAM kaTurohiNIm||208|| pittashleShmaharastveSha kaShAyo hyAnulomikaH| trivRutAsharkarAyuktaH pittashleShmajwarapahaH||209|| Translation in English – The decoction of either jātī, āmalaka and mustā or that of dhanavayavāsakam along with guḍa (jaggery) should be given to the patient suffering from jwara where the dośhās are in vibaddha state (adhered to dhātūs). The decoction of triphalā, trāyamāṇa, mṛdvīkā and katu rohiṇī alleviates pitta and śleṡmā and causes the anulomana of dośhās. This decoction when taken along with trivṛt and śarkarā cures jwara caused by the aggravation of pitta and śleṡmā. Shloka - बृहत्यौ वत्सकं मुस्तं देवदारु महौषधम्| कोलवल्ली च योगोऽयं सन्निपातज्वरापहः||२१०|| शटी पुष्करमूलं च व्याघ्री शृङ्गी दुरालभा| गुडूची नागरं पाठा किरातं कटुरोहिणी||२११|| एष शट्यादिको वर्गः सन्निपातज्वरापहः| कासहृद्ग्रहपार्श्वार्तिश्वासतन्द्रासु शस्यते||२१२|| बृहत्यौ पौष्करं भार्गी शटी शृङ्गी दुरालभा| वत्सकस्य च बीजानि पटोलं कटुरोहिणी||२१३|| बृहत्यादिर्गणः प्रोक्तः सन्निपातज्वरापहः| कासादिषु च सर्वेषु दद्यात् सोपद्रवेषु च||२१४|| Transliteration – br̥hatyau vatsakaṁ mustaṁ dēvadāru mahauṣadham| kōlavallī ca yōgō'yaṁ sannipātajvarāpahaḥ||210|| śaṭī puṣkaramūlaṁ ca vyāghrī śr̥ṅgī durālabhā| guḍūcī nāgaraṁ pāṭhā kirātaṁ kaṭurōhiṇī||211|| ēṣa śaṭyādikō vargaḥ sannipātajvarāpahaḥ| kāsahr̥dgrahapārśvārtiśvāsatandrāsu śasyatē||212|| br̥hatyau pauṣkaraṁ bhārgī śaṭī śr̥ṅgī durālabhā| vatsakasya ca bījāni paṭōlaṁ kaṭurōhiṇī||213|| br̥hatyādirgaṇaḥ prōktaḥ sannipātajvarāpahaḥ| kāsādiṣu ca sarvēṣu dadyāt sōpadravēṣu ca||214||

bRuhatyau vatsakaM mustaM devadAru mahauShadham| kolavallI ca yogo~ayaM sannipAtajwarapahaH||210|| shaTI puShkaramUlaM ca vyAghrI shRu~ggI durAlabhA| guDUcI nAgaraM pAThA kirAtaM kaTurohiNI||211|| eSha shaTyAdiko vargaH sannipAtajwarapahaH| kAsahRudgrahapArshvArtishvAsatandrAsu shasyate||212|| bRuhatyau pauShkaraM bhArgI shaTI shRu~ggI durAlabhA| vatsakasya ca bIjAni paTolaM kaTurohiNI||213|| bRuhatyAdirgaNaH proktaH sannipAtajwarapahaH| kAsAdiShu ca sarveShu dadyAt sopadraveShu ca||214||

Translation in English – A decoction prepared from both the varities of bṛhatī, vatsaka, mustā, devadāru, mahauśhadha, and kolavallī cures sannipāta jwara. śaṭī, puśkaramūla, vyāghrī, śringī, durālabhā, guḍucī, nāgara, pāthā, kirāta, kaṭurohiṇī, - all together are called by the name of śaṭyādi varga. The decoction made from these drugs helps in curing sannipāta jwara along with kāsa (coughs), hṛd graham (a kind of heart disease), pārśva artī (pain in the flanks), śvāsa (breathlessness) and tandrā (drowsiness). Both the varieties of bṛhatī, pauṡhkar, bhārgī, śaṭī, ṡṛngī, durālabhā, seeds of vatsaka, patola and katu rohiṇī – are together called the Bṛhatyādi gaṇa and the decoction made from it cures the sannipāta jwara. And is also useful in complications like kasa. Shloka - कषायाश्च यवाग्वश्च पिपासाज्वरनाशनाः| निर्दिष्टा भेषजाध्याये भिषक्तानपि योजयेत्||२१५|| Transliteration – kaṣāyāśca yavāgvaśca pipāsājwaranāśanāḥ| nirdiṣṭā bhēṣajādhyāyē bhiṣaktānapi yōjayēt||215||

kaShAyAshca yavAgvashca pipAsAjwaranAshanAH| nirdiShTA bheShajAdhyAye bhiShaktAnapi yojayet||215||

Translation in English – Different types of decoctions and gruels are also described in the first four chapters of Sūtra śthāna which also cure pipāsā (thirst) and jwara. They may also be used by the physician for the treatment of jwara. Shloka - ज्वराः कषायैर्वमनैर्लङ्घनैर्लघुभोजनैः| रूक्षस्य ये न शाम्यन्ति सर्पिस्तेषां भिषग्जितम्||२१६|| रूक्षं तेजो ज्वरकरं तेजसा रूक्षितस्य च| यः स्यादनुबलो धातुः स्नेहवध्यः [१] स चानिलः||२१७|| Transliteration –

jvarāḥ kaṣāyairvamanairlaṅghanairlaghubhōjanaiḥ| rūkṣasya yē na śāmyanti sarpistēṣāṁ bhiṣagjitam||216|| rūkṣaṁ tējō jwarakaraṁ tējasā rūkṣitasya ca| yaḥ syādanubalō dhātuḥ snēhavadhyaḥ [1] sa cānilaḥ||217||

jwaraH kaShAyairvamanairla~gghanairlaghubhojanaiH| rUkShasya ye na shAmyanti sarpisteShAM bhiShagjitam||216|| rUkShaM tejo jwarakaraM tejasA rUkShitasya ca| yaH syAdanubalo dhAtuH snehavadhyaH [1] sa cAnilaH||217|| Translation in English – If in a person of ununctuous disposition, jwara doesn’t get cured by the use of decoctions, emesis, fasting and by light diet, then jwara in such a person should be cured by the use of medicated ghṛt. Jwara is manifested by ununctuous state of tejasa in such a person and a patient suffering from jwara further develops ununctuousness due to the action of this tejas (pitta). The vāta gets aggravated subsequently due to the action of this tejasa and it can be corrected by the use of some unctuous material like ghṛt. Shloka - कषायाः सर्व एवैते सर्पिषा सह योजिताः| प्रयोज्या ज्वरशान्त्यर्थमग्निसन्धुक्षणाः शिवाः||२१८|| पिप्पल्यश्चन्दनं मुस्तमुशीरं कटुरोहिणी| कलिङ्गकास्तामलकी सारिवाऽतिविषा स्थिरा||२१९|| द्राक्षामलकबिल्वानि त्रायमाणा निदिग्धिका| सिद्धमितैर्घृतं सद्यो जीर्णज्वरमपोहति||२२०|| क्षयं कासं शिरःशूलं पार्श्वशूलं हलीमकम्| अंसाभितापमाग्निं च विषमं सन्नियच्छति||२२१|| वासां गुडूचीं त्रिफलां त्रायमाणां यवासकम्| पक्त्वा तेन कषायेण पयसा द्विगुणेन च||२२२|| पिप्पलीमुस्तमृद्वीकाचन्दनोत्पलनागरैः| कल्कीकृतैश्च विपचेद्धृतं जीर्णज्वरापहम्||२२३|| बलां श्वदंष्ट्रां बृहतीं कलसीं धावनीं स्थिराम्| निम्बं पर्पटकं मुस्तं त्रायमाणां दुरालभाम्||२२४|| कृत्वा कषायं पेष्यार्थे दद्यात्तामलकीं शटीम्| द्राक्षां पुष्करमूलं च मेदामामलकानि च||२२५|| घृतं पयश्च तत् सिद्धं सर्पिर्ज्वरहरं परम्| क्षयकासशिरःशूलपार्श्वशूलांसतापनुत् [३] ||२२६|| Transliteration – kaṣāyāḥ sarva ēvaitē sarpiṣā saha yōjitāḥ| prayōjyā jwaraśāntyarthamagnisandhukṣaṇāḥ śivāḥ||218|| pippalyaścandanaṁ mustamuśīraṁ kaṭurōhiṇī| kaliṅgakāstāmalakī sārivā'tiviṣā sthirā||219|| drākṣāmalakabilvāni trāyamāṇā nidigdhikā| siddhamitairghr̥taṁ sadyō jīrṇajwaramapōhati||220|| kṣayaṁ kāsaṁ śiraḥśūlaṁ pārśvaśūlaṁ halīmakam| aṁsābhitāpamāgniṁ ca viṣamaṁ sanniyacchati||221|| vāsāṁ guḍūcīṁ triphalāṁ trāyamāṇāṁ yavāsakam| paktvā tēna kaṣāyēṇa payasā dviguṇēna ca||222|| pippalīmustamr̥dvīkācandanōtpalanāgaraiḥ| kalkīkr̥taiśca vipacēddhr̥taṁ jīrṇajvarāpaham||223|| balāṁ śvadaṁṣṭrāṁ br̥hatīṁ kalasīṁ dhāvanīṁ sthirām| nimbaṁ parpaṭakaṁ mustaṁ trāyamāṇāṁ durālabhām||224|| kr̥tvā kaṣāyaṁ pēṣyārthē dadyāttāmalakīṁ śaṭīm| drākṣāṁ puṣkaramūlaṁ ca mēdāmāmalakāni ca||225|| ghr̥taṁ payaśca tat siddhaṁ sarpirjwaraharaṁ param| kṣayakāsaśiraḥśūlapārśvaśūlāṁsatāpanut [3] ||226||

kaShAyAH sarva evaite sarpiShA saha yojitAH| prayojyA jwarashAntyarthamagnisandhukShaNAH shivAH||218|| pippalyashcandanaM mustamushIraM kaTurohiNI| kali~ggakAstAmalakI sArivA~ativiShA sthirA||219|| drAkShAmalakabilvAni trAyamANA nidigdhikA| siddhamitairghRutaM sadyo jIrNajwaramapohati||220|| kShayaM kAsaM shiraHshUlaM pArshvashUlaM halImakam| aMsAbhitApamAgniM ca viShamaM sanniyacchati||221|| vAsAM guDUcIM triphalAM trAyamANAM yavAsakam| paktvA tena kaShAyeNa payasA dviguNena ca||222|| pippalImustamRudvIkAcandanotpalanAgaraiH| kalkIkRutaishca vipaceddhRutaM jIrNajwarapaham||223|| balAM shvadaMShTrAM bRuhatIM kalasIM dhAvanIM sthirAm| nimbaM parpaTakaM mustaM trAyamANAM durAlabhAm||224|| kRutvA kaShAyaM peShyArthe dadyAttAmalakIM shaTIm| drAkShAM puShkaramUlaM ca medAmAmalakAni ca||225|| ghRutaM payashca tat siddhaM sarpirjwaraharaM param| kShayakAsashiraHshUlapArshvashUlAMsatApanut [3] ||226|| Translation in English – Ghṛt should be added to all those decoctions described above for the alleviation of jwara. They stimulate the power of digestion and endow auspiciousness. Medicated ghṛt prepared by boiling with pipalī, candana, mustā, katurohiṇī, kalingaka, tāmalakī (bhūmyāmalakī), sārivā, ativiśā, sthirā, drākṡā, āmalaka, bilva, trāyamāṇa and nidigdhikā cure chronic types of jwara instantaneously. It also cures kṡaya (consumption), kāsa (coughs), śiraḥśula (headache), pārśvasūla (pain in the sides of chest), halīmaka (a type of jaundice), ansābhitāpa (burning sensation in the scapular region) and viṡama agnī (irregularity in the power of digestion). Ghṛt prepared from the decoction made by boiling vāsa, guḍucī, triphalā, trāyamāṇa and yavāsaka, milk in double the quantity, paste of pippalī, mustā, mṛdvīkā, candana, utpala and nagara cures chronic fevers. Ghṛt prepared from boiling the decoction of balā, śvadamṡtrā, bṛhatī, kalasī, dhāvānī, sthirā, nimbi, parpaṭaka, mustaka, trāyamāṇā and durālabhā; paste of tāmalakī, śatī, drāksā, puṡkarmūla, medā and āmalakī, ghī and milk; is an excellent medicine for the treatment of jwara. It also cures kṡaya (consumption), kāsa (coughs), śiraḥśula (headache), pārśvasūla (pain in the sides of chest), halīmaka (a type of jaundice), ansābhitāpa (burning sensation in the scapular region. Shloka - ज्वरिभ्यो बहुदोषेभ्य ऊर्ध्वं चाधश्च बुद्धिमान्| दद्यात् संशोधनं काले कल्पे यदुपदेक्ष्यते||२२७|| मदनं पिप्पलीभिर्वा कलिङ्गैर्मधुकेन वा| युक्तमुष्णाम्बुना पेयं वमनं ज्वरशान्तये||२२८|| क्षौद्राम्बुना रसेनेक्षोरथवा लवणाम्बुना| ज्वरे प्रच्छर्दनं शस्तं मद्यैर्वा तर्पणेन वा||२२९|| मृद्वीकामलकानां वा रसं प्रस्कन्दनं पिबेत्| रसमामलकानां वा घृतभृष्टं ज्वरापहम्||२३०|| लिह्याद्वा त्रैवृतं चूर्णं संयुक्तं मधुसर्पिषा| पिबेद्वा क्षौद्रमावाप्य सघृतं त्रिफलारसम्||२३१|| आरग्वधं वा पयसा मृद्वीकानां रसेन वा| त्रिवृतां त्रायमाणां वा पयसा ज्वरितः पिबेत्||२३२|| ज्वराद्विमुच्यते पीत्वा मृद्वीकाभिः सहाभयाम्| पयोऽनुपानमुष्णं वा पीत्वा द्राक्षारसं नरः||२३३|| Transliteration – jvaribhyō bahudōṣēbhya ūrdhvaṁ cādhaśca buddhimān| dadyāt saṁśōdhanaṁ kālē kalpē yadupadēkṣyatē||227|| madanaṁ pippalībhirvā kaliṅgairmadhukēna vā| yuktamuṣṇāmbunā pēyaṁ vamanaṁ jwaraśāntayē||228|| kṣaudrāmbunā rasēnēkṣōrathavā lavaṇāmbunā| jvarē pracchardanaṁ śastaṁ madyairvā tarpaṇēna vā||229|| mr̥dvīkāmalakānāṁ vā rasaṁ praskandanaṁ pibēt| rasamāmalakānāṁ vā ghr̥tabhr̥ṣṭaṁ jvarāpaham||230|| lihyādvā traivr̥taṁ cūrṇaṁ saṁyuktaṁ madhusarpiṣā| pibēdvā kṣaudramāvāpya saghr̥taṁ triphalārasam||231|| āragvadhaṁ vā payasā mr̥dvīkānāṁ rasēna vā| trivr̥tāṁ trāyamāṇāṁ vā payasā jvaritaḥ pibēt||232|| jvarādvimucyatē pītvā mr̥dvīkābhiḥ sahābhayām| payō'nupānamuṣṇaṁ vā pītvā drākṣārasaṁ naraḥ||233||

jvaribhyo bahudoShebhya UrdhvaM cAdhashca buddhimAn| dadyAt saMshodhanaM kAle kalpe yadupadekShyate||227|| madanaM pippalIbhirvA kali~ggairmadhukena vA| yuktamuShNAmbunA peyaM vamanaM jwarashAntaye||228|| kShaudrAmbunA rasenekShorathavA lavaNAmbunA| jvare pracchardanaM shastaM madyairvA tarpaNena vA||229|| mRudvIkAmalakAnAM vA rasaM praskandanaM pibet| rasamAmalakAnAM vA ghRutabhRuShTaM jwarapaham||230|| lihyAdvA traivRutaM cUrNaM saMyuktaM madhusarpiShA| pibedvA kShaudramAvApya saghRutaM triphalArasam||231|| AragvadhaM vA payasA mRudvIkAnAM rasena vA| trivRutAM trAyamANAM vA payasA jvaritaH pibet||232|| jwaradvimucyate pItvA mRudvIkAbhiH sahAbhayAm| payo~anupAnamuShNaM vA pItvA drAkShArasaM naraH||233||

Translation in English – Elimination therapies (of dośhās), both in upward and downward routes should be administered at appropriate time, to a patient suffering from jwara, having more aggravated dośhās. Details of these methods and the formulations used for them will be discussed in the kalpa sthāna. Vamana performed by hot water and madana mixed with either pippalī, kalinga or madhūka alleviates jwara. Emetic therapy given by administering water mixed with honey, sugar cane juice, water mixed with rock salt, alcoholic drinks and tarpaṇa (roasted corn flour eaten mixed with water) is also useful in jwara. A patient suffering from jwara can also be given the juice of mṛdvīkā and āmalaka for purgation. The juice of āmalaka fried with ghṛt also cures jwara. Following recipes are also useful for a patient suffering from jwara – • powder of trivṛt mixed with honey and ghṛt prepared in the form of linctus. • Juice of triphalā mixed with honey and ghṛt • Āragvadha along with milk or the juice of mṛdvikā • tṛvrita and trāyamāṇa along with milk • mṛdvikā and abhayā along with warm milk or the juice of drākṡā as anupāna. Shloka - कासाच्छ्वासाच्छिरःशूलात्पार्श्वशूलाच्चिरज्वरात्| मुच्यते ज्वरितः पीत्वा पञ्चमूलीशृतं पयः||२३४|| एरण्डमूलोत्क्वथितं ज्वरात् सपरिकर्तिकात्| पयो विमुच्यते पीत्वा तद्वद्बिल्वशलाटुभिः||२३५|| त्रिकण्टकबलाव्याघ्रीगुडनागरसाधितम्| वर्चोमूत्रविबन्धघ्नं शोफज्वरहरं पयः||२३६|| सनागरं समृद्वीकं सघृतक्षौद्रशर्करम्| शृतं पयः सखर्जूरं पिपासाज्वरनाशनम्||२३७|| चतुर्गुणेनाम्भसा वा शृतं ज्वरहरं पयः| धारोष्णं वा पयः सद्यो वातपित्तज्वरं जयेत्||२३८|| जीर्णज्वराणां सर्वेषां पयः प्रशमनं परम्| पेयं तदुष्णं शीतं वा यथास्वं भेषजैः शृतम्||२३९|| Transliteration – kāsācchvāsācchiraḥśūlātpārśvaśūlāccirajvarāt| mucyatē jvaritaḥ pītvā pañcamūlīśr̥taṁ payaḥ||234|| ēraṇḍamūlōtkvathitaṁ jvarāt saparikartikāt| payō vimucyatē pītvā tadvadbilvaśalāṭubhiḥ||235|| trikaṇṭakabalāvyāghrīguḍanāgarasādhitam| varcōmūtravibandhaghnaṁ śōphajwaraharaṁ payaḥ||236|| sanāgaraṁ samr̥dvīkaṁ saghr̥takṣaudraśarkaram| śr̥taṁ payaḥ sakharjūraṁ pipāsājwaranāśanam||237|| caturguṇēnāmbhasā vā śr̥taṁ jwaraharaṁ payaḥ| dhārōṣṇaṁ vā payaḥ sadyō vātapittajwaraṁ jayēt||238|| jīrṇajvarāṇāṁ sarvēṣāṁ payaḥ praśamanaṁ param| pēyaṁ taduṣṇaṁ śītaṁ vā yathāsvaṁ bhēṣajaiḥ śr̥tam||239||

kAsAcchvAsAcchiraHshUlAtpArshvashUlAccirajwarat| mucyate jvaritaH pItvA pa~jcamUlIshRutaM payaH||234|| eraNDamUlotkvathitaM jwarat saparikartikAt| payo vimucyate pItvA tadvadbilvashalATubhiH||235|| trikaNTakabalAvyAghrIguDanAgarasAdhitam| varcomUtravibandhaghnaM shophajwaraharaM payaH||236|| sanAgaraM samRudvIkaM saghRutakShaudrasharkaram| shRutaM payaH sakharjUraM pipAsAjwaranAshanam||237|| caturguNenAmbhasA vA shRutaM jwaraharaM payaH| dhAroShNaM vA payaH sadyo vAtapittajwaraM jayet||238|| jIrNajwaraNAM sarveShAM payaH prashamanaM param| peyaM taduShNaM shItaM vA yathAsvaM bheShajaiH shRutam||239||

Translation in English – A patient suffering from cira jwara (chronic type of fevers), kāsa, śvāsa, śirah śūla and pārśva śūla gets cured by taking milk boiled with panchamūla (bilva and śyonāka, gambhāri, pātalā and gaṇikārikā). Milk boiled either with the root of eranda or the śalātū (unripe fruit cut into pieces) of bilva when taken cures fever along with parikartikā in the abdomen (sawing pain). Milk boiled with trikanṭaka, balā, vyāghrī, guḍa and nāgara, cures jwara along with śopha (oedema) and obstruction of the urine and faeces. The medicine prepared by boiling milk with nāgara, mṛdvīkā, khajūra and added with ghṛt, honey and sugar cures jwara associated with thirst. Milk boiled by adding water four times cures jwara. Dhārośṇa mlk (freshly milked from the cow, when its still hot) immediately cures jwara caused by the aggravation of vāta and pitta. All types of chronic fevers are alleviated by milk. It can be taken either hot, cold or after boiling with drugs appropriate to the kind of fever. Shloka - प्रयोजयेज्ज्वरहरान्निरूहान् सानुवासनान्| पक्वाशयगते दोषे वक्ष्यन्ते ये च सिद्धिषु||२४०|| पटोलारिष्टपत्राणि सोशीरश्चतुरङ्गुलः| ह्रीबेरं रोहिणी तिक्ता श्वदंष्ट्रा मदनानि च||२४१|| स्थिरा बला च तत् सर्वं पयस्यर्धोदके शृतम्| क्षीरावशेषं निर्यूहं संयुक्तं मधुसर्पिषा||२४२|| कल्कैर्मदनमुस्तानां पिप्पल्या मधुकस्य च| वत्सकस्य च संयुक्तं बस्तिं दद्याज्ज्वरापहम्||२४३|| शुद्धे मार्गे हृते दोषे विप्रसन्नेषु धातुषु| गताङ्गशूलो लघ्वङ्गः सद्यो भवति विज्वरः||२४४|| आरग्वधमुशीरं च मदनस्य फलं तथा| चतस्रः पर्णिनीश्चैव [१] निर्यूहमुपकल्पयेत्||२४५|| प्रियङ्गुर्मदनं मुस्तं शताह्वा मधुयष्टिका| कल्कः सर्पिर्गुडः क्षौद्रं ज्वरघ्नो बस्तिरुत्तमः||२४६|| गुडूचीं त्रायमाणां च चन्दनं मधुकं वृषम्| स्थिरां बलां पृश्निपर्णीं मदनं चेति साधयेत्||२४७|| रसं जाङ्गलमांसस्य रसेन सहितं भिषक्| पिप्पलीफलमुस्तानां कल्केन मधुकस्य च||२४८|| ईषत्सलवणं युक्त्या निरूहं मधुसर्पिषा| ज्वरप्रशमनं दद्याद्बलस्वेदरुचिप्रदम्||२४९|| जीवन्तीं मधुकं मेदां पिप्पलीं मदनं वचाम्| ऋद्धिं रास्नां बलां विश्वं [२] शतपुष्पां शतावरीम्||२५०|| पिष्ट्वा क्षीरं जलं सर्पिस्तैलं च विपचेद्भिषक्| आनुवासनिकं स्नेहमेतं विद्याज्ज्वरापहम्||२५१|| पटोलपिचुमर्दाभ्यां गुडूच्या मधुकेन च| मदनैश्च शृतः स्नेहो ज्वरघ्नमनुवासनम्||२५२|| चन्दनागुरुकाश्मर्यपटोलमधुकोत्पलैः| सिद्धः स्नेहो ज्वरहरः स्नेहबस्तिः प्रशस्यते||२५३|| Transliteration – prayōjayējjwaraharānnirūhān sānuvāsanān| pakvāśayagatē dōṣē vakṣyantē yē ca siddhiṣu||240|| paṭōlāriṣṭapatrāṇi sōśīraścaturaṅgulaḥ| hrībēraṁ rōhiṇī tiktā śvadaṁṣṭrā madanāni ca||241|| sthirā balā ca tat sarvaṁ payasyardhōdakē śr̥tam| kṣīrāvaśēṣaṁ niryūhaṁ saṁyuktaṁ madhusarpiṣā||242|| kalkairmadanamustānāṁ pippalyā madhukasya ca| vatsakasya ca saṁyuktaṁ bastiṁ dadyājjvarāpaham||243|| śuddhē mārgē hr̥tē dōṣē viprasannēṣu dhātuṣu| gatāṅgaśūlō laghvaṅgaḥ sadyō bhavati vijwaraḥ||244|| āragvadhamuśīraṁ ca madanasya phalaṁ tathā| catasraḥ parṇinīścaiva [1] niryūhamupakalpayēt||245|| priyaṅgurmadanaṁ mustaṁ śatāhvā madhuyaṣṭikā| kalkaḥ sarpirguḍaḥ kṣaudraṁ jwaraghnō bastiruttamaḥ||246|| guḍūcīṁ trāyamāṇāṁ ca candanaṁ madhukaṁ vr̥ṣam| sthirāṁ balāṁ pr̥śniparṇīṁ madanaṁ cēti sādhayēt||247|| rasaṁ jāṅgalamāṁsasya rasēna sahitaṁ bhiṣak| pippalīphalamustānāṁ kalkēna madhukasya ca||248|| īṣatsalavaṇaṁ yuktyā nirūhaṁ madhusarpiṣā| jwarapraśamanaṁ dadyādbalasvēdarucipradam||249|| jīvantīṁ madhukaṁ mēdāṁ pippalīṁ madanaṁ vacām| r̥ddhiṁ rāsnāṁ balāṁ viśvaṁ [2] śatapuṣpāṁ śatāvarīm||250|| piṣṭvā kṣīraṁ jalaṁ sarpistailaṁ ca vipacēdbhiṣak| ānuvāsanikaṁ snēhamētaṁ vidyājjvarāpaham||251|| paṭōlapicumardābhyāṁ guḍūcyā madhukēna ca| madanaiśca śr̥taḥ snēhō jwaraghnamanuvāsanam||252|| candanāgurukāśmaryapaṭōlamadhukōtpalaiḥ| siddhaḥ snēhō jwaraharaḥ snēhabastiḥ praśasyatē||253||

prayojayejjwaraharAnnirUhAn sAnuvAsanAn| pakvAshayagate doShe vakShyante ye ca siddhiShu||240|| paTolAriShTapatrANi soshIrashcatura~ggulaH| hrIberaM rohiNI tiktA shvadaMShTrA madanAni ca||241|| sthirA balA ca tat sarvaM payasyardhodake shRutam| kShIrAvasheShaM niryUhaM saMyuktaM madhusarpiShA||242|| kalkairmadanamustAnAM pippalyA madhukasya ca| vatsakasya ca saMyuktaM bastiM dadyAjjwarapaham||243|| shuddhe mArge hRute doShe viprasanneShu dhAtuShu| gatA~ggashUlo laghva~ggaH sadyo bhavati vijwaraH||244|| AragvadhamushIraM ca madanasya phalaM tathA| catasraH parNinIshcaiva [1] niryUhamupakalpayet||245|| priya~ggurmadanaM mustaM shatAhvA madhuyaShTikA| kalkaH sarpirguDaH kShaudraM jwaraghno bastiruttamaH||246|| guDUcIM trAyamANAM ca candanaM madhukaM vRuSham| sthirAM balAM pRushniparNIM madanaM ceti sAdhayet||247|| rasaM jA~ggalamAMsasya rasena sahitaM bhiShak| pippalIphalamustAnAM kalkena madhukasya ca||248|| IShatsalavaNaM yuktyA nirUhaM madhusarpiShA| jwaraprashamanaM dadyAdbalasvedarucipradam||249|| jIvantIM madhukaM medAM pippalIM madanaM vacAm| RuddhiM rAsnAM balAM vishvaM [2] shatapuShpAM shatAvarIm||250|| piShTvA kShIraM jalaM sarpistailaM ca vipacedbhiShak| AnuvAsanikaM snehametaM vidyAjjwarapaham||251|| paTolapicumardAbhyAM guDUcyA madhukena ca| madanaishca shRutaH sneho jwaraghnamanuvAsanam||252|| candanAgurukAshmaryapaTolamadhukotpalaiH| siddhaH sneho jwaraharaH snehabastiH prashasyate||253||

Translation in English – Niruha and anuvāsana types of bastīs (medicated enemas) which will be described in the siddhī sthāna should be administered when the dośhās are lodged in the pakwāśaya, for the treatment of jwara. Paṭola, ariśṭa leaves, uśīra, caturangula, hṛībera, rohiṇī, tiktā, śvadanṡṭrā, madana, sthirā and balā – these drugs should be boiled in milk by adding water which should be taken in equal the quantity of milk. This should be boiled till the amount equal to that of milk is left. To this mixture honey and ghṛt should be added along with the kalka of madana, mustā, pippalī, madhūka and vatsaka. This portion should be administered in the form of enema for the cure jwara. When the margās (channels) are clean, the dośhās are eliminated and the dhātūs are refreshed. Then the pain in the body disappears and the body becomes light and instantaneously free from fevers. A decoction prepared from āragvadha, uśīra, fruits of madana, śālaparṇī, pṛśnīparṇī, māśaparṇī and mudgaparṇī, mixed with the paste of priyangū, madana, mustā, śatāvhā and madhuyaśṭī should be used as an enema, for the cure of jwara. A decoction prepared from Guḍūcī, trāyamāṇa, candana, madhūka, vṛṡa, sthirā, balā, pṛśnīparṇī and madana, to which meat soup of jāngala type of animals (those inhabiting in arid lands) and the paste of pippalī, phala, mustā and madhūka has been added. A small quantity of rock salt should also be added to this decoction along with honey and ghṛta and used as nirūha type of medicated enema for the alleviation of jwara as it promotes strength, sweating and taste appreciation. A medicated ghṛt prepared from the paste of jīvantī, madhūa, medā, pippalī, madana, vacā, ṛddhī, rāsnā, balā, biśva, śatapuśpā and śatāvarī, boiled with milk, water, ghṛta and oil, should be used as anuvāsana vastī for the treatment of jwara. The sneha (ghṛt and oil) boiled with paṭola, picumarda, guḍucī, madhūka and madana should also be used as anuvāsana vastī for the treatment of jwara. The sneha boiled with candana, agurū, kāśmarya, paṭola, madhūka and utpala is exceedingly useful for the administration as anuvāsana vastī to cure jwara. Shloka - यदुक्तं भेषजाध्याये विमाने रोगभेषजे| शिरोविरेचनं कुर्याद्युक्तिज्ञस्तज्ज्वरापहम्||२५४|| यच्च नावनिकं तैलं याश्च तैलं याश्च प्राग्धूमवर्तयः| मात्राशितीये निर्दिष्टाः प्रयोज्यास्ता ज्वरेष्वपि||२५५|| Transliteration – yaduktaṁ bhēṣajādhyāyē vimānē rōgabhēṣajē| śirōvirēcanaṁ kuryādyuktijñastajjvarāpaham||254|| yacca nāvanikaṁ tailaṁ yāśca tailaṁ yāśca prāgdhūmavartayaḥ| mātrāśitīyē nirdiṣṭāḥ prayōjyāstā jvarēṣvapi||255|| yaduktaM bheShajAdhyAye vimAne rogabheShaje| shirovirecanaM kuryAdyuktij~jastajjwarapaham||254|| yacca nAvanikaM tailaM yAshca tailaM yAshca prAgdhUmavartayaH| mAtrAshitIye nirdiShTAH prayojyAstA jvareShvapi||255|| Translation in English – Drugs for śirovirecana therapy (module of taking out the dośhās from the uttamānaga - śira) are already described in the Bheṡajādhyāya of Sūtra sthāna and Rog bhiṡagjitīya chapter of vimāna sthāna. A physician well versed in these treatment modules should apply them for the treatment of jwara. The medicated oil and the dhuma vartī described for application as nasal drop and dhuma varti respectively in the mātrāśitīya chapter, should also be used for the treatment of jwara. Shloka - अभ्यङ्गांश्च प्रदेहांश्च परिषेकांश्च कारयेत्| यथाभिलाषं शीतोष्णं विभज्य द्विविधं ज्वरम्||२५६|| सहस्रधौतं सर्पिर्वा तैलं वा चन्दनादिकम्| दाहज्वरप्रशमनं दद्यादभ्यञ्जनं भिषक्||२५७|| Transliteration – abhyaṅgāṁśca pradēhāṁśca pariṣēkāṁśca kārayēt| yathābhilāṣaṁ śītōṣṇaṁ vibhajya dvividhaṁ jwaram||256|| sahasradhautaṁ sarpirvā tailaṁ vā candanādikam| dāhajwarapraśamanaṁ dadyādabhyañjanaṁ bhiṣak||257||

abhya~ggAMshca pradehAMshca pariShekAMshca kArayet| yathAbhilAShaM shItoShNaM vibhajya dvividhaM jwaram||256|| sahasradhautaM sarpirvA tailaM vA candanAdikam| dAhajwaraprashamanaM dadyAdabhya~jjanaM bhiShak||257||

Translation in English – Abhyanga (massage), pradeha (unction) and pariṡeka (medicated bath) should be given to the patient, either hot or cold, according to the appropriateness of the two types of jwara of the patient. Medicated ghṛt called as Sahasra dhauta ghṛta and medicated oil called candanādya taila should be given for massage to the patient, as these alleviate jwara associated with burning.

Shloka - अथ चन्दनाद्यं तैलमुपदेक्ष्यामः-चन्दनभद्रश्रीकालानुसार्यकालीयकपद्मापद्मकोशीरसारिवामधुकप्रपौण्डरीकनागपुष्पोदीच्यवन्यपद्मोत्पलनलिनकुमुद-सौगन्धिकपुण्डरीकशतपत्रबिसमृणालशालूकशैवालकशेरुकानन्ताकुशकाशेक्षुदर्भशरनलशालिमूलजम्बुवेतसवानीरगुन्द्रा-ककुभासनाश्वकर्णस्यन्दनवातपोथशालतालधवतिनिशखदिरकदरकदम्बकाश्मर्यफलसर्जप्लक्षवटकपीतनोदुम्बराश्वत्थ-न्यग्रोधधातकीदूर्वेत्कटशृङ्गाटकमञ्जिष्ठाज्योतिष्मतीपुष्करबीजक्रौञ्चादनबदरीकोविदारकदली-संवर्तकारिष्टशतपर्वाशीतकुम्भिकाशतावरीश्रीपर्णीश्रावणीमहाश्रावणीरोहिणीशीतपाक्योदनपाकीकालबलापयस्याविदारी-जीवकर्षभकमेदामहामेदामधुरसर्ष्यप्रोक्तातृणशून्यमोचरसाटरूषकबकुलकुटजपटोलनिम्बशाल्मलीनारिकेल-खर्जूरमृद्वीकाप्रियालप्रियङ्गुधन्वनात्मागुप्तामधूकानामन्येषां [१] च शीतवीर्याणां यथालाभमौषधानां कषायं कारयेत्| तेन कषायेण द्विगुणितपयसा तेषामेव च कल्केन कषायार्धमात्रं मृद्वग्निना साधयेत्तैलम्| एतत्तैलमभ्यङ्गात् सद्यो दाहज्वरमपनयति| एतैरेव चौषधैरश्लक्ष्णपिष्टैः सुशीतैः प्रदेहं कारयेत्| एतैरेव च शृतशीतं सलिलमवगाहपरिषेकार्थं प्रयुञ्जीत||२५८|| इति चन्दनाद्यं तैलम्| मध्वारनालक्षीरदधिघृतसलिलसेकावगाहाश्च सद्यो दाहज्वरमपनयन्ति शीतस्पर्शत्वात्||२५९|| Transliteration – atha candanādyaṁ tailamupadēkṣyāmaḥ-candanabhadraśrīkālānusāryakālīyakapadmāpadmakōśīrasārivāmadhukaprapauṇḍarīkanāgapuṣpōdīcyavanyapadmōtpalanalinakumuda-saugandhikapuṇḍarīkaśatapatrabisamr̥ṇālaśālūkaśaivālakaśērukānantākuśakāśēkṣudarbhaśaranalaśālimūlajambuvētasavānīragundrā-kakubhāsanāśvakarṇasyandanavātapōthaśālatāladhavatiniśakhadirakadarakadambakāśmaryaphalasarjaplakṣavaṭakapītanōdumbarāśvattha-nyagrōdhadhātakīdūrvētkaṭaśr̥ṅgāṭakamañjiṣṭhājyōtiṣmatīpuṣkarabījakrauñcādanabadarīkōvidārakadalī-saṁvartakāriṣṭaśataparvāśītakumbhikāśatāvarīśrīparṇīśrāvaṇīmahāśrāvaṇīrōhiṇīśītapākyōdanapākīkālabalāpayasyāvidārī-jīvakarṣabhakamēdāmahāmēdāmadhurasarṣyaprōktātr̥ṇaśūnyamōcarasāṭarūṣakabakulakuṭajapaṭōlanimbaśālmalīnārikēla-kharjūramr̥dvīkāpriyālapriyaṅgudhanvanātmāguptāmadhūkānāmanyēṣāṁ [1] ca śītavīryāṇāṁ yathālābhamauṣadhānāṁ kaṣāyaṁ kārayēt| tēna kaṣāyēṇa dviguṇitapayasā tēṣāmēva ca kalkēna kaṣāyārdhamātraṁ mr̥dvagninā sādhayēttailam| ētattailamabhyaṅgāt sadyō dāhajwaramapanayati| ētairēva cauṣadhairaślakṣṇapiṣṭaiḥ suśītaiḥ pradēhaṁ kārayēt| ētairēva ca śr̥taśītaṁ salilamavagāhapariṣēkārthaṁ prayuñjīta||258|| iti candanādyaṁ tailam| madhvāranālakṣīradadhighr̥tasalilasēkāvagāhāśca sadyō dāhajwaramapanayanti śītasparśatvāt||259||

atha candanAdyaM tailamupadekShyAmaH-candanabhadrashrIkAlAnusAryakAlIyakapadmApadmakoshIrasArivAmadhukaprapauNDarIkanAgapuShpodIcyavanyapadmotpalanalinakumuda-saugandhikapuNDarIkashatapatrabisamRuNAlashAlUkashaivAlakasherukAnantAkushakAshekShudarbhasharanalashAlimUlajambuvetasavAnIragundrA-kakubhAsanAshvakarNasyandanavAtapothashAlatAladhavatinishakhadirakadarakadambakAshmaryaphalasarjaplakShavaTakapItanodumbarAshvattha-nyagrodhadhAtakIdUrvetkaTashRu~ggATakama~jjiShThAjyotiShmatIpuShkarabIjakrau~jcAdanabadarIkovidArakadalI-saMvartakAriShTashataparvAshItakumbhikAshatAvarIshrIparNIshrAvaNImahAshrAvaNIrohiNIshItapAkyodanapAkIkAlabalApayasyAvidArI-jIvakarShabhakamedAmahAmedAmadhurasarShyaproktAtRuNashUnyamocarasATarUShakabakulakuTajapaTolanimbashAlmalInArikela-kharjUramRudvIkApriyAlapriya~ggudhanvanAtmAguptAmadhUkAnAmanyeShAM [1] ca shItavIryANAM yathAlAbhamauShadhAnAM kaShAyaM kArayet| tena kaShAyeNa dviguNitapayasA teShAmeva ca kalkena kaShAyArdhamAtraM mRudvagninA sAdhayettailam| etattailamabhya~ggAt sadyo dAhajwaramapanayati| etaireva cauShadhairashlakShNapiShTaiH sushItaiH pradehaM kArayet| etaireva ca shRutashItaM salilamavagAhapariShekArthaM prayu~jjIta||258|| iti candanAdyaM tailam| madhvAranAlakShIradadhighRutasalilasekAvagAhAshca sadyo dAhajwaramapanayanti shItasparshatvAt||259||

Translation in English – Now, Candanādya taila preparation will be described – candana (red variety of candana), bhadraśrī (white variety of candana), kālānusārya, kāiyaka, padma, padmaka, uśira, sārivā, madhuka, nāgapuśpa, udīcya, vanya, padma, utpala, nalina (a white variety of padma), kumuda; saugandhika, punḍarīka, śata patra, bias, mṛnāla, śālūka, śaivāla, kaśeruka, anantā, kuśa, kāsa, ikṡu, darbha, śara, nala – root of śāli, jambu, vetasa, vānīra (a variety of vetasa which do not have fragrant root), gundrā, kakubha, asana, aśvakarṇa (a variety of śāla), syandana (nemi vṛkṡa), vātapothā (palāśa), śala, tāla, dava, tiniśa (vañjula), khadira, kadara (viṭkhadira), kadamba, fruit of kāśmarya, sarja, plakṡa, vaṭa (the variety without any adventitious root), kapītana (popularly known as gandhamuṅḍa), udumbara, aśvattha, nyagodhra, dhātakī, dūrvā, itkaṭa, śṛṅgāṭaka, mañjiśthā, jyotiṡmatī (kangaṇikā), seeds of puṡkara, karuñacandana, badarī, kovidāra, kadalī, samvartaka, ariṡṭa (a variety of neem growing in the hills), śataparvā (bibhītaka), śita kumbhikā (kāṡṭha pāṭalā), śatāvarī, śriparṇī, śrāvaṇī, mahā śrāvaṇī (alambuśa – having big fruits), rohiṇī, sīta pākī (gaṅḍa dūrvā), odana pākī (nīla bheṅḍī), kālā (kākolī), balā, payasyā, vidārī, jīvaka, ṛṡabhaka, medā, mahamedā, madurasa, ṛṡyaproktā (ṛddhī), tṛṇa śūnya (ketakī), mocarasa, ātaruṡaka, bakula, kuṭaja, paṭola, śālmalī, nārīkela, kharjūra, mṛdvīkā, priyāla, priyangū, dhanvana, ātma guptā, madhūka, and such other drugs which are cold in potency. Also the drugs which have the same cooling effect can also be added to prepare this decoction, using double the quantity of water. The kalka (paste) of all the above mentioned drugs must also be taken. Oil mixed with the above stated decoction and paste should be boiled on mild fire till half the quantity is left. Massage of this medicated oil instantaneously cures dāha jwara. The above mentioned drugs should be made in the form of a fine paste and then used as a pradeha when it has cooled. The water boiled with these drugs should be used when cooled for avagāha and pariṡeka (bathing and sprinkling over the body respectively). The seka and avagāha (sprinkling of water and bathing) with madhu, ārnāla (sour gruel), milk, curd, ghṛta and water cure dāha jwara instantaneously, because of their cold touch. Shloka - भवन्ति चात्र- पौष्करेषु सुशीतेषु पद्मोत्पलदलेषु च| कदलीनां च पत्रेषु क्षौमेषु विमलेषु च||२६०|| चन्दनोदकशीतेषु शीते [५] धारागृहेऽपि वा| हिमाम्बुसिक्ते सदने दाहार्तः [६] संविशेत् सुखम्||२६१|| हेमशङ्खप्रवालानां मणीनां मौक्तिकस्य च| चन्दनोदकशीतानां संस्पर्शानुरसान् [७] स्पृशेत्||२६२|| स्रग्भिर्नीलोत्पलैः पद्मैर्व्यजनैर्विविधैरपि| शीतवातावहैर्व्यज्ज्येच्चन्दनोदकवर्षिभिः [८] ||२६३|| नद्यस्तडागाः पद्मिन्यो ह्रदाश्च विमलोदकाः| अवगाहे हिता दाहतृष्णाग्लानिज्वरापहाः||२६४|| प्रियाः प्रदक्षिणाचाराः प्रमदाश्चन्दनोक्षिताः| सान्त्वयेयुः परैः कामैर्मणिमौक्तिकभूषणाः||२६५|| शीतानि चान्नपानानि शीतान्युपवनानि च| वायवश्चन्द्रपादाश्च शीता दाहज्वरापहाः||२६६|| Transliteration – bhavanti cātra- pauṣkarēṣu suśītēṣu padmōtpaladalēṣu ca| kadalīnāṁ ca patrēṣu kṣaumēṣu vimalēṣu ca||260|| candanōdakaśītēṣu śītē [5] dhārāgr̥hē'pi vā| himāmbusiktē sadanē dāhārtaḥ [6] saṁviśēt sukham||261|| hēmaśaṅkhapravālānāṁ maṇīnāṁ mauktikasya ca| candanōdakaśītānāṁ saṁsparśānurasān [7] spr̥śēt||262|| sragbhirnīlōtpalaiḥ padmairvyajanairvividhairapi| śītavātāvahairvyajjyēccandanōdakavarṣibhiḥ [8] ||263|| nadyastaḍāgāḥ padminyō hradāśca vimalōdakāḥ| avagāhē hitā dāhatr̥ṣṇāglānijvarāpahāḥ||264|| priyāḥ pradakṣiṇācārāḥ pramadāścandanōkṣitāḥ| sāntvayēyuḥ paraiḥ kāmairmaṇimauktikabhūṣaṇāḥ||265|| śītāni cānnapānāni śītānyupavanāni ca| vāyavaścandrapādāśca śītā dāhajvarāpahāḥ||266||

bhavanti cAtra- pauShkareShu sushIteShu padmotpaladaleShu ca| kadalInAM ca patreShu kShaumeShu vimaleShu ca||260|| candanodakashIteShu shIte [5] dhArAgRuhe~api vA| himAmbusikte sadane dAhArtaH [6] saMvishet sukham||261|| hemasha~gkhapravAlAnAM maNInAM mauktikasya ca| candanodakashItAnAM saMsparshAnurasAn [7] spRushet||262|| sragbhirnIlotpalaiH padmairvyajanairvividhairapi| shItavAtAvahairvyajjyeccandanodakavarShibhiH [8] ||263|| nadyastaDAgAH padminyo hradAshca vimalodakAH| avagAhe hitA dAhatRuShNAglAnijwarapahAH||264|| priyAH pradakShiNAcArAH pramadAshcandanokShitAH| sAntvayeyuH paraiH kAmairmaNimauktikabhUShaNAH||265|| shItAni cAnnapAnAni shItAnyupavanAni ca| vAyavashcandrapAdAshca shItA dAhajwarapahAH||266||

Translation in English – A patient of jwara suffering from burning sensation should reside in a house cooled by the leaves of puṡkara, padma, utpala, kadalī or kṡauma. The house can also be cooled by cold water of sandalwood or the patient can also reside in a dhāra gṛha (a house coled by running water either flowing from above or falling from the roof) or a house cooled by ice cool water. This gives comfort to the patient. His body should be touched with the pleasant touch of gold or conch shell or coral or jewels and pearls which are cooled by the sandalwood water. He should be made to wear the garlands made of nīlotpala or padma and fanned with the cold air from different types of fans which are cooled with sandalwood water. He should take bath in rivers, ponds, ponds having lotus plant and lakes having clean water. This bath alleviates burning sensation, morbid thirst, glāni and jwara. Such patient should also be comforted with the touch of ladies smeared with sandalwood paste, wearing desirable jewels and pearls; which are affectionate and skilled with polite manners. Diet and drinks which are cold, cooling gardens, cold wind and cold rays of the moon; alleviate jwara with burning sensation. Shloka - अथोष्णाभिप्रायिणां ज्वरितानामभ्यङ्गादीनुपक्रमानुपदेक्ष्यामः-अगुरुकुष्ठतगरपत्रनलदशैलेयध्यामकहरेणुकास्थौणेयकक्षेमकैलावराङ्गदलपुरतमालपत्रभूतीकरोहिषसरलशल्लकी-देवदार्वग्निमन्थबिल्वस्योनाककाश्मर्यपाटलापुनर्नवावृश्चीरकण्टकारीबृहतीशालपर्णीपृश्निपर्णीमाषपर्णीमुद्गपर्णीगोक्षुरकैरण्ड-शोभाञ्जनकवरुणार्कचिरबिल्वतिल्वकशटीपुष्करमूलगण्डीरोरुबूकपत्तूराक्षीवाश्मान्तकशिग्रुमातुलुङ्गपीलुकमूलकपर्णी-तिलपर्णीपीलुपर्णीमेषशृङ्गीहिंस्रादन्तशठैरावतकभल्लातकास्फोतकाण्डीरात्मजैकेषीकाकरञ्जधान्यकाजमोद-पृथ्वीकासुमुखसुरसकुठेरककालमालकपर्णासक्षवकफणिज्झकभूस्तृणशृङ्गवेरपिप्पलीसर्षपाश्वगन्धारास्नारुहारोहावचाबलातिबला-गुडूचीशतपुष्पाशीतवल्लीनाकुलीगन्धनाकुलीश्वेताज्योतिष्मतीचित्रकाध्यण्डाम्लचाङ्गेरी-तिलबदरकुलत्थमाषाणामेवंविधानामन्येषां [१] [२] [३] चोष्णवीर्याणां यथालाभमौषधानां कषायं कारयेत्, तेन कषायेण तेषामेव चकल्केन सुरासौवीरकतुषोदकमैरेयमेदकदधिमण्डारनालकट्वरप्रतिविनीतेन तैलपात्रं विपाचयेत्| तेन सुखोष्णेन तैलेनोष्णाभिप्रायिणं ज्वरितमभ्यञ्ज्यात्, तथा शीतज्वरः प्रशाम्यति; एतैरेव चौषधैः श्लक्ष्णपिष्टैः सुखोष्णैः प्रदेहंकारयेत्, एतैरेव च शृतं सुखोष्णं सलिलमवगाहनार्थं परिषेकार्थं च प्रयुञ्जीत शीतज्वरप्रशमार्थम्||२६७|| इत्यगुर्वाद्यं तैलम् Transliteration – athōṣṇābhiprāyiṇāṁ jvaritānāmabhyaṅgādīnupakramānupadēkṣyāmaḥ-agurukuṣṭhatagarapatranaladaśailēyadhyāmakaharēṇukāsthauṇēyakakṣēmakailāvarāṅgadalapuratamālapatrabhūtīkarōhiṣasaralaśallakī-dēvadārvagnimanthabilvasyōnākakāśmaryapāṭalāpunarnavāvr̥ścīrakaṇṭakārībr̥hatīśālaparṇīpr̥śniparṇīmāṣaparṇīmudgaparṇīgōkṣurakairaṇḍa-śōbhāñjanakavaruṇārkacirabilvatilvakaśaṭīpuṣkaramūlagaṇḍīrōrubūkapattūrākṣīvāśmāntakaśigrumātuluṅgapīlukamūlakaparṇī-tilaparṇīpīluparṇīmēṣaśr̥ṅgīhiṁsrādantaśaṭhairāvatakabhallātakāsphōtakāṇḍīrātmajaikēṣīkākarañjadhānyakājamōda-pr̥thvīkāsumukhasurasakuṭhērakakālamālakaparṇāsakṣavakaphaṇijjhakabhūstr̥ṇaśr̥ṅgavērapippalīsarṣapāśvagandhārāsnāruhārōhāvacābalātibalā-guḍūcīśatapuṣpāśītavallīnākulīgandhanākulīśvētājyōtiṣmatīcitrakādhyaṇḍāmlacāṅgērī- tilabadarakulatthamāṣāṇāmēvaṁvidhānāmanyēṣāṁ [1] [2] [3]cōṣṇavīryāṇāṁ yathālābhamauṣadhānāṁ kaṣāyaṁ kārayēt, tēna kaṣāyēṇa tēṣāmēva ca kalkēnasurāsauvīrakatuṣōdakamairēyamēdakadadhimaṇḍāranālakaṭvaraprativinītēna tailapātraṁ vipācayēt| tēna sukhōṣṇēna tailēnōṣṇābhiprāyiṇaṁ jvaritamabhyañjyāt, tathā śītajwaraḥ praśāmyati; ētairēva cauṣadhaiḥ ślakṣṇapiṣṭaiḥ sukhōṣṇaiḥ pradēhaṁkārayēt, ētairēva ca śr̥taṁ sukhōṣṇaṁ salilamavagāhanārthaṁ pariṣēkārthaṁ ca prayuñjīta śītajwarapraśamārtham||267|| ityagurvādyaṁ tailam

athoShNAbhiprAyiNAM jvaritAnAmabhya~ggAdInupakramAnupadekShyAmaH-agurukuShThatagarapatranaladashaileyadhyAmakahareNukAsthauNeyakakShemakailAvarA~ggadalapuratamAlapatrabhUtIkarohiShasaralashallakI-devadArvagnimanthabilvasyonAkakAshmaryapATalApunarnavAvRushcIrakaNTakArIbRuhatIshAlaparNIpRushniparNImAShaparNImudgaparNIgokShurakairaNDa-shobhA~jjanakavaruNArkacirabilvatilvakashaTIpuShkaramUlagaNDIrorubUkapattUrAkShIvAshmAntakashigrumAtulu~ggapIlukamUlakaparNI-tilaparNIpIluparNImeShashRu~ggIhiMsrAdantashaThairAvatakabhallAtakAsphotakANDIrAtmajaikeShIkAkara~jjadhAnyakAjamoda-pRuthvIkAsumukhasurasakuTherakakAlamAlakaparNAsakShavakaphaNijjhakabhUstRuNashRu~ggaverapippalIsarShapAshvagandhArAsnAruhArohAvacAbalAtibalA-guDUcIshatapuShpAshItavallInAkulIgandhanAkulIshvetAjyotiShmatIcitrakAdhyaNDAmlacA~ggerI- tilabadarakulatthamAShANAmevaMvidhAnAmanyeShAM [1] [2] [3]coShNavIryANAM yathAlAbhamauShadhAnAM kaShAyaM kArayet, tena kaShAyeNa teShAmeva ca kalkenasurAsauvIrakatuShodakamaireyamedakadadhimaNDAranAlakaTvaraprativinItena tailapAtraM vipAcayet| tena sukhoShNena tailenoShNAbhiprAyiNaM jvaritamabhya~jjyAt, tathA shItajwaraH prashAmyati; etaireva cauShadhaiH shlakShNapiShTaiH sukhoShNaiHpradehaM kArayet, etaireva ca shRutaM sukhoShNaM salilamavagAhanArthaM pariShekArthaM ca prayu~jjIta shItajwaraprashamArtham||267|| ityagurvAdyaM tailam

Translation in English – Now, we will explain the therapies for patients of jwara for whom hot treatment is desirable – A decoction prepared from aguru, kuṡṭha, tagara, patra, nalada, śaileya, dhyāmaka, hareṇuka, sthauṇeyaka, kṡemaka, elā, varāñga, dala, pura, tamāla patra, bhūtika, rohiṡa, sarala, śallakī, devadārū, agnimantha, bilva, śyonāka, kāśmarya, pāṭalā, punarnavā, vṛṡcīra, kanṭakārī, bṛhatī, śālaparṇī, pṛśniparṇī, māṡaparṇī, mudgaparṇī, gokṡur, eranda, śobhānjana, varuṇa, arka, cirabilva, tilvaka, śaṭī, puṡkaramūla, ganḍīra, urūbaka, pattūra, akṡīva, aṡmantaka, śigru, mātulunga, pīlūka, mūlaka prṇī, tila parṇī, pīlu parṇī, meṡa śṛngī, hiṁsrā, danta śaṭha, airāvata, bhallātaka, āsphoṭaka, āndḍīra, ātmajā, ekaiṡikā (ambaṡṭhā) karanja, dhānyaka, ajamodā, pṛthvīkā, sumukhā, surasā, kuṭheraka, kāla mālaka, parṇāsa, kṡavaka, phaṇijjhaka, bhūstṛṇa, śṛngabera, pippalī, sarṡapa, aśvagandhā, rāsnā, ruhā (vṛkṡa rūhā), rohā (añjalīkārikā), vacā, balā, atibalā, guḍucī, śatapuṡpā, śita vallī, nākulī, gandha nākulī, śvetā, jyotiṡmatī, citraka, adhyaṇdā, amla cāngerī, tila, badara, kulattha, māṡa, and such other drugs which are hot in potency. A decoction and paste should be prepared from all the drugs described or those amongst them which are available. These decoction and paste should be added with surā (alcoholic drinks), sauvīraka (vinegar), tuṡodaka (a type of vinegar), maireya (an alcoholic drink), dadhi manḍa (scum of curd), ārnāla (sour gruel recipe), kaṭvara (watery curd along with the fat content) should be boiled in one pātra of oil (3.072 l). When this oil is still luke warm, it should be massaged to the patient suffering from jwara for whom hot therapy is indicated. This will cure śīta jwara. The above mentioned drugs should be made in the form of a fine paste and then used as a pradeha when it is cooled. The water boiled with these drugs should be used when cooled for avagāha and pariṡeka (bathing and sprinkling over the body respectively). Shloka - भवन्ति चात्र- त्रयोदशविधः स्वेदः स्वेदाध्याये निदर्शितः| मात्राकालविदा युक्तः स च शीतज्वरापहः||२६८|| सा कुटी तच्च शयनं तच्चावच्छादनं ज्वरम्| शीतं प्रशमयन्त्याशु धूपाश्चागुरुजा घनाः||२६९|| चारूपचितगात्र्यश्च तरुण्यो यौवनोष्मणा| आश्लेषाच्छमयन्त्याशु प्रमदाः शिशिरज्वरम्||२७०|| स्वेदनान्यन्नपानानि वातश्लेष्महराणि च| शीतज्वरं जयन्त्याशु संसर्गबलयोजनात्||२७१|| Transliteration – bhavanti cātra- trayōdaśavidhaḥ svēdaḥ svēdādhyāyē nidarśitaḥ| mātrākālavidā yuktaḥ sa ca śītajvarāpahaḥ||268|| sā kuṭī tacca śayanaṁ taccāvacchādanaṁ jwaram| śītaṁ praśamayantyāśu dhūpāścāgurujā ghanāḥ||269|| cārūpacitagātryaśca taruṇyō yauvanōṣmaṇā| āślēṣācchamayantyāśu pramadāḥ śiśirajwaram||270|| svēdanānyannapānāni vātaślēṣmaharāṇi ca| śītajwaraṁ jayantyāśu saṁsargabalayōjanāt||271||

bhavanti cAtra- trayodashavidhaH svedaH svedAdhyAye nidarshitaH| mAtrAkAlavidA yuktaH sa ca shItajwarapahaH||268|| sA kuTI tacca shayanaM taccAvacchAdanaM jwaram| shItaM prashamayantyAshu dhUpAshcAgurujA ghanAH||269|| cArUpacitagAtryashca taruNyo yauvanoShmaNA| AshleShAcchamayantyAshu pramadAH shishirajwaram||270|| svedanAnyannapAnAni vAtashleShmaharANi ca| shItajwaraM jayantyAshu saMsargabalayojanAt||271||

Translation in English – Thirteen varities of sveda procedures have been described in the svedā adhyāya of sūtra sthāna. A physician who is well versed with the proper duration of sweda as suitable to the season and person should administer them for the treatment of śīta jwara. Sleeping on a bed and covering oneself with clothes in the kuṭi sveda (fomentation technique by keeping the patient in a cottage) immediately alleviates śīta. Similarly, the strong fumigation by agurū also alleviates śīta. Sīta jwara is also cured by the embrace of passionate ladies who are beautiful, have plump body and are young, due to the heat of their youth. Different types of diet and drinks which cause fomentation and alleviate vāta and kapha, instantaneously alleviate śīta jwara. These should be administered keeping in view of the saṁsarga (combination of two dośhās) and the bala of each dośha. Shloka - वातजे श्रमजे चैव पुराणे क्षतजे ज्वरे| लङ्घनं न हितं विद्याच्छमनैस्तानुपाचरेत्||२७२|| विक्षिप्यामाशयोष्माणं यस्माद्गत्वा रसं नृणाम्| ज्वरं कुर्वन्ति दोषास्तु हीयतेऽग्निबलं ततः||२७३|| यथा प्रज्वलितो वह्निः स्थाल्यामिन्धनवानपि| न पचत्योदनं सम्यगनिलप्रेरितो बहिः||२७४|| पक्तिस्थानात्तथा दोषैरूष्मा क्षिप्तो बहिर्नृणाम्| न पचत्यभ्यवहृतं कृच्छ्रात् पचति वा लघु||२७५|| अतोऽग्निबलरक्षार्थं लङ्घनादिक्रमो हितः| सप्ताहेन हि पच्यन्ते सप्तधातुगता मलाः||२७६|| निरामश्चाप्यतः प्रोक्तो ज्वरः प्रायोऽष्टमेऽहनि| उदीर्णदोषस्त्वल्पाग्निरश्नन् गुरु विशेषतः||२७७|| मुच्यते सहसा प्राणैश्चिरं क्लिश्यति वा नरः| एतस्मात्कारणाद्विद्वान् वातिकेऽप्यादितो ज्वरे||२७८|| नाति गुर्वति वा स्निग्धं भोजयेत् सहसा नरम्| ज्वरे मारुतजे त्वादावनपेक्ष्यापि हि क्रमम्||२७९|| कुर्यान्निरनुबन्धानामभ्यङ्गादीनुपक्रमान्| पाययित्वा कषायं च भोजयेद्रसभोजनम्||२८०|| जीर्णज्वरहरं कुर्यात् सर्वशश्चाप्युपक्रमम्| श्लेष्मलानामवातानां ज्वरोऽनुष्णः [१] कफाधिकः||२८१|| परिपाकं न सप्ताहेनापि याति मृदूष्मणाम्| तं क्रमेण यथोक्तेन लङ्घनाल्पाशनादिना||२८२|| आदशाहमुपक्रम्य कषायाद्यैरुपाचरेत्|२८३| Transliteration – vātajē śramajē caiva purāṇē kṣatajē jvarē| laṅghanaṁ na hitaṁ vidyācchamanaistānupācarēt||272|| vikṣipyāmāśayōṣmāṇaṁ yasmādgatvā rasaṁ nr̥ṇām| jwaraṁ kurvanti dōṣāstu hīyatē'gnibalaṁ tataḥ||273|| yathā prajvalitō vahniḥ sthālyāmindhanavānapi| na pacatyōdanaṁ samyaganilaprēritō bahiḥ||274|| paktisthānāttathā dōṣairūṣmā kṣiptō bahirnr̥ṇām| na pacatyabhyavahr̥taṁ kr̥cchrāt pacati vā laghu||275|| atō'gnibalarakṣārthaṁ laṅghanādikramō hitaḥ| saptāhēna hi pacyantē saptadhātugatā malāḥ||276|| nirāmaścāpyataḥ prōktō jwaraḥ prāyō'ṣṭamē'hani| udīrṇadōṣastvalpāgniraśnan guru viśēṣataḥ||277|| mucyatē sahasā prāṇaiściraṁ kliśyati vā naraḥ| ētasmātkāraṇādvidvān vātikē'pyāditō jvarē||278|| nāti gurvati vā snigdhaṁ bhōjayēt sahasā naram| jvarē mārutajē tvādāvanapēkṣyāpi hi kramam||279|| kuryānniranubandhānāmabhyaṅgādīnupakramān| pāyayitvā kaṣāyaṁ ca bhōjayēdrasabhōjanam||280|| jīrṇajwaraharaṁ kuryāt sarvaśaścāpyupakramam| ślēṣmalānāmavātānāṁ jvarō'nuṣṇaḥ [1] kaphādhikaḥ||281|| paripākaṁ na saptāhēnāpi yāti mr̥dūṣmaṇām| taṁ kramēṇa yathōktēna laṅghanālpāśanādinā||282|| ādaśāhamupakramya kaṣāyādyairupācarēt|283|

vAtaje shramaje caiva purANe kShataje jvare| la~gghanaM na hitaM vidyAcchamanaistAnupAcaret||272|| vikShipyAmAshayoShmANaM yasmAdgatvA rasaM nRuNAm| jwaraM kurvanti doShAstu hIyate~agnibalaM tataH||273|| yathA prajvalito vahniH sthAlyAmindhanavAnapi| na pacatyodanaM samyaganilaprerito bahiH||274|| paktisthAnAttathA doShairUShmA kShipto bahirnRuNAm| na pacatyabhyavahRutaM kRucchrAt pacati vA laghu||275|| ato~agnibalarakShArthaM la~gghanAdikramo hitaH| saptAhena hi pacyante saptadhAtugatA malAH||276|| nirAmashcApyataH prokto jwaraH prAyo~aShTame~ahani| udIrNadoShastvalpAgnirashnan guru visheShataH||277|| mucyate sahasA prANaishciraM klishyati vA naraH| etasmAtkAraNAdvidvAn vAtike~apyAdito jvare||278|| nAti gurvati vA snigdhaM bhojayet sahasA naram| jvare mArutaje tvAdAvanapekShyApi hi kramam||279|| kuryAnniranubandhAnAmabhya~ggAdInupakramAn| pAyayitvA kaShAyaM ca bhojayedrasabhojanam||280|| jIrNajwaraharaM kuryAt sarvashashcApyupakramam| shleShmalAnAmavAtAnAM jvaro~anuShNaH [1] kaphAdhikaH||281|| paripAkaM na saptAhenApi yAti mRudUShmaNAm| taM krameNa yathoktena la~gghanAlpAshanAdinA||282|| AdashAhamupakramya kaShAyAdyairupAcaret|283|

Translation in English – Langhana (fasting) is not useful for patients suffering from jwara caused by aggravated vāta, by exhaustion, in chronic fevers, in fevers caused by kṡata (external and internal injuries). Such patients should be treated by śamana therapy (alleviation therapy). The aggravated dośhas afflict the rasa dhātu and displace the agnī from the āmāśaya, for causing jwara. Thus such patients have less of agni (digestive strength). Even if a rice pot is kept on burning fire with sufficient fuel, the rice will not get cooked if the fire is blown out by a strong wind. Similarly in a patient of jwara, the ūṡmā (digestive fire) is blown out of the paktī sthāna (place of digestion) and in this condition the eaten food is not digested properly. If the food is light, then also it gets digested with difficulty. Therefore, the line of treatment in jwara of langhana is useful for the preservation of the power of digestion. The malās of the seven dhātus get cooked or metabolized in seven days. Therefore generally on the eighth day the jwara becomes nirāma (free from the accumulated metabolic waste product). If a person takes heavy food in the stage when the dośhās are aggravated and the power of digestion is suppressed, he succumbs to death immediately, or becomes miserable for a long time. Therefore, a wise physician should not immediately give either heavy or unctuous food in the beginning stage of jwara, even if it is caused by the aggravation of vāta. If the jwara is caused by vāta and is not associated with the other two doshas then, in exception to the above rule the patient should be given massage and such other therapies. He should be given decoctions and meat or vegetable soups to drink. All the therapies described for chronic fever are useful for the management of this kind of fever. Shloka -

सामा ये ये च कफजाः कफपित्तज्वराश्च ये||२८३|| लङ्घनं लङ्घनीयोक्तं तेषु कार्यं प्रति प्रति|२८४| वमनैश्च विरेकैश्च बस्तिभिश्च यथाक्रमम्||२८४|| ज्वरानुपचरेद्धीमान् कफपित्तानिलोद्भवान्|२८५| संसृष्टान् सन्निपतितान् बुद्ध्वा तरतमैः समैः||२८५|| ज्वरान् दोषक्रमापेक्षी यथोक्तैरौषधैर्जयेत्| वर्धनेनैकदोषस्य क्षपणेनोच्छ्रितस्य वा||२८६|| कफस्थानानुपूर्व्या वा सन्निपातज्वरं जयेत्|२८७| Transliteration – sāmā yē yē ca kaphajāḥ kaphapittajvarāśca yē||283|| laṅghanaṁ laṅghanīyōktaṁ tēṣu kāryaṁ prati prati|284| vamanaiśca virēkaiśca bastibhiśca yathākramam||284|| jvarānupacarēddhīmān kaphapittānilōdbhavān|285| saṁsr̥ṣṭān sannipatitān buddhvā taratamaiḥ samaiḥ||285|| jvarān dōṣakramāpēkṣī yathōktairauṣadhairjayēt| vardhanēnaikadōṣasya kṣapaṇēnōcchritasya vā||286|| kaphasthānānupūrvyā vā sannipātajwaraṁ jayēt|287|

sAmA ye ye ca kaphajAH kaphapittajwarashca ye||283|| la~gghanaM la~gghanIyoktaM teShu kAryaM prati prati|284| vamanaishca virekaishca bastibhishca yathAkramam||284|| jwaranupacareddhImAn kaphapittAnilodbhavAn|285| saMsRuShTAn sannipatitAn buddhvA taratamaiH samaiH||285|| jwaran doShakramApekShI yathoktairauShadhairjayet| vardhanenaikadoShasya kShapaNenocchritasya vA||286|| kaphasthAnAnupUrvyA vA sannipAtajwaraM jayet|287|

Translation in English – Langhana and similar other therapies described in the twenty second chapter of Sutra Sthana should be invariably administered in the following conditions – • When the jwara is in the sāma stage • When jwara is produced by the aggravated kapha dośha • When both the kapha and the pitta dośha are aggravated toether Vaman, virechana and bastī therapies should be administered to cure the jwara caused by the aggravated vāta, pitta and kapha dośha respectively. In the case of saṁsṛṡṭra and sannīpātaja (in case of combination of two or all the three doshas) type of jwara, the tara, tama and sama (lesser, greater or equal) status of the vitiated dośhās should be ascertained and the treatment planned according to the line of treatment and drugs prescribed for that dośha. Sannipātaja jwara should be treated by increasing one dośha, reducing the excessively aggravated one or by correcting the sites of the dośhās in order, beginning with the site of kapha. Shloka - सन्निपातज्वरस्यान्ते कर्णमूले सुदारूणः||२८७|| शोथः सञ्जायते तेन कश्चिदेव प्रमुच्यते| रक्तावसेचनैः शीघ्रं सर्पिष्पानैश्च तं जयेत्||२८८|| प्रदेहैः कफपित्तघ्नैर्नावनैः कवलग्रहैः|२८९| Transliteration – sannipātajwarasyāntē karṇamūlē sudārūṇaḥ||287|| śōthaḥ sañjāyatē tēna kaścidēva pramucyatē| raktāvasēcanaiḥ śīghraṁ sarpiṣpānaiśca taṁ jayēt||288|| pradēhaiḥ kaphapittaghnairnāvanaiḥ kavalagrahaiḥ|289

sannipAtajwarasyAnte karNamUle sudArUNaH||287|| shothaH sa~jjAyate tena kashcideva pramucyate| raktAvasecanaiH shIghraM sarpiShpAnaishca taM jayet||288|| pradehaiH kaphapittaghnairnAvanaiH kavalagrahaiH|289|

Translation in English – A seious sequale of sannipātaja jwara is inflammatoion near the root of the ears which is a very serious condition and very few of such paients survive. Thus, efforts must be made immediately to cure it through therapeutic measures which alleviate kapha and pitta like blood letting, intake of ghī, pradeha (application of unction), nāvana (nasal instillation) and kavala graham (mouthful of liquid medication). Shloka - शीतोष्णस्निग्धरूक्षाद्यैर्ज्वरो यस्य न शाम्यति||२८९|| शाखानुसारी रक्तस्य [१] सोऽवसेकात् प्रशाम्यति|२९०| Transliteration – śītōṣṇasnigdharūkṣādyairjvarō yasya na śāmyati||289|| śākhānusārī raktasya [1] sō'vasēkāt praśāmyati|290|

shItoShNasnigdharUkShAdyairjvaro yasya na shAmyati||289|| shAkhAnusArI raktasya [1] so~avasekAt prashAmyati|290|

Translation in English –

When the jwara doesn’t get cured by either hot or cold or unctuous or ununctuous therapies etc. , then it should be understood as śākhānusāri (that which is located in the peripheral tissues). Such type of fever gets cured by the administration of blood letting therapy. Shloka - विसर्पेणाभिघातेन यश्च विस्फोटकैर्ज्वरः||२९०|| तत्रादौ सर्पिषः पानं कफपित्तोत्तरो न चेत्|२९१| Transliteration – visarpēṇābhighātēna yaśca visphōṭakairjwaraḥ||290|| tatrādau sarpiṣaḥ pānaṁ kaphapittōttarō na cēt|291|

visarpeNAbhighAtena yashca visphoTakairjwaraH||290|| tatrAdau sarpiShaH pAnaM kaphapittottaro na cet|291|

Translation in English – If jwara arises in a patient as a complication of visarpa (erysipelas like disease), abhighāta (injury) and visphoṭaka (eruptions in the body), the patient in such case should be given ghī to drink provided kapha and pitta dośha are not aggravated. Shloka - दौर्बल्याद्देहधातूनां ज्वरो जीर्णोऽनुवर्तते||२९१|| बल्येः सम्बृंहणैस्तस्मादाहारैस्तमुपाचरेत्|२९२| Transliteration – daurbalyāddēhadhātūnāṁ jvarō jīrṇō'nuvartatē||291|| balyēḥ sambr̥ṁhaṇaistasmādāhāraistamupācarēt|292|

daurbalyAddehadhAtUnAM jvaro jIrNo~anuvartate||291|| balyeH sambRuMhaNaistasmAdAhAraistamupAcaret|292|

Translation in English – The fever turns chronic if there is weakness in the tissues of the body. Hence such patients should be given foods which promote the strength and are nourishing. Shloka - कर्म साधारणं जह्यात्तृतीयकचतुर्थकौ [१] ||२९२|| आगन्तुरनुबन्धो हि प्रायशो विषमज्वरे| वातप्रधानं सर्पिर्भिर्बस्तिभिः सानुवासनैः||२९३|| स्निग्धोष्णैरन्नपानैश्च शमयेद्विषमज्वरम्| विरेचनेन पयसा सर्पिषा संस्कृतेन च||२९४|| विषमं तिक्तशीतैश्च ज्वरं पित्तोत्तरं जयेत्| वमनं पाचनं रूक्षमन्नपानं विलङ्घनम्||२९५|| कषायोष्णं च विषमे ज्वरे शस्तं कफोत्तरे|२९६| Transliteration – karma sādhāraṇaṁ jahyāttr̥tīyakacaturthakau [1] ||292|| āganturanubandhō hi prāyaśō viṣamajvarē| vātapradhānaṁ sarpirbhirbastibhiḥ sānuvāsanaiḥ||293|| snigdhōṣṇairannapānaiśca śamayēdviṣamajwaram| virēcanēna payasā sarpiṣā saṁskr̥tēna ca||294|| viṣamaṁ tiktaśītaiśca jwaraṁ pittōttaraṁ jayēt| vamanaṁ pācanaṁ rūkṣamannapānaṁ vilaṅghanam||295|| kaṣāyōṣṇaṁ ca viṣamē jvarē śastaṁ kaphōttarē|296| karma sAdhAraNaM jahyAttRutIyakacaturthakau [1] ||292|| Aganturanubandho hi prAyasho viShamajvare| vAtapradhAnaM sarpirbhirbastibhiH sAnuvAsanaiH||293|| snigdhoShNairannapAnaishca shamayedviShamajwaram| virecanena payasA sarpiShA saMskRutena ca||294|| viShamaM tiktashItaishca jwaraM pittottaraM jayet| vamanaM pAcanaM rUkShamannapAnaM vila~gghanam||295|| kaShAyoShNaM ca viShame jvare shastaM kaphottare|296|

Translation in English – The general line of treatment of jvarās should not be followed for the management of tṛtīyaka and caturthaka jwara as these two types of fever are mostly associated with āgantu or extraneous factors as būtās or evil spirits including germs. When vāyu is predominantly aggravated in these two types of jwara, then they should be cured by the administration of ghī, niruha and anuvāsana vastīs (medicated enemas), unctuous and hot diet and drinks. When the pitta dośha is dominant the patient should be given purgation therapy, medicated milk, ghī and articles which are bitter and cold. In state of kapha predominance, then the patient should be administered emetic therapy, pācana (therapy which promotes the digestion and metabolism), ununctuos diet and drinks, fasting and hot decoctions are useful. Shloka - योगाः पराः [२] प्रवक्ष्यन्ते विषमज्वरनाशनाः||२९६|| प्रयोक्तव्या मतिमता दोषादीन् प्रविभज्य ते| सुरा समण्डा पानार्थे भक्ष्यार्थे चरणायुधः||२९७|| तित्तिरिश्च मयूरश्च प्रयोज्या विषमज्वरे| पिबेद्वा षट्पलं सर्पिरभयां वा प्रयोजयेत्||२९८|| त्रिफलायाः कषायं वा गुडूच्या रसमेव वा| नीलिनीमजगन्धां च त्रिवृतां कटुरोहिणीम्||२९९|| पिबेज्ज्वरागमे युक्त्या स्नेहस्वेदोपपादितः| सर्पिषो महतीं मात्रां पीत्वा वा छर्दयेत् पुनः||३००|| उपयुज्यान्नपानं वा प्रभूतं पुनरुल्लिखेत्| सान्नं मद्यं प्रभूतं वा पीत्वा स्वप्याज्ज्वरागमे||३०१|| आस्थापनं यापनं वा कारयेद्विषमज्वरे| पयसा वृषदंशस्य शकृद्वा [३] तदहः पिबेत्||३०२|| वृषस्य दधिमण्डेन सुरया वा [४] ससैन्धवम्| पिप्पल्यास्त्रिफलायाश्च दध्नस्तक्रस्य सर्पिषः||३०३|| पञ्चगव्यस्य पयसः प्रयोगो विषमज्वरे| रसोनस्य सतैलस्य प्राग्भक्तमुपसेवनम्||३०४|| मेद्यानामुष्णवीर्याणामामिषाणां च भक्षणम्| हिङ्गुतुल्या तु वैयाघ्री वसा नस्यं ससैन्धवा||३०५|| पुराणसर्पिः सिंहस्य वसा तद्वत् ससैन्धवा| सैन्धवं पिप्पलीनां च तण्डुलाः समनःशिलाः||३०६|| नेत्राञ्जनं तैलपिष्टं शस्यते विषमज्वरे| पलङ्कषा निम्बपत्रं वचा कुष्ठं हरीतकी||३०७|| सर्षपाः सयवाः सर्पिर्धूपनं ज्वरनाशनम्| ये धूमा धूपनं यच्च नावनं चाञ्जनं च यत्||३०८|| मनोविकारे निर्दिष्टं कार्यं तद्विषमज्वरे| मणीनामोषधीनां च मङ्गल्यानां विषस्य च||३०९|| धारणादगदानां च सेवनान्न भवेज्ज्वरः|३१०| Transliteration –

yōgāḥ parāḥ [2] pravakṣyantē viṣamajwaranāśanāḥ||296|| prayōktavyā matimatā dōṣādīn pravibhajya tē| surā samaṇḍā pānārthē bhakṣyārthē caraṇāyudhaḥ||297|| tittiriśca mayūraśca prayōjyā viṣamajvarē| pibēdvā ṣaṭpalaṁ sarpirabhayāṁ vā prayōjayēt||298|| triphalāyāḥ kaṣāyaṁ vā guḍūcyā rasamēva vā| nīlinīmajagandhāṁ ca trivr̥tāṁ kaṭurōhiṇīm||299|| pibējjvarāgamē yuktyā snēhasvēdōpapāditaḥ| sarpiṣō mahatīṁ mātrāṁ pītvā vā chardayēt punaḥ||300|| upayujyānnapānaṁ vā prabhūtaṁ punarullikhēt| sānnaṁ madyaṁ prabhūtaṁ vā pītvā svapyājjvarāgamē||301|| āsthāpanaṁ yāpanaṁ vā kārayēdviṣamajvarē| payasā vr̥ṣadaṁśasya śakr̥dvā [3] tadahaḥ pibēt||302|| vr̥ṣasya dadhimaṇḍēna surayā vā [4] sasaindhavam| pippalyāstriphalāyāśca dadhnastakrasya sarpiṣaḥ||303|| pañcagavyasya payasaḥ prayōgō viṣamajvarē| rasōnasya satailasya prāgbhaktamupasēvanam||304|| mēdyānāmuṣṇavīryāṇāmāmiṣāṇāṁ ca bhakṣaṇam| hiṅgutulyā tu vaiyāghrī vasā nasyaṁ sasaindhavā||305|| purāṇasarpiḥ siṁhasya vasā tadvat sasaindhavā| saindhavaṁ pippalīnāṁ ca taṇḍulāḥ samanaḥśilāḥ||306|| nētrāñjanaṁ tailapiṣṭaṁ śasyatē viṣamajvarē| palaṅkaṣā nimbapatraṁ vacā kuṣṭhaṁ harītakī||307|| sarṣapāḥ sayavāḥ sarpirdhūpanaṁ jwaranāśanam| yē dhūmā dhūpanaṁ yacca nāvanaṁ cāñjanaṁ ca yat||308|| manōvikārē nirdiṣṭaṁ kāryaṁ tadviṣamajvarē| maṇīnāmōṣadhīnāṁ ca maṅgalyānāṁ viṣasya ca||309|| dhāraṇādagadānāṁ ca sēvanānna bhavējjwaraḥ|310|

yogAH parAH [2] pravakShyante viShamajwaranAshanAH||296|| prayoktavyA matimatA doShAdIn pravibhajya te| surA samaNDA pAnArthe bhakShyArthe caraNAyudhaH||297|| tittirishca mayUrashca prayojyA viShamajvare| pibedvA ShaTpalaM sarpirabhayAM vA prayojayet||298|| triphalAyAH kaShAyaM vA guDUcyA rasameva vA| nIlinImajagandhAM ca trivRutAM kaTurohiNIm||299|| pibejjwaragame yuktyA snehasvedopapAditaH| sarpiSho mahatIM mAtrAM pItvA vA chardayet punaH||300|| upayujyAnnapAnaM vA prabhUtaM punarullikhet| sAnnaM madyaM prabhUtaM vA pItvA svapyAjjwaragame||301|| AsthApanaM yApanaM vA kArayedviShamajvare| payasA vRuShadaMshasya shakRudvA [3] tadahaH pibet||302|| vRuShasya dadhimaNDena surayA vA [4] sasaindhavam| pippalyAstriphalAyAshca dadhnastakrasya sarpiShaH||303|| pa~jcagavyasya payasaH prayogo viShamajvare| rasonasya satailasya prAgbhaktamupasevanam||304|| medyAnAmuShNavIryANAmAmiShANAM ca bhakShaNam| hi~ggutulyA tu vaiyAghrI vasA nasyaM sasaindhavA||305|| purANasarpiH siMhasya vasA tadvat sasaindhavA| saindhavaM pippalInAM ca taNDulAH samanaHshilAH||306|| netrA~jjanaM tailapiShTaM shasyate viShamajvare| pala~gkaShA nimbapatraM vacA kuShThaM harItakI||307|| sarShapAH sayavAH sarpirdhUpanaM jwaranAshanam| ye dhUmA dhUpanaM yacca nAvanaM cA~jjanaM ca yat||308|| manovikAre nirdiShTaM kAryaM tadviShamajvare| maNInAmoShadhInAM ca ma~ggalyAnAM viShasya ca||309|| dhAraNAdagadAnAM ca sevanAnna bhavejjwaraH|310| Tran

Translation in English – Formulations which are very effective in curing jwara are being described. A wise physician should administer them, keeping in view their suitability for the type of dośha involved. These recipes are as follows – • Surā along with its manḍa (alcohol along with its supernatant part) as drink • The meat of cock, patridge and peacock are used as food • Intake of medicated ghī called as śaṭapala; abhayā; triphalā decoction; guḍuci juice; preparation of nīlinī, ajagandhā, trivṛta and kaṭurohiṇī during the onset of fever. These things should be administered to the patient appropriately, after the patient is given snehana and svedana therapies (oleation and sudation). • Emesis after the administration of ghī in large quantity • Emesis after taking large quantity of food and drinks • Sleeping after taking large quantity of alcohol along with food when the attack of fever is due • Administration of āsthāpana and yāpanā bastīs • Intake of cat’s stool mixed with milk on the same day • Intake of cat’s stool mixed with either dadhi manḍa (scum of curd) or alcohol or rock salt or pippalī or triphalā or curd or butter or milk or ghī or pancagavya (mixture of five products obtained from cow); • Intake of rasona along with oil immediately before food • Intake of meat of animals which are fatty and hot in potency • Inhalation of hingu and vasā of vyāghra (tiger) taken in equal quantity and mixed with rock salt. • Inhalation of old ghī and vasā of siṁha (lion) taken in equal quantity and mixed with rock salt. • Application of anjana prepared of rock salt, seeds of pippalī and manaḥśilā mixed with oil • Fumigation by palaṅkaṡā, leaves of nimba, vacā, kuṡṭha, harītakī, sarṡapa, yava and ghī • Administration of formulations of dhūma (medicated smoking), dhūpana (fumigation), nāvana (nasal instillation of medicine), and anjana (collyrium) which are prescribed in the treatment of manovikāra or psychic ailments like unmāda and apasamāra. • Wearing of maṇis (precious stones and jewels), auṡadha (drugs), mangalya (auspicious talisman) and viṡa (poisonous substances) • Intake of agada (antidote like drugs). Shloka - सोमं सानुचरं देवं समातृगणमीश्वरम्||३१०|| पूजयन् प्रयतः शीघ्रं मुच्यते विषमज्वरात्| विष्णुं सहस्रमूर्धानं चराचरपतिं विभुम्||३११|| स्तुवन्नामसहस्रेण ज्वरान् सर्वानपोहति| ब्रह्माणमश्विनाविन्द्रं हुतभक्षं हिमाचलम्||३१२|| गङ्गां मरुद्गणांश्चेष्ट्या [५] पूजयञ्जयति ज्वरान्| भक्त्या मातुः पितुश्चैव गुरूणां पूजनेन च||३१३|| ब्रह्मचर्येण तपसा सत्येन नियमेन च| जपहोमप्रदानेन वेदानां श्रवणेन च||३१४|| ज्वराद्विमुच्यते शीघ्रं साधूनां दर्शनेन च| ज्वरे रसस्थे वमनमुपवासं च कारयेत्||३१५|| सेकप्रदेहौ रक्तस्थे तथा संशमनानि च| विरेचनं सोपवासं मांसमेदःस्थिते हितम्||३१६|| अस्थिमज्जगते देया निरूहाः सानुवासनाः|३१७| Transliteration –

sōmaṁ sānucaraṁ dēvaṁ samātr̥gaṇamīśvaram||310|| pūjayan prayataḥ śīghraṁ mucyatē viṣamajvarāt| viṣṇuṁ sahasramūrdhānaṁ carācarapatiṁ vibhum||311|| stuvannāmasahasrēṇa jvarān sarvānapōhati| brahmāṇamaśvināvindraṁ hutabhakṣaṁ himācalam||312|| gaṅgāṁ marudgaṇāṁścēṣṭyā [5] pūjayañjayati jvarān| bhaktyā mātuḥ pituścaiva gurūṇāṁ pūjanēna ca||313|| brahmacaryēṇa tapasā satyēna niyamēna ca| japahōmapradānēna vēdānāṁ śravaṇēna ca||314|| jvarādvimucyatē śīghraṁ sādhūnāṁ darśanēna ca| jvarē rasasthē vamanamupavāsaṁ ca kārayēt||315|| sēkapradēhau raktasthē tathā saṁśamanāni ca| virēcanaṁ sōpavāsaṁ māṁsamēdaḥsthitē hitam||316|| asthimajjagatē dēyā nirūhāḥ sānuvāsanāḥ|317|

somaM sAnucaraM devaM samAtRugaNamIshvaram||310|| pUjayan prayataH shIghraM mucyate viShamajwarat| viShNuM sahasramUrdhAnaM carAcarapatiM vibhum||311|| stuvannAmasahasreNa jwaran sarvAnapohati| brahmANamashvinAvindraM hutabhakShaM himAcalam||312|| ga~ggAM marudgaNAMshceShTyA [5] pUjaya~jjayati jwaran| bhaktyA mAtuH pitushcaiva gurUNAM pUjanena ca||313|| brahmacaryeNa tapasA satyena niyamena ca| japahomapradAnena vedAnAM shravaNena ca||314|| jwaradvimucyate shIghraM sAdhUnAM darshanena ca| jvare rasasthe vamanamupavAsaM ca kArayet||315|| sekapradehau raktasthe tathA saMshamanAni ca| virecanaM sopavAsaM mAMsamedaHsthite hitam||316|| asthimajjagate deyA nirUhAH sAnuvAsanAH|317| Translation in English – Prayers should be offered to lord īsvara along with umā, their attendents and matṛs. this immediately cures viṡama jwara. Recitation of the sahasra nāma (one thousand names) of Lord Viṡnū, who has one thousand heads, who is the chief of the carācara (moving and unmoving things of the universe) and who is omnipresent cures all type of jwara. Offering prayers through iṡṭī or yajña (fire ritual) to Brahmā, the Aśvinīs, īndra, āgni, the Himalayās, the Ganges and the followerz of Māruts cures the jwara. Devotion to father and mother, prayer to gurūs, observance of celibacy, practice of tapa (penance), truthfulness and niyama (religious rites), japa (incantations), homa (like yajña – offering oblation to fire), hearing the recitation of the vedās and the darśana (visiting) of saints immediately cures jwara. When the dośhās causing jwara are located in – • the rasa dhātu, then vamana and upavāsa (emesis and fasting) should be done • the rakta dhātu, then seka and pradeha (pouring of hot medicated liquids and ointment application) should be done • in the mānsa and the medas virecana and upavāsa should be done • in the asthī and majjā dhātūs, nirūha and anuvāsana bastīs should be given. Shloka - शापाभिचाराद्भूतानामभिषङ्गाच्च यो ज्वरः||३१७|| दैवव्यपाश्रयं तत्र सर्वमौषधमिष्यते| अभिघातज्वरो नश्येत् [२] पानाभ्यङ्गेन सर्पिषः||३१८|| रक्तावसेकैर्मद्यैश्च [३] सात्म्यैर्मांसरसौदनैः| सानाहो मद्यसात्म्यानां मदिरारसभोजनैः||३१९|| क्षतानां व्रणितानां च क्षतव्रणचिकित्सया| आश्वासेनेष्टलाभेन वायोः प्रशमनेन च||३२०|| हर्षणैश्च शमं यान्ति कामशोकभयज्वराः| काम्यैरर्थैर्मनोज्ञैश्च पित्तघ्नैश्चाप्युपक्रमैः||३२१|| सद्वाक्यैश्च शमं याति ज्वरः क्रोधसमुत्थितः| कामात् क्रोधज्वरो नाशं क्रोधात् कामसमुद्भवः||३२२|| याति ताभ्यामुभाभ्यां च भयशोकसमुत्थितः|३२३| ज्वरस्य वेगं कालं च चिन्तयञ्ज्वर्यते तु यः||३२३|| तस्येष्टैस्तु विचित्रैश्च विषयैर्नाशयेत् स्मृतिम्|३२४| Transliteration – śāpābhicārādbhūtānāmabhiṣaṅgācca yō jwaraḥ||317|| daivavyapāśrayaṁ tatra sarvamauṣadhamiṣyatē| abhighātajvarō naśyēt [2] pānābhyaṅgēna sarpiṣaḥ||318|| raktāvasēkairmadyaiśca [3] sātmyairmāṁsarasaudanaiḥ| sānāhō madyasātmyānāṁ madirārasabhōjanaiḥ||319|| kṣatānāṁ vraṇitānāṁ ca kṣatavraṇacikitsayā| āśvāsēnēṣṭalābhēna vāyōḥ praśamanēna ca||320|| harṣaṇaiśca śamaṁ yānti kāmaśōkabhayajvarāḥ| kāmyairarthairmanōjñaiśca pittaghnaiścāpyupakramaiḥ||321|| sadvākyaiśca śamaṁ yāti jwaraḥ krōdhasamutthitaḥ| kāmāt krōdhajvarō nāśaṁ krōdhāt kāmasamudbhavaḥ||322|| yāti tābhyāmubhābhyāṁ ca bhayaśōkasamutthitaḥ|323| jwarasya vēgaṁ kālaṁ ca cintayañjvaryatē tu yaḥ||323|| tasyēṣṭaistu vicitraiśca viṣayairnāśayēt smr̥tim|324|

shApAbhicArAdbhUtAnAmabhiSha~ggAcca yo jwaraH||317|| daivavyapAshrayaM tatra sarvamauShadhamiShyate| abhighAtajvaro nashyet [2] pAnAbhya~ggena sarpiShaH||318|| raktAvasekairmadyaishca [3] sAtmyairmAMsarasaudanaiH| sAnAho madyasAtmyAnAM madirArasabhojanaiH||319|| kShatAnAM vraNitAnAM ca kShatavraNacikitsayA| AshvAseneShTalAbhena vAyoH prashamanena ca||320|| harShaNaishca shamaM yAnti kAmashokabhayajwaraH| kAmyairarthairmanoj~jaishca pittaghnaishcApyupakramaiH||321|| sadvAkyaishca shamaM yAti jwaraH krodhasamutthitaH| kAmAt krodhajvaro nAshaM krodhAt kAmasamudbhavaH||322|| yAti tAbhyAmubhAbhyAM ca bhayashokasamutthitaH|323| jwarasya vegaM kAlaM ca cintaya~jjvaryate tu yaH||323|| tasyeShTaistu vicitraishca viShayairnAshayet smRutim|324|

Translation in English – The jwara caused by śāpa (curse), abhicāra (black magic), bhūta (micro organisms) and abhiśanga (affliction by evil spirits) – Daiva vipāśraya cikitsā (performance of religious rites) is the most desired therapy. Jwara caused by abhighāta (external injury) gets cured by the intake and massage of ghī, blood letting, in take of rice with wholesome meat soup. If such patients are suffering from ānāha (gaseous distention of abdomen due to constipation) and are accustomed to alcohol, then they should be given food with alcohol and meat soup. For the treatment of jwara caused by kṡata (injury like cuts, stabs etc.) and vraṇa (ulcers) line of treatment suggested for kṡata and vraṇa should be adopted. The jwara caused by kāma (passion), śoka (grief) and bhaya (fear) gets cured by the āśvāśana (consoling), iśṭa lābha (providing the desired object), alleviation of vāyu and harśaṇa (bringing excietment). The jwara caused by krodha gets subsided by providing the kāmya artha (desired object), manojña artha (pleasing object), therapies for the alleviation of pitta and sadavākya (correct advice). The jwara caused by krodha gets subsided by kāma and that caused by kāma gets cured by krodha. Jwara caused by bhaya (fear) and shoka (grief or sorrow) gets subsided by both kāma and krodha. If a patient gets jwara just by the thought of the time of the onset of the disease, then his mind should be diverted to desirable, different and surprising incidents (viśaya). Shloka - ज्वरप्रमोक्षे पुरुषः कूजन् वमति चेष्टते| श्वसन्विवर्णः स्विन्नाङ्गो वेपते लीयते मुहुः||३२४|| प्रलपत्युष्णसर्वाङ्गः शीताङ्गश्च भवत्यपि| विसञ्ज्ञो ज्वरवेगार्तः सक्रोध इव वीक्ष्यते [१] ||३२५|| सदोषशब्दं च शकृद्द्रवं स्रवति वेगवत्| लिङ्गान्येतानि जानीयाज्ज्वरमोक्षे विचक्षणः||३२६|| बहुदोषस्य बलवान् [२] प्रायेणाभिनवो ज्वरः| सत्क्रियादोषपक्त्या [३] चेद्विमुञ्चति सुदारुणम्||३२७|| कृत्वा दोषवशाद्वेगं क्रमादुपरमन्ति ये| तेषामदारुणो मोक्षो ज्वराणां चिरकारिणाम्||३२८|| Transliteration – jwarapramōkṣē puruṣaḥ kūjan vamati cēṣṭatē| śvasanvivarṇaḥ svinnāṅgō vēpatē līyatē muhuḥ||324|| pralapatyuṣṇasarvāṅgaḥ śītāṅgaśca bhavatyapi| visañjñō jwaravēgārtaḥ sakrōdha iva vīkṣyatē [1] ||325|| sadōṣaśabdaṁ ca śakr̥ddravaṁ sravati vēgavat| liṅgānyētāni jānīyājjwaramōkṣē vicakṣaṇaḥ||326|| bahudōṣasya balavān [2] prāyēṇābhinavō jwaraḥ| satkriyādōṣapaktyā [3] cēdvimuñcati sudāruṇam||327|| kr̥tvā dōṣavaśādvēgaṁ kramāduparamanti yē| tēṣāmadāruṇō mōkṣō jvarāṇāṁ cirakāriṇām||328||

jwarapramokShe puruShaH kUjan vamati ceShTate| shvasanvivarNaH svinnA~ggo vepate lIyate muhuH||324|| pralapatyuShNasarvA~ggaH shItA~ggashca bhavatyapi| visa~jj~jo jwaravegArtaH sakrodha iva vIkShyate [1] ||325|| sadoShashabdaM ca shakRuddravaM sravati vegavat| li~ggAnyetAni jAnIyAjjwaramokShe vicakShaNaH||326|| bahudoShasya balavAn [2] prAyeNAbhinavo jwaraH| satkriyAdoShapaktyA [3] cedvimu~jcati sudAruNam||327|| kRutvA doShavashAdvegaM kramAduparamanti ye| teShAmadAruNo mokSho jwaraNAM cirakAriNAm||328||

Translation in English – The clinical features manifested at the time of remission of (sannipāta jwara) are – the patient produces kūjana (rumbling) sound, vomiting, purposeless movements of the limbs (ceṡṭā), heavy breathing or difficulty in breathing, discoloration, svinnānga (sweating), trembling (vepate), frequent fainting (līyate muhuḥ), delirium, the body becoming very hot and cold at times, unconsciousness, more rise of temperature, angry appearance and passage of liquid motion with the dośhās and sound along with force. In a serious kind of fever in which dośhās are aggravated in excess is treated with appropriate therapy, then dośha pāka occurs and because of it, the sudden remmision of jwara occurs (dāruṇa mokṡa). this mostly happens in abhinava jwara (acute fevers). Shloka - विगतक्लमसन्तापमव्यथं विमलेन्द्रियम्| युक्तं प्रकृतिसत्त्वेन विद्यात् पुरुषमज्वरम्||३२९|| Transliteration – vigataklamasantāpamavyathaṁ vimalēndriyam| yuktaṁ prakr̥tisattvēna vidyāt puruṣamajwaram||329||

vigataklamasantApamavyathaM vimalendriyam| yuktaM prakRutisattvena vidyAt puruShamajwaram||329||

Translation in English – Dissapearence of klama (mental fatigue) and santāpa (temperature), absence of pain, clarity of senses, gaining natural mental faculties – are all the signs and symptoms of a person who has become free from jwara. Shloka - सज्वरो ज्वरमुक्तश्च विदाहीनि गुरूणि च| असात्म्यान्यन्नपानानि विरुद्धानि च वर्जयेत्||३३०|| व्यवायमतिचेष्टाश्च स्नानमत्यशनानि च| तथा ज्वरः शमं याति प्रशान्तो जायते न च||३३१|| व्यायामं च व्यवायं च स्नानं चङ्क्रमणानि च| ज्वरमुक्तो न सेवेत यावन्न बलवान् भवेत्||३३२|| Transliteration – sajvarō jwaramuktaśca vidāhīni gurūṇi ca| asātmyānyannapānāni viruddhāni ca varjayēt||330|| vyavāyamaticēṣṭāśca snānamatyaśanāni ca| tathā jwaraḥ śamaṁ yāti praśāntō jāyatē na ca||331|| vyāyāmaṁ ca vyavāyaṁ ca snānaṁ caṅkramaṇāni ca| jwaramuktō na sēvēta yāvanna balavān bhavēt||332||

sajvaro jwaramuktashca vidAhIni gurUNi ca| asAtmyAnyannapAnAni viruddhAni ca varjayet||330|| vyavAyamaticeShTAshca snAnamatyashanAni ca| tathA jwaraH shamaM yAti prashAnto jAyate na ca||331|| vyAyAmaM ca vyavAyaM ca snAnaM ca~gkramaNAni ca| jwaramukto na seveta yAvanna balavAn bhavet||332||

Translation in English – A person suffering from fever and the one who has become free from it should not indulge in and avoid the following - the intake of food and drinks which are vidāhī (causing burning sensation), guru (heavy), asātmya (unwholesome) and virrudha (mutually contradictory); sexual intercourse, excessive exhaustion, bath and excessive walking. By observing these rules the fever gets alleviated and does not attack again. Exercise, sexual intercourse, bath, cankramaṇa (brisk walk) – these should be avoided by the person who has become free from jwara till he regains strength. Shloka - असञ्जातबलो यस्तु ज्वरमुक्तो निषेवते| वर्ज्यमेतन्नरस्तस्य पुनरावर्तते ज्वरः||३३३|| दुर्हृतेषु च दोषेषु यस्य वा विनिवर्तते| स्वल्पेनप्यपचारेण तस्य व्यावर्तते पुनः||३३४|| चिरकालपरिक्लिष्टं दुर्बलं हीनतेजसम् [१] | अचिरेणैव कालेन स हन्ति पुनरागतः||३३५|| अथवाऽपि [२] परीपाकं धातुष्वेव क्रमान्मलाः| यान्ति ज्वरमकुर्वन्तस्ते तथाऽप्यपकुर्वते||३३६|| दीनतां श्वयथुं ग्लानिं पाण्डुतां नान्नकामताम्| कण्डूरुक्तोठपिडकाः कुर्वन्त्यग्निं च ते मृदुम्||३३७|| एवमन्येऽपि च गदा व्यावर्तन्ते पुनर्गताः| अनिर्घातेन दोषाणामल्पैरप्यहितैर्नृणाम्||३३८|| निर्वृत्तेऽपि ज्वरे तस्माद्यथावस्थं यथाबलम्| यथाप्राणं हरेद्दोषं प्रयोगैर्वा शमं नयेत्||३३९|| मृदुभिः शोधनैः शुद्धिर्यापना बस्तयो हिताः| हिताश्च लघवो यूषा जाङ्गलामिषजा रसाः||३४०|| अभ्यङ्गोद्वर्तनस्नानधूपनान्यञ्जनानि च| हितानि पुनरावृत्ते ज्वरे तिक्तघृतानि च||३४१|| गुर्व्यभिष्यन्द्यसात्म्यानां भोजनात् पुनरागते| लङ्घनोष्णोपचारादिः क्रमः कार्यश्च पूर्ववत्||३४२|| किराततिक्तकं तिक्ता मुस्तं पर्पटकोऽमृता| घ्नन्ति पीतानि चाभ्यासात् पुनरावर्तकं ज्वरम्||३४३|| Transliteration – asañjātabalō yastu jwaramuktō niṣēvatē| varjyamētannarastasya punarāvartatē jwaraḥ||333|| durhr̥tēṣu ca dōṣēṣu yasya vā vinivartatē| svalpēnapyapacārēṇa tasya vyāvartatē punaḥ||334|| cirakālaparikliṣṭaṁ durbalaṁ hīnatējasam [1] | acirēṇaiva kālēna sa hanti punarāgataḥ||335|| athavā'pi [2] parīpākaṁ dhātuṣvēva kramānmalāḥ| yānti jwaramakurvantastē tathā'pyapakurvatē||336|| dīnatāṁ śvayathuṁ glāniṁ pāṇḍutāṁ nānnakāmatām| kaṇḍūruktōṭhapiḍakāḥ kurvantyagniṁ ca tē mr̥dum||337|| ēvamanyē'pi ca gadā vyāvartantē punargatāḥ| anirghātēna dōṣāṇāmalpairapyahitairnr̥ṇām||338|| nirvr̥ttē'pi jvarē tasmādyathāvasthaṁ yathābalam| yathāprāṇaṁ harēddōṣaṁ prayōgairvā śamaṁ nayēt||339|| mr̥dubhiḥ śōdhanaiḥ śuddhiryāpanā bastayō hitāḥ| hitāśca laghavō yūṣā jāṅgalāmiṣajā rasāḥ||340|| abhyaṅgōdvartanasnānadhūpanānyañjanāni ca| hitāni punarāvr̥ttē jvarē tiktaghr̥tāni ca||341|| gurvyabhiṣyandyasātmyānāṁ bhōjanāt punarāgatē| laṅghanōṣṇōpacārādiḥ kramaḥ kāryaśca pūrvavat||342|| kirātatiktakaṁ tiktā mustaṁ parpaṭakō'mr̥tā| ghnanti pītāni cābhyāsāt punarāvartakaṁ jwaram||343||

asa~jjAtabalo yastu jwaramukto niShevate| varjyametannarastasya punarAvartate jwaraH||333|| durhRuteShu ca doSheShu yasya vA vinivartate| svalpenapyapacAreNa tasya vyAvartate punaH||334|| cirakAlaparikliShTaM durbalaM hInatejasam [1] | acireNaiva kAlena sa hanti punarAgataH||335|| athavA~api [2] parIpAkaM dhAtuShveva kramAnmalAH| yAnti jwaramakurvantaste tathA~apyapakurvate||336|| dInatAM shvayathuM glAniM pANDutAM nAnnakAmatAm| kaNDUruktoThapiDakAH kurvantyagniM ca te mRudum||337|| evamanye~api ca gadA vyAvartante punargatAH| anirghAtena doShANAmalpairapyahitairnRuNAm||338|| nirvRutte~api jvare tasmAdyathAvasthaM yathAbalam| yathAprANaM hareddoShaM prayogairvA shamaM nayet||339|| mRudubhiH shodhanaiH shuddhiryApanA bastayo hitAH| hitAshca laghavo yUShA jA~ggalAmiShajA rasAH||340|| abhya~ggodvartanasnAnadhUpanAnya~jjanAni ca| hitAni punarAvRutte jvare tiktaghRutAni ca||341|| gurvyabhiShyandyasAtmyAnAM bhojanAt punarAgate| la~gghanoShNopacArAdiH kramaH kAryashca pUrvavat||342|| kirAtatiktakaM tiktA mustaM parpaTako~amRutA| ghnanti pItAni cAbhyAsAt punarAvartakaM jwaram||343||

Translation in English – If a person, who has become free from jwara, resorts to prohibited factors (as described before) before gaining strength, then the jwara reappears. If a person becomes free from jwara when the dośhās have not been eliminated properly, then, evn with mild irregularity in regimens (apacāra), it reappears. As such patients have already suffered for a long time; hence there is weakness and loss of vitality in the tissues. If the fever reappears in them and then this certainly leads to their death. Sometimes, dośhās undergo paripāka (metabolic transformation) in the dhātūs and gradually the fever subsides. But, their harmful effects continue as a result of which the patient suffers from dīnata (uneasiness), śvayathu (oedema), glāni (a feeling as if covered with wet cloth), pānḍutā (pallor or anemia), loss of appetite, itching, urticaria, pimples and suppression of the power of digestion. Similarly, other diseases which are already cured reappear in the individual due to the non – elimination of the dośhās completely, even by resorting to little unwholesome regime after the cure of the disease. Therefore, the dośhās should be eliminated from the body either by elimination or alleviation therapies depending upon the stage and strength of the dośhās, even after the fever subsides in a patient of jwara. For this purpose mild elimination therapies and yāpanā bastīs should be administered. Yūśa (vegetable soups) and rasa (meat soups) of jāngala animal’s meat, which are light, are useful in this condition. Abhyanga, udvartana, snāna, dhūpana, anjana and ghī prepared boiling with bitter drugs are useful in the treatment of jwara, which has reappeared in a patient. If the fever reappears because of the intake of food which is guru (heavy), abhiṡyandī (which cause obstruction in the channels of the body) and unwholesome; then langhana (fasting) and hot therapies should be administered for its treatment as described before. Habitual intake of the decoction of kirāta tiktaka, tiktā, mustā; parpaṭaka and amṛtā cures repeated fever. Shloka - तस्यां तस्यामवस्थायां ज्वरितानां विचक्षणः| ज्वराक्रियाक्रमापेक्षी कुर्यात्तत्तच्चिकित्सितम्||३४४|| Transliteration – tasyāṁ tasyāmavasthāyāṁ jvaritānāṁ vicakṣaṇaḥ| jvarākriyākramāpēkṣī kuryāttattaccikitsitam||344||

tasyAM tasyAmavasthAyAM jvaritAnAM vicakShaNaH| jwarakriyAkramApekShI kuryAttattaccikitsitam||344|| Translation in English – The wise physician should treat the patient in different stages of jwara, according to the line of treatment of jwara. Shloka - रोगराट् सर्वभूतानामन्तकृद्दारुणो ज्वरः| तस्माद्विशेषतस्तस्य यतेत प्रशमे भिषक्||३४५|| Transliteration –

rōgarāṭ sarvabhūtānāmantakr̥ddāruṇō jwaraḥ| tasmādviśēṣatastasya yatēta praśamē bhiṣak||345||

rogarAT sarvabhUtAnAmantakRuddAruNo jwaraH| tasmAdvisheShatastasya yateta prashame bhiShak||345|| Translation in English – Jwara is the king of diseases and it causes the death of all creatures and is of serious nature. Therefore, the physician should make special efforts for its treatment.

Shloka - तत्र श्लोकः- यथाक्रमं यथाप्रश्नमुक्तं ज्वरचिकित्सितम्| आत्रेयेणाग्निवेशाय भूतानां हितकाम्यया||३४६|| Transliteration – tatra ślōkaḥ- yathākramaṁ yathāpraśnamuktaṁ jwaracikitsitam| ātrēyēṇāgnivēśāya bhūtānāṁ hitakāmyayā||346||

tatra shlokaH- yathAkramaM yathAprashnamuktaM jwaracikitsitam| AtreyeNAgniveshAya bhUtAnAM hitakAmyayA||346||

Translation in English – With a desire for the welfare of the living creatures, Ātreya has furnished the replies to the queries of Agniveśa regarding the treatment of jwara.

Glossary of Jwara

Prakriti (prakRuti; प्रकृति) - the nature of the disease Pravritti (pravRutti; प्रवृत्ति ) – the origin of the disease of the disease Prabhava (prabhAva; प्रभाव) – the manifestation of the disease Adhishthana (Adhiśthāna; अधिष्ठानं) - place of manifestation of the disease, or the place of residing or the location Atma Lakshana (Ātma lakṡaṇa; आत्मलक्षण) - clinical features which are invariably associated with this disease Vimunchatah (vimu~jcataH ; विमुञ्चतः) - getting cured, Prashant (prashAnta ; प्रशान्त ) - being alleviated Aahuti (āhūtī ; आहूती) - pouring of ghī and other substances considered sacred in the sacrificial fire Yagya (Yajña; यज्ञ ) - Ritual of sacrifice in which sacrifices are made in a small holy fire along with hymn chanting Parigraha (parigraha; परिग्रह) - Feeling of attachment and greed Sheela (shIla; शील) – the general behavior and conduct of the person Saumya (saumya; सौम्य) – one in a modest form, not very fierce, in context of jwarait is the kind of jwara which is predominated by kapha dosha or is cold in nature Agneya (āgneya; आग्नेय) – predominated by heat or pitta dosha Antarvegi (antarvegi; अन्तर्वेगी)- that which is presenting with more features of doshas circulating within the body tissues, more related to koshtha; is diffic ult to treat. Bahirvegi (Bahirvegi; बहिर्वेगो) – the form in which the doshas are circulating in the shakha and hence the features are more evident Prakrita (prAkRut; प्राकृत) – the one which is natural; here it means dosha aggravation occuring naturally according to the seasons Vaikrita (vaikRuta; वैकृत)- unseasonal, the aggravation of dosha in a time which is not its natural aggravating time. Nishpratyaneeka (niShpratyanIka; निष्प्रत्यनीक) - having no opponent or which can’t be inhibited. The dośās involved in the the manifestation of santata type of jwara are very similar in property to the season (kāla), dhātūs (duśya), and the physical constitution of the patient (prakṛtī) due to which it is having no opponent Suduhsah (suduHsahaH; सुदुःसहः )- that which is unbearable. Sapratyaneeka (sapratyanIka; सप्रत्यनीक) – that which can be counteracted. Gatabalaah (gatabalAH; गतबलाः) - losing one’s strength; here the doshas after aggravation present with the clinical features and in that case the dośās get consumed and lose their strength Shookai (shUkai; शूकै ) - sharp edged thorns or bristles like the covering of the cereals Paridagdha (paridagdhA; परिदग्धा) - the tongue of the patient appears burn’t (blackish) at the margins Kharasparsha - (kharasparshA; खरस्पर्शा ) is rough in touch Srastaangata (srastA~ggatA; स्रस्ताङ्गता) - excessive prostration Bhuta (bhUta; भूत) - evil spirits or germs Abhichaara (abhicAra; अभिचार) - evil tāntric rituals (AbhishAp; अभिशापा) – curse or bad spell Tandra (tandrA; तन्द्रा) - drowsiness Moha (moha; मोह ) – increased attachment such as lust, unconsciousness, Pralaapa (pralApa; प्रलाप) - delirium Vibaddha (Vibaddha; विबद्ध) - obstruction or non – elimination Vyaamishra (vyAmishra; व्यामिश्र) – that which is of mixed type yogavāhī (yogavAhi; योगवाहि) – one which accentuates the properties of others jwarasyAmasya ( jwarasyAmasya; र्ज्वरस्यामस्य) - The āma jwara or the first stage of jwara in which the body is predominated by dosha having ama. Pachyamaanasya (pacyamAnasya; पच्यमानस्य) the stage of fevers in which the ama is being digested, resultantly the obstruction of the srotasas gets relieved and the features start presenting in a more bahirvegi manner Niraama jwara (nirAmajwara; निरामज्वर) – the condition when the patient’s body becomes free from the āma Ashtaaho (aShTAho; अष्टाहो ) - the 8th day of the fever when usually the body becomes free from the effect of ama Kashaaya (kaShAya; कषाय) - medicines having astringent taste Vijwara (Vijwara; विज्वर) - jwara subsides Anupasthita doshanam (anupasthitadoShANAM; अनुपस्थितदोषाणां) - the dośās have not reached the stage of utkleśa (verge of coming out) and thus are not presenting themselves for being removed out of the body. References -