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==== ''Kapha''-dominant ''jwara'' ====

==== ''Kapha''-dominant ''jwara'' ====

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स्निग्धगुरुमधुरपिच्छिलशीताम्ललवणदिवास्वप्नहर्षाव्यायामेभ्योऽतिसेवितेभ्यः श्लेष्मा प्रकोपमापद्यते||२५||

स्निग्धगुरुमधुरपिच्छिलशीताम्ललवणदिवास्वप्नहर्षाव्यायामेभ्योऽतिसेवितेभ्यः श्लेष्मा प्रकोपमापद्यते||२५||

स यदा प्रकुपितः प्रविश्यामाशयमूष्मणा सह मिश्रीभूयाद्यमाहारपरिणामधातुं  

स यदा प्रकुपितः प्रविश्यामाशयमूष्मणा सह मिश्रीभूयाद्यमाहारपरिणामधातुं  

रसनामानमन्ववेत्य रसस्वेदवहानि स्रोतांसि पिधायाग्निमुपहत्य पक्तिस्थानादूष्माणं बहिर्निरस्य प्रपीडयन् केवलं शरीरमनुप्रपद्यते, तदा ज्वरमभिनिर्वर्तयति||२६||

रसनामानमन्ववेत्य रसस्वेदवहानि स्रोतांसि पिधायाग्निमुपहत्य पक्तिस्थानादूष्माणं बहिर्निरस्य प्रपीडयन् केवलं शरीरमनुप्रपद्यते, तदा ज्वरमभिनिर्वर्तयति||२६||

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sa yadā prakupitaḥ  praviśyāmāśayamūṣmaṇā saha miśrībh- ūyādyamāhārapariṇāmadhātuï rasanāmānamanvavetya rasa-svedavahāni srotāṁsi pidhāyāgnimupahatya paktisthānādūṣ-māṇaï bahirnirasya prapīḍayan kevalaï śarīramanupra-padyate, tadā jwaramabhinirvartayati||26||

sa yadā prakupitaḥ  praviśyāmāśayamūṣmaṇā saha miśrībh- ūyādyamāhārapariṇāmadhātuï rasanāmānamanvavetya rasa-svedavahāni srotāṁsi pidhāyāgnimupahatya paktisthānādūṣ-māṇaï bahirnirasya prapīḍayan kevalaï śarīramanupra-padyate, tadā jwaramabhinirvartayati||26||

sa yadA prakupitaH pravishyAmAshayamUShmaNA sahamishrIbhUyAdyamAhArapariNAmadhAtuM rasanAmAnamanvavetya rasasvedavahAni srotAMsipidhAyAgnimupahatya paktisthAnAdUShmANaM bahirnirasya prapIDayan kevalaM sharIramanuprapadyate, tadA jvaramabhinirvartayati||26||  

sa yadA prakupitaH pravishyAmAshayamUShmaNA sahamishrIbhUyAdyamAhArapariNAmadhAtuM rasanAmAnamanvavetya rasasvedavahAni srotAMsipidhAyAgnimupahatya paktisthAnAdUShmANaM bahirnirasya prapIDayan kevalaM sharIramanuprapadyate, tadA jvaramabhinirvartayati||26||  

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Excessive use of unctuous, heavy, sweet, slimy, cold, sour, salty substances, day sleep, joy and a sedentary lifestyle –vitiate ''sleshma'' or ''kapha''. [25] The vitiated ''kapha'' enters the ''amashaya'' and gets mixed with the initial ''dhatu'' formed in the process, ''rasa'', along with the digested food. This improperly formed ''rasa'' cause sluggish circulation and further block the micro channels of ''rasa'' and ''sweda''. The core digestive ''agni'' gets displaced out of its original site (''pakti sthana''), spreading out through the body. As channels of sweat are blocked and are unable to dissipate the heat, temperature rises all over the body, causing ''jwara''. [26]

The vitiated ''kapha'' enters the ''amashaya'' and gets mixed with the initial ''dhatu'' formed in the process, ''rasa'', along with the digested food. This improperly formed ''rasa'' cause sluggish circulation and further block the micro channels of ''rasa'' and ''sweda''. The core digestive ''agni'' gets displaced out of its original site (''pakti sthana''), spreading out through the body. As channels of sweat are blocked and are unable to dissipate the heat, temperature rises all over the body, causing ''jwara''. [26]

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The symptoms of ''shleshmaja'' (''kaphaja'') ''jwara'' include the simultaneous onset of mild fever in the whole body, specially just after meals, forenoon, early night or spring season. This type of fever causes heaviness in the body, less desire to eat, excess secretion of ''shleshma'' (phlegm), sweet taste in the mouth, nausea, coating in the heart (causing wheezing), vomiting, mild appetite, excessive sleep or narcolepsy, stiffness, drowsiness, cough, dyspnea, coryza, coldness, whiteness in nails, eyes, face, urine and skin, urticarial patches in the body, desire to be subjected to heat, unsuitability of the described etiological factors and suitability of opposite to them. [27]

The symptoms of ''shleshmaja'' (''kaphaja'') ''jwara'' include the simultaneous onset of mild fever in the whole body, specially just after meals, forenoon, early night or spring season. This type of fever causes heaviness in the body, less desire to eat, excess secretion of ''shleshma'' (phlegm), sweet taste in the mouth, nausea, coating in the heart (causing wheezing), vomiting, mild appetite, excessive sleep or narcolepsy, stiffness, drowsiness, cough, dyspnea, coryza, coldness, whiteness in nails, eyes, face, urine and skin, urticarial patches in the body, desire to be subjected to heat, unsuitability of the described etiological factors and suitability of opposite to them. [27]

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===== ''Sannipatika jwara'' =====

 

==== ''Sannipatika jwara'' ====

===== Causes =====

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===== ''Sannipatika jwara'' =====

====== Clinical features ======

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When the symptoms exhibit the dominance of two ''doshas'', it is called ''sansrishta'' (''dwandaja'') ''jwara'' and in case all three ''doshas'' are vitiated, it is called ''sannipatika jwara'' (tridoshic fever). [29]

When the symptoms exhibit the dominance of two ''doshas'', it is called ''sansrishta'' (''dwandaja'') ''jwara'' and in case all three ''doshas'' are vitiated, it is called ''sannipatika jwara'' (tridoshic fever). [29]

===== ''Agantu jwara'' (fever of exogenous origin) =====

==== ''Agantu jwara'' (Exogenous fever) ====

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''Agantuja jwara'' (''jwara'' caused due to exogenous factors) is the eighth type of fever. This fever is accompanied with pain and is often caused by trauma, association with evil, fascination, and wrath (of the wise and the elders). These causes directly manifest as fever without any prodromal symptoms for a transitional duration. Slowly, with the passage of time, ''doshas'' get vitiated and their effects manifest as above. Fevers caused due to trauma influence blood pathology, while association with evil afflicts ''vata'' and ''pitta'', and fascination and wrath causes ''sannipata'' (and therefore, leads to an incurable condition). [30]

''Agantuja jwara'' (''jwara'' caused due to exogenous factors) is the eighth type of fever. This fever is accompanied with pain and is often caused by trauma, association with evil, fascination, and wrath (of the wise and the elders). These causes directly manifest as fever without any prodromal symptoms for a transitional duration. Slowly, with the passage of time, ''doshas'' get vitiated and their effects manifest as above. Fevers caused due to trauma influence blood pathology, while association with evil afflicts ''vata'' and ''pitta'', and fascination and wrath causes ''sannipata'' (and therefore, leads to an incurable condition). [30]

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All the seven doshic ''jwara'' have their own doshic specifications with respect to the onset, symptomatology, and treatment principles. The exception is the ''agantuja jwara'' (exogenous), which should be treated with appropriate consideration to the ''jwara''’s specific etiology. [31]

All the seven doshic ''jwara'' have their own doshic specifications with respect to the onset, symptomatology, and treatment principles. The exception is the ''agantuja jwara'' (exogenous), which should be treated with appropriate consideration to the ''jwara''’s specific etiology. [31]

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Per doshic classification of ''jwara, santapa'' (excessively hot sensation) is of only one type common to all ''jwara''. But according to other classifications it is of two types - ''nija'' (endogenous) and ''agantuja'' (exogenous). ''Nija'' again could be classified into two types (''saumya'' or mild) and ''agneya'' (high grade fever)), three types (''vatika, paitika, shleshmika''), four types (''vatika, paittika'', ''sleshmika'' and ''agantuja''), or seven types (''vatika, paittika, shleshmika, vata-paittika, vata-shleshmika, pitta-shleshmika''). [32]

Per doshic classification of ''jwara, santapa'' (excessively hot sensation) is of only one type common to all ''jwara''. But according to other classifications it is of two types - ''nija'' (endogenous) and ''agantuja'' (exogenous). ''Nija'' again could be classified into two types (''saumya'' or mild) and ''agneya'' (high grade fever)), three types (''vatika, paitika, shleshmika''), four types (''vatika, paittika'', ''sleshmika'' and ''agantuja''), or seven types (''vatika, paittika, shleshmika, vata-paittika, vata-shleshmika, pitta-shleshmika''). [32]

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==== General premonitory signs of all ''jwara'' ====

 

==== General premonitory features of all ''jwara'' ====

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Premonitory symptoms of ''jwara'' include abnormal taste in the mouth, heaviness in the body, aversion to food, restless eyes, lacrymation, excessive sleep, restlessness body, yawning, bending, shivering, exhaustion (without exercise), giddiness, delirium, sometimes sleeplessness, horripilation, oversensitive teeth, tolerance and intolerance to sound, cold, wind and heat, anorexia, indigestion, weakness, body-ache, malaise, reduced vitality, mental agitations, lethargic, idleness, lack of natural activities, apathy to daily regimen, disrespect to the words of elders, agitation with  children, aversion to doing work, uncomfortable with flowers and perfumes, aversion to sweet edibles, and desirous for sour, salty and pungent things. These premonitory symptoms rise before the onset of ''jwara'' and may continue through the course of the fever. [33]

Premonitory features of ''jwara'' include abnormal taste in the mouth, heaviness in the body, aversion to food, restless eyes, lacrymation, excessive sleep, restlessness body, yawning, bending, shivering, exhaustion (without exercise), giddiness, delirium, sometimes sleeplessness, horripilation, oversensitive teeth, tolerance and intolerance to sound, cold, wind and heat, anorexia, indigestion, weakness, body-ache, malaise, reduced vitality, mental agitations, lethargic, idleness, lack of natural activities, apathy to daily regimen, disrespect to the words of elders, agitation with  children, aversion to doing work, uncomfortable with flowers and perfumes, aversion to sweet edibles, and desirous for sour, salty and pungent things. These premonitory symptoms rise before the onset of ''jwara'' and may continue through the course of the fever. [33]

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Thus the symptoms of separate single doshic ''jwara'' are described in details and double and triple doshic ''jwara'' are described in brief [34].

Thus the symptoms of separate single doshic ''jwara'' are described in details and double and triple doshic ''jwara'' are described in brief [34].

==== Consequence of ''jwara'' ====

==== Consequences of ''jwara'' ====

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==== Management of ''jwara'' ====

==== Principles of management of ''jwara'' ====

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When premonitory symptoms manifest or at the onset of the fever, dieting or fasting is useful because the disease originates from the ''amashaya''. In such a case, intake of ''kashaya'' (decoctions), massage, oleation, fomentation, ''pradeha'' (sprinkling), ''anulepana'' (anointing with pastes), emesis, purgation, decoction and oily enema, pacificatory measures, snuffing, fumigation, smoking, collyrium, medicated milk and a specific dietetic regimen should be indicated as per the condition. [36]

When premonitory symptoms manifest or at the onset of the fever, dieting or fasting is useful because the disease originates from the ''amashaya''. In such a case, intake of ''kashaya'' (decoctions), massage, oleation, fomentation, ''pradeha'' (sprinkling), ''anulepana'' (anointing with pastes), emesis, purgation, decoction and oily enema, pacificatory measures, snuffing, fumigation, smoking, collyrium, medicated milk and a specific dietetic regimen should be indicated as per the condition. [36]

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==== Management of chronic ''jwara'' ====

 

==== Management principles of '' jeerna jwara''(chronic fever) ====

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As water is sprinkled on burning houses to douse (the fire), ghee is administered to manage chronic fever. No other ''sneha'' (oil etc.) brings the refinement properties of ''sanskara'' (processing with drugs) as ghee and therefore it is said the best one of all the ''snehas''. [38-40]

As water is sprinkled on burning houses to douse (the fire), ghee is administered to manage chronic fever. No other ''sneha'' (oil etc.) brings the refinement properties of ''sanskara'' (processing with drugs) as ghee and therefore it is said the best one of all the ''snehas''. [38-40]

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