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|title=Jwara Nidana

|title=Jwara Nidana

|titlemode=append

|titlemode=append

|keywords=Diagnosis, nidana, etiology, poorvarupa, premonitory signs, rupa, clinical signs, upashaya, pacifying factors, samprapti, pathogenesis, jwara, nija, aagantu jwara, ghrita ,ghee , fever

|keywords=Diagnosis, nidana, etiology, poorvarupa, premonitory signs, rupa, clinical signs, upashaya, pacifying factors, samprapti, pathogenesis, jwara, nija, aagantu jwara, ghrita ,ghee , fever, ayurveda, charak samhita

|description=Nidana Sthana Chapter 1. Chapter on Fundamental Principles of Diagnosis and Fever

|description=Nidana Sthana Chapter 1. Fundamental Principles of Diagnosis and Fever

}}

}}

<big>'''Nidana Sthana Chapter 1. Chapter on Fundamental Principles of Diagnosis and Fever '''</big>

<big>'''Nidana Sthana Chapter 1. Fundamental Principles of Diagnosis and Fever '''</big>

<big>'''Abstract'''</big>

<big>'''Abstract'''</big>

<div style="text-align:justify;">Nidana Sthana deals with the etiology, symptomatology, and means of diagnosis of diseases. It begins with a generalized set of fundamental principles of diagnosis and then proceeds to specialized studies of diseases. The first part of this chapter deals with necessary tools for acquiring a comprehensive knowledge of any disease. A set of five important tools/components - etiology, premonitory signs, clinical features, pacifying factors and pathogenesis termed as ‘Nidana Panchaka’ helps in understanding a disease thoroughly. Each of these tools has a specific significance in diagnosis and explores an important aspect of the disease. Etiology helps to ascertain the causative factors of the disease and diagnosis helps in determining the nature of the disease by causative factors, premonitory signs, actual signs, exploratory signs, and pathogenesis. Comprehensive management of disease and restoration of health is not possible without complete knowledge of all aspects of the disease process. The second part of the chapter uses these tools to explain fever (jwara) and its types (endogenous and exogenous), as well as methods to manage it. Jwara is caused by the accumulation of vitiated dosha at the site of digestion and further affliction of digestion and thermal regulation in the body. Considering the basic tools for comprehensive understanding of disease, it is regarded as an important chapter. </div>

<div style="text-align:justify;">Nidana Sthana deals with the etiology, symptomatology, and means of diagnosis of diseases. It begins with a generalized set of fundamental principles of diagnosis and then proceeds to specialized studies of diseases. The first part of this chapter deals with the necessary tools for acquiring a comprehensive knowledge of any disease. A set of five important tools/components - etiology, premonitory signs, clinical features, pacifying factors and pathogenesis termed as ‘Nidana Panchaka’ helps in understanding a disease thoroughly. Each of these tools has a specific significance in diagnosis and explores an important aspect of the disease. Etiology helps to ascertain the causative factors of the disease and diagnosis helps in determining the nature of the disease by causative factors, premonitory signs, actual signs, exploratory signs, and pathogenesis. Comprehensive management of disease and restoration of health is not possible without complete knowledge of all aspects of the disease process. The second part of the chapter uses these tools to explain fever (jwara) and its types (endogenous and exogenous), as well as methods to manage it. Jwara is caused by the accumulation of vitiated dosha at the site of digestion and further affliction of digestion and thermal regulation in the body. Considering the basic tools for comprehensive understanding of disease, it is regarded as an important chapter. </div>

'''Keywords''': Diagnosis, ''nidana'', etiology, ''poorvarupa'', premonitory signs, ''rupa'', clinical signs, ''upashaya'', pacifying factors, ''samprapti'', pathogenesis, ''jwara'', ''nija'', ''aagantu jwara'', ''ghrita'' ,ghee , fever.

'''Keywords''': Diagnosis, ''nidana'', etiology, ''poorvarupa'', premonitory signs, ''rupa'', clinical signs, ''upashaya'', pacifying factors, ''samprapti'', pathogenesis, ''jwara'', ''nija'', ''aagantu jwara'', ''ghrita'' ,ghee , fever.

</div></div>

</div></div>

Now I shall expound the chapter on "Diagnosis of Jwara (Fever)".  

Now we shall expound the chapter "Jwara Nidana"(Fundamental Principles of Diagnosis and Fever). Thus said Lord Atreya. [1-2]

 

Thus said Lord Atreya. [1-2]

=== Principles of knowledge of disease ===

=== Principles of knowledge of disease ===

|  || Prasara || The third phase signifies to spread which generally takes place with help of vata and rakta. Dosha are stated to spread over and extend to other parts of the body. || the cytokine factors are released into general circulation, where they migrate to the cytokine factors are released into general circulation, where they migrate to the circumventricular organs of the brain due to easier absorption caused by the blood–brain barrier's reduced filtration action there. The cytokine factors then bind with endothelial receptors on vessel walls, or interact with local microglial cells. When these cytokine factors bind, the arachidonic acid pathway is then activated. Prostaglandin E2 (PGE2) is released which is mediated by the enzymes phospholipase A2 (PLA2), cyclooxygenase-2 (COX-2), and prostaglandin E2 synthase.

|  || Prasara || The third phase signifies to spread which generally takes place with help of vata and rakta. Dosha are stated to spread over and extend to other parts of the body. || the cytokine factors are released into general circulation, where they migrate to the cytokine factors are released into general circulation, where they migrate to the circumventricular organs of the brain due to easier absorption caused by the blood–brain barrier's reduced filtration action there. The cytokine factors then bind with endothelial receptors on vessel walls, or interact with local microglial cells. When these cytokine factors bind, the arachidonic acid pathway is then activated. Prostaglandin E2 (PGE2) is released which is mediated by the enzymes phospholipase A2 (PLA2), cyclooxygenase-2 (COX-2), and prostaglandin E2 synthase.

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|  || sthanasansrayam || It is prodromal phase or the phase of poorvarupa wherein disease is yet to be manifested fully. The excited dosha having extended to other parts of the body become localized and it marks the beginning of specific diseases pertaining to those sthan/ structures. It is also known as the stage of disease augmentation. Sthana samshraya means taking shelter in a place.  || PGE2 is the ultimate mediator of the febrile response. PGE2 acts on neurons in the preoptic area (POA) through the prostaglandin E receptor 3 (EP3). EP3-expressing neurons in the POA innervate the dorsomedial hypothalamus (DMH), the rostral raphe pallidus nucleus in the medulla oblongata (rRPa), and the paraventricular nucleus (PVN) of the hypothalamus. Fever signals sent to the DMH and rRPa lead to stimulation of the sympathetic output system, which evokes non-shivering thermo-genesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface. It is presumed that the innervations from the POA to the PVN mediates the neuroendocrine effects of fever through the pathway involving pituitary gland and various endocrine organs.

|  || sthanasanshrayam || It is prodromal phase or the phase of poorvarupa wherein disease is yet to be manifested fully. The excited dosha having extended to other parts of the body become localized and it marks the beginning of specific diseases pertaining to those sthan/ structures. It is also known as the stage of disease augmentation. Sthana samshraya means taking shelter in a place.  || PGE2 is the ultimate mediator of the febrile response. PGE2 acts on neurons in the preoptic area (POA) through the prostaglandin E receptor 3 (EP3). EP3-expressing neurons in the POA innervate the dorsomedial hypothalamus (DMH), the rostral raphe pallidus nucleus in the medulla oblongata (rRPa), and the paraventricular nucleus (PVN) of the hypothalamus. Fever signals sent to the DMH and rRPa lead to stimulation of the sympathetic output system, which evokes non-shivering thermo-genesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface. It is presumed that the innervations from the POA to the PVN mediates the neuroendocrine effects of fever through the pathway involving pituitary gland and various endocrine organs.

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|  || Vyakti || This stage may be stated to be that of manifestation of the fully developed disease- the resultant dosha dushya samurchana || the brain ultimately orchestrates heat effector mechanisms via the autonomic nervous system. It causes increased heat production by increased muscle tone, shivering and hormones like epinephrine (adrenaline) and also prevents heat loss by way of vasoconstriction.

|  || Vyakti || This stage may be stated to be that of manifestation of the fully developed disease- the resultant dosha dushya samurchana || the brain ultimately orchestrates heat effector mechanisms via the autonomic nervous system. It causes increased heat production by increased muscle tone, shivering and hormones like epinephrine (adrenaline) and also prevents heat loss by way of vasoconstriction.