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Exercise, sexual intercourse, bath, ''chankramana'' (brisk walk) – these should be avoided by the person who has become free from ''jwara'' till he regains strength. [330-332]
 
Exercise, sexual intercourse, bath, ''chankramana'' (brisk walk) – these should be avoided by the person who has become free from ''jwara'' till he regains strength. [330-332]
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==== Punaravarti jwara (recurrent jwara) ====
+
==== ''Punaravarti jwara'' (recurrent ''jwara'') ====
    
असञ्जातबलो यस्तु ज्वरमुक्तो निषेवते|  
 
असञ्जातबलो यस्तु ज्वरमुक्तो निषेवते|  
 
वर्ज्यमेतन्नरस्तस्य पुनरावर्तते ज्वरः||३३३||  
 
वर्ज्यमेतन्नरस्तस्य पुनरावर्तते ज्वरः||३३३||  
 +
 
दुर्हृतेषु च दोषेषु यस्य वा विनिवर्तते|  
 
दुर्हृतेषु च दोषेषु यस्य वा विनिवर्तते|  
 
स्वल्पेनप्यपचारेण तस्य व्यावर्तते पुनः||३३४||  
 
स्वल्पेनप्यपचारेण तस्य व्यावर्तते पुनः||३३४||  
 +
 
चिरकालपरिक्लिष्टं दुर्बलं हीनतेजसम् [१] |  
 
चिरकालपरिक्लिष्टं दुर्बलं हीनतेजसम् [१] |  
 
अचिरेणैव कालेन स हन्ति पुनरागतः||३३५||  
 
अचिरेणैव कालेन स हन्ति पुनरागतः||३३५||  
 +
 
अथवाऽपि  परीपाकं धातुष्वेव क्रमान्मलाः|  
 
अथवाऽपि  परीपाकं धातुष्वेव क्रमान्मलाः|  
 
यान्ति ज्वरमकुर्वन्तस्ते तथाऽप्यपकुर्वते||३३६||  
 
यान्ति ज्वरमकुर्वन्तस्ते तथाऽप्यपकुर्वते||३३६||  
 +
 
दीनतां श्वयथुं ग्लानिं पाण्डुतां नान्नकामताम्|  
 
दीनतां श्वयथुं ग्लानिं पाण्डुतां नान्नकामताम्|  
 
कण्डूरुत्कोठपिडकाः कुर्वन्त्यग्निं च ते मृदुम्||३३७||  
 
कण्डूरुत्कोठपिडकाः कुर्वन्त्यग्निं च ते मृदुम्||३३७||  
 +
 
एवमन्येऽपि च गदा व्यावर्तन्ते पुनर्गताः|  
 
एवमन्येऽपि च गदा व्यावर्तन्ते पुनर्गताः|  
 
अनिर्घातेन दोषाणामल्पैरप्यहितैर्नृणाम्||३३८||  
 
अनिर्घातेन दोषाणामल्पैरप्यहितैर्नृणाम्||३३८||  
 +
 
निर्वृत्तेऽपि ज्वरे तस्माद्यथावस्थं यथाबलम्|  
 
निर्वृत्तेऽपि ज्वरे तस्माद्यथावस्थं यथाबलम्|  
 
यथाप्राणं हरेद्दोषं प्रयोगैर्वा शमं नयेत्||३३९||  
 
यथाप्राणं हरेद्दोषं प्रयोगैर्वा शमं नयेत्||३३९||  
 +
 
मृदुभिः शोधनैः शुद्धिर्यापना बस्तयो हिताः|  
 
मृदुभिः शोधनैः शुद्धिर्यापना बस्तयो हिताः|  
 
हिताश्च लघवो यूषा जाङ्गलामिषजा रसाः||३४०||  
 
हिताश्च लघवो यूषा जाङ्गलामिषजा रसाः||३४०||  
 +
 
अभ्यङ्गोद्वर्तनस्नानधूपनान्यञ्जनानि च|  
 
अभ्यङ्गोद्वर्तनस्नानधूपनान्यञ्जनानि च|  
 
हितानि पुनरावृत्ते ज्वरे तिक्तघृतानि च||३४१||  
 
हितानि पुनरावृत्ते ज्वरे तिक्तघृतानि च||३४१||  
 +
 
गुर्व्यभिष्यन्द्यसात्म्यानां भोजनात् पुनरागते|  
 
गुर्व्यभिष्यन्द्यसात्म्यानां भोजनात् पुनरागते|  
 
लङ्घनोष्णोपचारादिः क्रमः कार्यश्च पूर्ववत्||३४२||  
 
लङ्घनोष्णोपचारादिः क्रमः कार्यश्च पूर्ववत्||३४२||  
 +
 
किराततिक्तकं तिक्ता मुस्तं पर्पटकोऽमृता|  
 
किराततिक्तकं तिक्ता मुस्तं पर्पटकोऽमृता|  
 
घ्नन्ति पीतानि चाभ्यासात् पुनरावर्तकं ज्वरम्||३४३||  
 
घ्नन्ति पीतानि चाभ्यासात् पुनरावर्तकं ज्वरम्||३४३||  
 +
 
asañjātabalō yastu jvaramuktō niṣēvatē|  
 
asañjātabalō yastu jvaramuktō niṣēvatē|  
 
varjyamētannarastasya punarāvartatē jvaraḥ||333||  
 
varjyamētannarastasya punarāvartatē jvaraḥ||333||  
 +
 
durhr̥tēṣu ca dōṣēṣu yasya vā vinivartatē|  
 
durhr̥tēṣu ca dōṣēṣu yasya vā vinivartatē|  
 
svalpēnapyapacārēṇa tasya vyāvartatē punaḥ||334||  
 
svalpēnapyapacārēṇa tasya vyāvartatē punaḥ||334||  
 +
 
cirakālaparikliṣṭaṁ durbalaṁ hīnatējasam  |  
 
cirakālaparikliṣṭaṁ durbalaṁ hīnatējasam  |  
 
acirēṇaiva kālēna sa hanti punarāgataḥ||335||  
 
acirēṇaiva kālēna sa hanti punarāgataḥ||335||  
 +
 
athavā'pi  parīpākaṁ dhātuṣvēva kramānmalāḥ|  
 
athavā'pi  parīpākaṁ dhātuṣvēva kramānmalāḥ|  
 
yānti jvaramakurvantastē tathā'pyapakurvatē||336||  
 
yānti jvaramakurvantastē tathā'pyapakurvatē||336||  
 +
 
dīnatāṁ śvayathuṁ glāniṁ pāṇḍutāṁ nānnakāmatām|  
 
dīnatāṁ śvayathuṁ glāniṁ pāṇḍutāṁ nānnakāmatām|  
 
kaṇḍūrutkōṭhapiḍakāḥ kurvantyagniṁ ca tē mr̥dum||337||  
 
kaṇḍūrutkōṭhapiḍakāḥ kurvantyagniṁ ca tē mr̥dum||337||  
 +
 
ēvamanyē'pi ca gadā vyāvartantē punargatāḥ|  
 
ēvamanyē'pi ca gadā vyāvartantē punargatāḥ|  
 
anirghātēna dōṣāṇāmalpairapyahitairnr̥ṇām||338||  
 
anirghātēna dōṣāṇāmalpairapyahitairnr̥ṇām||338||  
 +
 
nirvr̥ttē'pi jvarē tasmādyathāvasthaṁ yathābalam|  
 
nirvr̥ttē'pi jvarē tasmādyathāvasthaṁ yathābalam|  
 
yathāprāṇaṁ harēddōṣaṁ prayōgairvā śamaṁ nayēt||339||  
 
yathāprāṇaṁ harēddōṣaṁ prayōgairvā śamaṁ nayēt||339||  
 +
 
mr̥dubhiḥ śōdhanaiḥ śuddhiryāpanā bastayō hitāḥ|  
 
mr̥dubhiḥ śōdhanaiḥ śuddhiryāpanā bastayō hitāḥ|  
 
hitāśca laghavō yūṣā jāṅgalāmiṣajā rasāḥ||340||  
 
hitāśca laghavō yūṣā jāṅgalāmiṣajā rasāḥ||340||  
 +
 
abhyaṅgōdvartanasnānadhūpanānyañjanāni ca|  
 
abhyaṅgōdvartanasnānadhūpanānyañjanāni ca|  
 
hitāni punarāvr̥ttē jvarē tiktaghr̥tāni ca||341||  
 
hitāni punarāvr̥ttē jvarē tiktaghr̥tāni ca||341||  
 +
 
gurvyabhiṣyandyasātmyānāṁ bhōjanāt punarāgatē|  
 
gurvyabhiṣyandyasātmyānāṁ bhōjanāt punarāgatē|  
 
laṅghanōṣṇōpacārādiḥ kramaḥ kāryaśca pūrvavat||342||  
 
laṅghanōṣṇōpacārādiḥ kramaḥ kāryaśca pūrvavat||342||  
 +
 
kirātatiktakaṁ tiktā mustaṁ parpaṭakō'mr̥tā|  
 
kirātatiktakaṁ tiktā mustaṁ parpaṭakō'mr̥tā|  
 
ghnanti pītāni cābhyāsāt punarāvartakaṁ jvaram||343||  
 
ghnanti pītāni cābhyāsāt punarāvartakaṁ jvaram||343||  
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asa~jjAtabalo yastu jvaramukto niShevate|  
 
asa~jjAtabalo yastu jvaramukto niShevate|  
 
varjyametannarastasya punarAvartate jvaraH||333||  
 
varjyametannarastasya punarAvartate jvaraH||333||  
 +
 
durhRuteShu ca doSheShu yasya vA vinivartate|  
 
durhRuteShu ca doSheShu yasya vA vinivartate|  
 
svalpenapyapacAreNa tasya vyAvartate punaH||334||  
 
svalpenapyapacAreNa tasya vyAvartate punaH||334||  
 +
 
cirakAlaparikliShTaM durbalaM hInatejasam [1] |  
 
cirakAlaparikliShTaM durbalaM hInatejasam [1] |  
 
acireNaiva kAlena sa hanti punarAgataH||335||  
 
acireNaiva kAlena sa hanti punarAgataH||335||  
 +
 
athavA~api [2] parIpAkaM dhAtuShveva kramAnmalAH|  
 
athavA~api [2] parIpAkaM dhAtuShveva kramAnmalAH|  
 
yAnti jvaramakurvantaste tathA~apyapakurvate||336||  
 
yAnti jvaramakurvantaste tathA~apyapakurvate||336||  
 +
 
dInatAM shvayathuM glAniM pANDutAM nAnnakAmatAm|  
 
dInatAM shvayathuM glAniM pANDutAM nAnnakAmatAm|  
 
kaNDUrutkoThapiDakAH kurvantyagniM ca te mRudum||337||  
 
kaNDUrutkoThapiDakAH kurvantyagniM ca te mRudum||337||  
 +
 
evamanye~api ca gadA vyAvartante punargatAH|  
 
evamanye~api ca gadA vyAvartante punargatAH|  
 
anirghAtena doShANAmalpairapyahitairnRuNAm||338||  
 
anirghAtena doShANAmalpairapyahitairnRuNAm||338||  
 +
 
nirvRutte~api jvare tasmAdyathAvasthaM yathAbalam|  
 
nirvRutte~api jvare tasmAdyathAvasthaM yathAbalam|  
 
yathAprANaM hareddoShaM prayogairvA shamaM nayet||339||  
 
yathAprANaM hareddoShaM prayogairvA shamaM nayet||339||  
 +
 
mRudubhiH shodhanaiH shuddhiryApanA bastayo hitAH|  
 
mRudubhiH shodhanaiH shuddhiryApanA bastayo hitAH|  
 
hitAshca laghavo yUShA jA~ggalAmiShajA rasAH||340||  
 
hitAshca laghavo yUShA jA~ggalAmiShajA rasAH||340||  
 +
 
abhya~ggodvartanasnAnadhUpanAnya~jjanAni ca|  
 
abhya~ggodvartanasnAnadhUpanAnya~jjanAni ca|  
 
hitAni punarAvRutte jvare tiktaghRutAni ca||341||  
 
hitAni punarAvRutte jvare tiktaghRutAni ca||341||  
 +
 
gurvyabhiShyandyasAtmyAnAM bhojanAt punarAgate|  
 
gurvyabhiShyandyasAtmyAnAM bhojanAt punarAgate|  
 
la~gghanoShNopacArAdiH kramaH kAryashca pUrvavat||342||  
 
la~gghanoShNopacArAdiH kramaH kAryashca pUrvavat||342||  
 +
 
kirAtatiktakaM tiktA mustaM parpaTako~amRutA|  
 
kirAtatiktakaM tiktA mustaM parpaTako~amRutA|  
 
ghnanti pItAni cAbhyAsAt punarAvartakaM jvaram||343||  
 
ghnanti pItAni cAbhyAsAt punarAvartakaM jvaram||343||  
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, even with mild irregularity in regimens (apachara), 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), shvayathu (oedema), glani (lassitude), panduta (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.
+
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 ''doshas'' have not been eliminated properly, then, even with mild irregularity in regimens (''apachara''), 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.
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 animal’s meat, which are light, are useful in this condition. Abhyanga, udvartana, snāna, dhūpana, anjana and ghee 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. (333-343)
+
Sometimes, ''doshas'' 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), ''shvayathu'' (edema), ''glani'' (lassitude), ''panduta'' (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 ''doshas'' completely, even by resorting to little unwholesome regime after the cure of the disease.
 +
 
 +
Therefore, the ''doshas'' should be eliminated from the body either by elimination or alleviation therapies depending upon the stage and strength of the ''doshas'', 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 animal’s meat, which are light, are useful in this condition. ''Abhyanga, udvartana, snāna, dhūpana, anjana'' and ghee 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. [333-343]
    
==== Guidelines for management ====
 
==== Guidelines for management ====

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