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Line 36: − === Sanskrit text, Transliteration and English Translation ===+ Line 53:
Line 53: − We shall now explain the chapter on the treatment of ''jwara'' (different types of fever).+ − Thus said lord Atreya.[1-2]+ − − ==== Queries of Agnivesha ==== Line 181:
Line 179: − ==== Synonyms of ''jwara'' ====+ Line 200:
Line 198: − ==== ''Prakriti'' or nature of ''jwara'' ====+ Line 239:
Line 237: − ==== ''Pravritti'' (origin of the disease) ====+ Line 392:
Line 390: − ==== ''Prabhava'', the sequels of the disease ====+ Line 428:
Line 426: − ==== Premonitory symptoms of ''jwara'' ====+ Line 459:
Line 457: − ==== Sites of ''jwara'' ====+ Line 478:
Line 476: − ==== Cardinal feature ====+ Line 497:
Line 495: − ==== Classification ====+ Line 566:
Line 564: − ==== Clinical features of somatic and psychic ''jwara'' ====+ Line 591:
Line 589: − ==== Desires of patient to diagnose ''dosha'' dominance ====+ Line 610:
Line 608: − ==== Attenuating nature of ''vata dosha'' ====+ Line 629:
Line 627: − ==== Features of internal and external ''jwara'' ====+ Line 668:
Line 666: − ==== ''Prakrita jwara''(seasonal ''jwara'') ====+ Line 779:
Line 777: − ===== ''Vaikrita jwara'' =====+ Line 787:
Line 785: − ==== Prognosis of ''jwara'' ====+ Line 834:
Line 832: − ===== ''Sadhya'' (curable) ''jwara'' =====+ − ===== ''Asadhya'' (incurable) ''jwara'' =====+ Line 851:
Line 849: − ==== Five types of ''jwara'' as per frequency ====+ − ===== ''Santata jwara'' =====+ Line 961:
Line 959: − ===== ''Satata jwara'' =====+ Line 986:
Line 984: − ===== ''Anyedyushka jwara'' =====+ Line 1,011:
Line 1,009: − ===== ''Tritiyaka'' and ''chaturthaka jwara'' =====+ Line 1,064:
Line 1,062: − ==== Cause of alterations in ''jwara'' episodes ====+ Line 1,176:
Line 1,174: − ==== ''Dhatugata jwara'' ====+ Line 1,305:
Line 1,303: − ==== Clinical features of ''jwara'' due to combination of two ''dosha'' ====+ Line 1,398:
Line 1,396: − ==== ''Sannipataja jwara'' ====+ Line 1,679:
Line 1,677: − ==== Prognosis of ''sannipata jwara'' ====+ Line 1,712:
Line 1,710: − ==== Classification of ''agantuja jwara'' ====+ Line 1,731:
Line 1,729: − ==== ''Abhighataja jwara'' (due to injury or trauma) ====+ Line 1,762:
Line 1,760: − ==== ''Abhishangaja, abhishapaja'' and ''abhicharaja jwara'' ====+ Line 1,974:
Line 1,972: − ==== General patho-physiology of ''jwara'' ====+ Line 2,021:
Line 2,019: − ==== Cause of lack of sweating ====+ Line 2,040:
Line 2,038: − ==== Clinical features of ''Ama Jwara'' (first stage of ''jwara'') ====+ Line 2,092:
Line 2,090: − ==== Clinical features of ''pachyamana jwara'' (second stage of ''jwara'') ====+ Line 2,111:
Line 2,109: − ==== Clinical features of ''nirama jwara'' (third stage of ''jwara'') ====+ Line 2,130:
Line 2,128: − ==== Precaution at initial stage of ''jwara'' ====+ Line 2,149:
Line 2,147: − ==== Contra-indications of ''langhana'' (fasting) ====+ Line 2,168:
Line 2,166: − ==== Benefits of ''langhana'' (fasting) in ''jwara'' ====+ Line 2,201:
Line 2,199: − ==== Management principle of ''jwara'' ====+ Line 2,220:
Line 2,218: − ==== Various drinks for management of thirst ====+ Line 2,257:
Line 2,255: − ==== ''Shadanga paniya'' ====+ Line 2,276:
Line 2,274: − ==== Indication of ''vamana'' (therapeutic emesis) ====+ Line 2,297:
Line 2,295: − ==== Hazards of improper ''vamana'' (therapeutic emesis) ====+ Line 2,328:
Line 2,326: − ==== Post ''vamana'' protocol ====+ Line 2,395:
Line 2,393: − ==== Contra-indications of ''yavagu'' ====+ Line 2,437:
Line 2,435: − ==== Guidelines for diet, mouth cleansing and tooth brush ==== + Line 2,509:
Line 2,507: − ==== Contra-indications of ''kashaya'' (astringents) ====+ Line 2,540:
Line 2,538: − ==== ''Yusha'' (soup) indications ====+ Line 2,559:
Line 2,557: − ==== Indications and contra-indications of ''ghrita'' ====+ Line 2,606:
Line 2,604: − ==== Indication of milk ====+ Line 2,628:
Line 2,626: − ==== Indication of ''virechana'' ====+ Line 2,647:
Line 2,645: − ==== Indications of ''niruha'' (enema with decoction) ====+ Line 2,694:
Line 2,692: − ==== Indication of ''anuvasana'' (unctuous enema) ====+ Line 2,716:
Line 2,714: − ==== Indications of ''murdha-virechana'' (nasal errhines) ====+ Line 2,735:
Line 2,733: − ==== Various external procedures ====+ Line 2,782:
Line 2,780: − ==== Various dietary articles used in treatment ====+ Line 2,815:
Line 2,813: − ==== Ten types of ''yavagu'' (gruel) in ''jwara'' ====+ Line 2,939:
Line 2,937: − ==== Indications of soup ====+ Line 2,958:
Line 2,956: − ==== Indications of vegetables ====+ Line 2,977:
Line 2,975: − ==== Indication of animal meat soups ====+ Line 3,034:
Line 3,032: − ==== ''Anupana''(beverages) ====+ Line 3,053:
Line 3,051: − ==== Contra-indications in ''jwara'' ====+ Line 3,080:
Line 3,078: − ==== Decoctions indicated in ''jwara'' ====+ Line 3,126:
Line 3,124: − ==== ''Kashaya'' in ''vishama jwara'' ====+ Line 3,271:
Line 3,269: − ==== Formulations used in ''sannipata jwara'' ====+ Line 3,357:
Line 3,355: − ==== Advantage of ghee ====+ Line 3,405:
Line 3,403: − ==== Various medicated ghee formulations ====+ Line 3,518:
Line 3,516: − ==== Formulations used in purification therapies ====+ Line 3,624:
Line 3,622: − ==== Formulations with medicated milk ====+ Line 3,715:
Line 3,713: − ==== Medicated enemas ====+ Line 3,904:
Line 3,902: − ==== Indications of ''shiro-virechana'' (nasal errhines) ====+ Line 3,937:
Line 3,935: − ==== External applications ====+ Line 3,970:
Line 3,968: − ==== ''Chandanadya taila'' ====+ Line 4,028:
Line 4,026: − ==== Guidelines for a patient with burning sensation ====+ Line 4,131:
Line 4,129: − ==== ''Agurvadya tailam'' ====+ Line 4,162:
Line 4,160: − ==== Indications of fomentation for alleviating cold ====+ Line 4,229:
Line 4,227: − ====Contra-indications of ''langhana'' ====+ Line 4,248:
Line 4,246: − ==== Guidelines for improving ''agni'' (digestive strength) ====+ Line 4,387:
Line 4,385: − ==== Guidelines for management in ''sannipata'' conditions ====+ Line 4,451:
Line 4,449: − ==== Management of ''karnamulika shotha'' (inflammatoion near the root of the ears) ====+ Line 4,482:
Line 4,480: − ==== Indications of blood letting ====+ Line 4,501:
Line 4,499: − ==== Indication of consumption of ghee ====+ Line 4,520:
Line 4,518: − ==== Management of ''jeerna jwara'' (chronic stage) ====+ Line 4,539:
Line 4,537: − ==== Management of ''dosha'' dominance in ''vishamajwara'' ====+ Line 4,594:
Line 4,592: − ==== Guidelines and various formulations in ''vishama jwara'' ====+ Line 4,787:
Line 4,785: − ==== Spiritual therapy ====+ Line 4,858:
Line 4,856: − ==== Management of ''jwara'' located in various ''dhatu'' ====+ Line 4,895:
Line 4,893: − ==== Management of ''abhicharaja'' and ''abhishangaja jwara'' ====+ Line 4,914:
Line 4,912: − ==== Management of ''abhighataja jwara'' ====+ Line 4,945:
Line 4,943: − ==== Management of ''agantuja jwara'' due to mental factors ====+ Line 5,006:
Line 5,004: − ==== Signs of remission of ''jwara'' ====+ Line 5,077:
Line 5,075: − ==== Signs of completely cured ''jwara'' patient ====+ Line 5,096:
Line 5,094: − ==== Precautions after being cured from ''jwara'' ====+ Line 5,141:
Line 5,139: − ==== ''Punaravarti jwara'' (recurrent ''jwara'') ====+ Line 5,288:
Line 5,286: − ==== Guidelines for management ====+ Line 5,318:
Line 5,316: − ==== Summary ====+
→Sanskrit text, Transliteration and English Translation
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== Sanskrit text, Transliteration and English Translation ==
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Now we shall expound the chapter "Jwara Chikitsa" (Management of different types of fever). Thus said lord Atreya.[1-2]
=== Queries of Agnivesha ===
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After hearing this statement of Agnivesha, the preceptor (Atreya) replied: “all these will be explained in this chapter on the description of fever. Oh benevolent one, listen to the details.”[3-10]
After hearing this statement of Agnivesha, the preceptor (Atreya) replied: “all these will be explained in this chapter on the description of fever. Oh benevolent one, listen to the details.”[3-10]
=== Synonyms of ''jwara'' ===
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''Jwara, vikara, roga, vyadhi'' and ''atanka'' – these terms are synonymous and used to indicate this condition. [11]
''Jwara, vikara, roga, vyadhi'' and ''atanka'' – these terms are synonymous and used to indicate this condition. [11]
=== ''Prakriti'' or nature of ''jwara'' ===
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''Kshaya'' (emaciation), ''tama'' (feeling of entering into darkness), ''jwara, papma'' (manifestations of the sinful acts) and ''mrityu'' (death) are all the various presentations of Yamaraja (lord of deaths). These are the causes of death (''panchatva'') in individuals suffering from various grievances, due to their own deeds and hence have been accepted as equivalent to Yama (lord of death). In this way the ''prakriti'' (basic nature) of ''jwara'' has been described. [12-13]
''Kshaya'' (emaciation), ''tama'' (feeling of entering into darkness), ''jwara, papma'' (manifestations of the sinful acts) and ''mrityu'' (death) are all the various presentations of Yamaraja (lord of deaths). These are the causes of death (''panchatva'') in individuals suffering from various grievances, due to their own deeds and hence have been accepted as equivalent to Yama (lord of death). In this way the ''prakriti'' (basic nature) of ''jwara'' has been described. [12-13]
=== ''Pravritti'' (origin of the disease) ===
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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 mischiefs and destroying the sacrament and the meditation of the ''rishis'' (sages). Daksha Prajapati was capable of combating these demons but he ignored his duties of opposing those demons and further organized a ''yajna'' (ritual of sacrifice) in which he did not offer any share to Lord Shiva in spite of being told to do so by the other lords. He even did not chant the hymns (''richa'') described in the ''veda'' of lord Shiva which provide fulfilment to the desired objective of ''yajna'' and even did not offer ''ahuti'' (pouring of ghee in the sacrificial fire) to Lord Shiva. Lord Shiva perceived whole of this situation regarding Daksha 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 Daksha. That child demolished the ''yajna'' of Daksha 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 rishis offered those substantial hymns to Lord Shiva till he became pleased and switched over to his Shiva (the compassionate or benevolent and auspicious) form. When it was known that Lord Shiva is returned to his auspicious disposition, then Virabhadra who was produced from the wrathful fire of Lord Shiva, 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 Shiva with folded hands and enquired about his future work. Lord Shiva 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.”[14-25]
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 mischiefs and destroying the sacrament and the meditation of the ''rishis'' (sages). Daksha Prajapati was capable of combating these demons but he ignored his duties of opposing those demons and further organized a ''yajna'' (ritual of sacrifice) in which he did not offer any share to Lord Shiva in spite of being told to do so by the other lords. He even did not chant the hymns (''richa'') described in the ''veda'' of lord Shiva which provide fulfilment to the desired objective of ''yajna'' and even did not offer ''ahuti'' (pouring of ghee in the sacrificial fire) to Lord Shiva. Lord Shiva perceived whole of this situation regarding Daksha 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 Daksha. That child demolished the ''yajna'' of Daksha 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 rishis offered those substantial hymns to Lord Shiva till he became pleased and switched over to his Shiva (the compassionate or benevolent and auspicious) form. When it was known that Lord Shiva is returned to his auspicious disposition, then Virabhadra who was produced from the wrathful fire of Lord Shiva, 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 Shiva with folded hands and enquired about his future work. Lord Shiva 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.”[14-25]
=== ''Prabhava'', the sequels of the disease ===
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Earlier in the [[Nidana Sthana]] the etiological factors for each of the eight varieties of ''jwara'' have been described separately. [27]
Earlier in the [[Nidana Sthana]] the etiological factors for each of the eight varieties of ''jwara'' have been described separately. [27]
=== Premonitory symptoms of ''jwara'' ===
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Laziness, lacrimation, yawning, heaviness, mental fatigue, uncertainty 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''.[28-29]
Laziness, lacrimation, yawning, heaviness, mental fatigue, uncertainty 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''.[28-29]
=== Sites of ''jwara'' ===
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The whole body and the mind are the sites of manifestation of ''jwara''. The severity and the time of manifestation of ''jwara'' have been described in [[Nidana Sthana]].[30]
The whole body and the mind are the sites of manifestation of ''jwara''. The severity and the time of manifestation of ''jwara'' have been described in [[Nidana Sthana]].[30]
=== Cardinal feature ===
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The clinical features invariably associated with ''jwara'' are the feeling of heat or increased body temperature and discomfort in body and mind. ''Jwara'' afflicts the whole body including mind and sensory organs in all living beings. [31]
The clinical features invariably associated with ''jwara'' are the feeling of heat or increased body temperature and discomfort in body and mind. ''Jwara'' afflicts the whole body including mind and sensory organs in all living beings. [31]
=== Classification ===
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''Jwara'' is classified into eight types on the basis of eight causes of ''jwara'' (''dosha'' predominance). [32-35]
''Jwara'' is classified into eight types on the basis of eight causes of ''jwara'' (''dosha'' predominance). [32-35]
=== Clinical features of somatic and psychic ''jwara'' ===
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The ''sharira'' type of ''jwara'' first appears in the body and the ''manasa'' type, first appears in the mind. ''Vaichitya'' (mental instability), ''arati'' (disliking for everything) and ''glani'' (feeling of weakness in the body) are the signs and symptoms of the ''manas tapa'' (mental affliction of ''jwara''). The loss of ease in sensing the objects is the feature of the ''santapa'' of the ''indriya''. [36-37]
The ''sharira'' type of ''jwara'' first appears in the body and the ''manasa'' type, first appears in the mind. ''Vaichitya'' (mental instability), ''arati'' (disliking for everything) and ''glani'' (feeling of weakness in the body) are the signs and symptoms of the ''manas tapa'' (mental affliction of ''jwara''). The loss of ease in sensing the objects is the feature of the ''santapa'' of the ''indriya''. [36-37]
=== Desires of patient to diagnose ''dosha'' dominance ===
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A patient suffering from ''vatapittaja'' variety of ''jwara'' desires for cold things, while, a patient suffering from ''jwara'' caused by ''vata'' and ''kapha dosha'' longs for hot things. However, when both of these types of ''doshas'' get mixed then such patient manifests both the kinds of symptoms. [37-38]
A patient suffering from ''vatapittaja'' variety of ''jwara'' desires for cold things, while, a patient suffering from ''jwara'' caused by ''vata'' and ''kapha dosha'' longs for hot things. However, when both of these types of ''doshas'' get mixed then such patient manifests both the kinds of symptoms. [37-38]
=== Attenuating nature of ''vata dosha'' ===
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''Vata dosha'' is exceedingly ''yogavahi'' (which accentuates the properties of others) in nature. It produces both type of effects on combination with the two ''doshas''. On combining with ''tejas'' it produces burning sensation while in combination with ''soma'' it produces cooling effect. [38-39]
''Vata dosha'' is exceedingly ''yogavahi'' (which accentuates the properties of others) in nature. It produces both type of effects on combination with the two ''doshas''. On combining with ''tejas'' it produces burning sensation while in combination with ''soma'' it produces cooling effect. [38-39]
=== Features of internal and external ''jwara'' ===
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Excessive rise in the body temperature and above features in mild form are the features of ''bahirvegi'' (external type of ''jwara'') and this type of ''jwara'' is easily curable. [39-41]
Excessive rise in the body temperature and above features in mild form are the features of ''bahirvegi'' (external type of ''jwara'') and this type of ''jwara'' is easily curable. [39-41]
=== ''Prakrita jwara''(seasonal ''jwara'') ===
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A patient of ''jwara'' should be treated keeping in view the strength of the ''doshas'' in the beginning, middle and the end of the spring and autumn seasons. This way, depending upon the nature of the seasons, the seasonal types of ''jwara'' are described.
A patient of ''jwara'' should be treated keeping in view the strength of the ''doshas'' in the beginning, middle and the end of the spring and autumn seasons. This way, depending upon the nature of the seasons, the seasonal types of ''jwara'' are described.
==== ''Vaikrita jwara'' ====
Generally, the ''jwara'' caused by ''vata dosha'' is difficult to treat in every season. The other types of ''jwara'', get their initial strength from the predominant season, those are (''Vaikrita jwara'') difficult to treat are:
Generally, the ''jwara'' caused by ''vata dosha'' is difficult to treat in every season. The other types of ''jwara'', get their initial strength from the predominant season, those are (''Vaikrita jwara'') difficult to treat are:
*''vatika jwara'' irrespective of its season of occurrence
*''vatika jwara'' irrespective of its season of occurrence
The causative factors of the different types of ''jwara'' have been described in [[Nidana Sthana]] (in ''jwara''). [42-49]
The causative factors of the different types of ''jwara'' have been described in [[Nidana Sthana]] (in ''jwara''). [42-49]
=== Prognosis of ''jwara'' ===
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==== ''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 ''dosha'' and if there are no complications.
''Jwara'' is easily curable if it occurs in a person with strong physique, or if it is caused by the vitiation of lesser amount of ''dosha'' and if there are no complications.
==== ''Asadhya'' (incurable) ''jwara'' ====
''Jwara'' having the following characteristics are incurable and lead to death –
''Jwara'' having the following characteristics are incurable and lead to death –
''Jwara'' occurring in a weak and emaciated person (''kshina''), associated with edema (''shunasya''), seated in deeper body tissues (''gambhira''), severe (''balvan'') and that occurring for very long durations (''dirgha ratrika'') are incurable ones. The ''jwara'' in which, the mid hair part of scalp becomes visible, is also considered incurable (''kesha simanta krita'').[49-53]
''Jwara'' occurring in a weak and emaciated person (''kshina''), associated with edema (''shunasya''), seated in deeper body tissues (''gambhira''), severe (''balvan'') and that occurring for very long durations (''dirgha ratrika'') are incurable ones. The ''jwara'' in which, the mid hair part of scalp becomes visible, is also considered incurable (''kesha simanta krita'').[49-53]
=== Five types of ''jwara'' as per frequency ===
==== ''Santata jwara'' ====
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If, some of the 12 constituents of this fever get purified, while some others remain unpurified, then the fever goes in latent stage on the 12th day and reappears on the 13th day and may persist for longer duration. In this way, a physician should understand the causes and features of this type of fever and should initiate the treatment only after a proper understanding of these factors, mostly by the methods beginning with ''apatarpana''. [53-61]
If, some of the 12 constituents of this fever get purified, while some others remain unpurified, then the fever goes in latent stage on the 12th day and reappears on the 13th day and may persist for longer duration. In this way, a physician should understand the causes and features of this type of fever and should initiate the treatment only after a proper understanding of these factors, mostly by the methods beginning with ''apatarpana''. [53-61]
==== ''Satata jwara'' ====
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The aggravated ''dosha'' when generally lodges in the ''rakta dhatu'', then they manifest with fever twice in 24 hours (Nycthemeron) depending on the time of ''dosha'' aggravation or subsidence. The ''dosha'' in this type of ''jwara'' can be counteracted. [61-62]
The aggravated ''dosha'' when generally lodges in the ''rakta dhatu'', then they manifest with fever twice in 24 hours (Nycthemeron) depending on the time of ''dosha'' aggravation or subsidence. The ''dosha'' in this type of ''jwara'' can be counteracted. [61-62]
==== ''Anyedyushka jwara'' ====
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Vitiated ''dosha'' produce ''anyedushka'' type of ''jwara'' with the support of any one factor amongst the ''kala'' (time), ''prakriti'' (physical constitution) and ''dushya'' (vitiated factors) leading to obstruction in ''medo vaha sira'' (the channel of circulation of ''medasa'' (fat)). It can be counteracted. This ''jwara'' occurs only once during day and night. [63-64]
Vitiated ''dosha'' produce ''anyedushka'' type of ''jwara'' with the support of any one factor amongst the ''kala'' (time), ''prakriti'' (physical constitution) and ''dushya'' (vitiated factors) leading to obstruction in ''medo vaha sira'' (the channel of circulation of ''medasa'' (fat)). It can be counteracted. This ''jwara'' occurs only once during day and night. [63-64]
==== ''Tritiyaka'' and ''chaturthaka jwara'' ====
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''Anyedushka jwara'' occurs every day, while ''tritiyaka jwara'' occurs after a gap of one day and ''chaurthaka'' occurs after two days gap. [64-67]
''Anyedushka jwara'' occurs every day, while ''tritiyaka jwara'' occurs after a gap of one day and ''chaurthaka'' occurs after two days gap. [64-67]
=== Cause of alterations in ''jwara'' episodes ===
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These five types of ''jwara'' are mostly caused by ''sannipata'' (simultaneous vitiation of the three ''dosha''), however, the ''dosha'', which is predominant among the three ''doshas'' is generally attributed as the causative factors. [74]
These five types of ''jwara'' are mostly caused by ''sannipata'' (simultaneous vitiation of the three ''dosha''), however, the ''dosha'', which is predominant among the three ''doshas'' is generally attributed as the causative factors. [74]
=== ''Dhatugata jwara'' ===
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The ''jwara'' in which ''doshas'' are located in the ''rasa, rakta, mamsa'' and ''medas dhatu'' are curable, while those in which the location is in the ''asthi'' and ''majja dhatu'' are difficult to treat. The ''jwara'' in which the vitiated ''dosha'' are located in ''shukra dhatu'' is incurable. [75-83]
The ''jwara'' in which ''doshas'' are located in the ''rasa, rakta, mamsa'' and ''medas dhatu'' are curable, while those in which the location is in the ''asthi'' and ''majja dhatu'' are difficult to treat. The ''jwara'' in which the vitiated ''dosha'' are located in ''shukra dhatu'' is incurable. [75-83]
=== Clinical features of ''jwara'' due to combination of two ''dosha'' ===
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Thus, here the features of different types of ''jwara'' caused by the simultaneous vitiation of two ''dosha'' have been described. [84-89]
Thus, here the features of different types of ''jwara'' caused by the simultaneous vitiation of two ''dosha'' have been described. [84-89]
=== ''Sannipataja jwara'' ===
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**The ''doshas'' undergo ''paka'' after a very long time (conversion into the healthy state of the ''doshas'' do not occur early). [103-109]
**The ''doshas'' undergo ''paka'' after a very long time (conversion into the healthy state of the ''doshas'' do not occur early). [103-109]
=== Prognosis of ''sannipata jwara'' ===
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The clinical features of ''jwaras'' caused by the individual ''doshas vata, pitta'' and ''kapha'' have been described separately in the [[Nidana Sthana]]. From these sign and symptoms, the features of ''dwandaja'' types and the ''sannipataja'' types can be known and decided. [109-110]
The clinical features of ''jwaras'' caused by the individual ''doshas vata, pitta'' and ''kapha'' have been described separately in the [[Nidana Sthana]]. From these sign and symptoms, the features of ''dwandaja'' types and the ''sannipataja'' types can be known and decided. [109-110]
=== Classification of ''agantuja jwara'' ===
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The eighth type of ''jwara'' i.e. ''agantuja'' type (that caused due to external/exogenous factors) is of four types, viz: ''abhihataja, abhishangaja, abhicharaja'' and ''abhishapaja''.[111]
The eighth type of ''jwara'' i.e. ''agantuja'' type (that caused due to external/exogenous factors) is of four types, viz: ''abhihataja, abhishangaja, abhicharaja'' and ''abhishapaja''.[111]
=== ''Abhighataja jwara'' (due to injury or trauma) ===
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The ''jwara'' caused by the injury from weapons, stones, hunters, wood, fist, palm of the sole, teeth and such other things is called ''abhighataja''. In this type, vitiated ''vata'' affects predominantly ''rakta'' (blood) to resulting in ''jwara'' with discomfort, swelling, discoloration and pain.[112-114]
The ''jwara'' caused by the injury from weapons, stones, hunters, wood, fist, palm of the sole, teeth and such other things is called ''abhighataja''. In this type, vitiated ''vata'' affects predominantly ''rakta'' (blood) to resulting in ''jwara'' with discomfort, swelling, discoloration and pain.[112-114]
=== ''Abhishangaja, abhishapaja'' and ''abhicharaja jwara'' ===
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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 ''agantuja jwaras'' have their own etiological factors and treatments. [114-129]
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 ''agantuja jwaras'' have their own etiological factors and treatments. [114-129]
=== General patho-physiology of ''jwara'' ===
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These aggravated ''dosha'' either alone 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 ''dosha''’s own heat 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''.[129-132]
These aggravated ''dosha'' either alone 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 ''dosha''’s own heat 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''.[129-132]
=== Cause of lack of sweating ===
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A person suffering from ''taruna jwara'' (the initial stage of ''jwara'') does not sweat because of the obstruction of the channels of circulation and the displacement of ''agni''. [132-133]
A person suffering from ''taruna jwara'' (the initial stage of ''jwara'') does not sweat because of the obstruction of the channels of circulation and the displacement of ''agni''. [132-133]
=== Clinical features of ''Ama Jwara'' (first stage of ''jwara'') ===
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*Absence of muscle emaciation [133-136]
*Absence of muscle emaciation [133-136]
=== Clinical features of ''pachyamana jwara'' (second stage of ''jwara'') ===
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The features of ''pachyamana jwara'' (second stage of fever) are as follows – high grade fever and excess thirst, delirium, dyspnea, giddiness and excess evacuation of wastes [136]
The features of ''pachyamana jwara'' (second stage of fever) are as follows – high grade fever and excess thirst, delirium, dyspnea, giddiness and excess evacuation of wastes [136]
=== Clinical features of ''nirama jwara'' (third stage of ''jwara'') ===
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Restoration of hunger, debility, lightness in the body, reduced fever, elimination of the ''dosha'' 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. [137-138]
Restoration of hunger, debility, lightness in the body, reduced fever, elimination of the ''dosha'' 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. [137-138]
=== Precaution at initial stage of ''jwara'' ===
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The patient, in the state of ''nava jwara'' (first stage fever) should avoid certain things as – daytime sleep, bath, massage, heavy to digest food, sexual intercourse, anger, direct exposure to wind, exercise, and ''kashaya'' (astringent foods). [138-139]
The patient, in the state of ''nava jwara'' (first stage fever) should avoid certain things as – daytime sleep, bath, massage, heavy to digest food, sexual intercourse, anger, direct exposure to wind, exercise, and ''kashaya'' (astringent foods). [138-139]
=== Contra-indications of ''langhana'' (fasting) ===
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''Langhana'' or fasting is prescribed in the initial stage of ''jwara'' except those caused by ''kshaya'' (consumption), ''vata'' dominant ''jwara'', fear, anger, passion, grief and physical exertion.[139-140]
''Langhana'' or fasting is prescribed in the initial stage of ''jwara'' except those caused by ''kshaya'' (consumption), ''vata'' dominant ''jwara'', fear, anger, passion, grief and physical exertion.[139-140]
=== Benefits of ''langhana'' (fasting) in ''jwara'' ===
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''Langhana'' should be performed to the extent that it does not hamper the vitality or strength of the individual. The aim of all these measures is to regain the health which also depends on the physical, mental and spiritual strength. [140-142]
''Langhana'' should be performed to the extent that it does not hamper the vitality or strength of the individual. The aim of all these measures is to regain the health which also depends on the physical, mental and spiritual strength. [140-142]
=== Management principle of ''jwara'' ===
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''Langhana'' (fasting), ''swedana'' (fomentation), ''kala'' (waiting period of eight days), ''yavagu'' (medicated gruels) and ''tikta rasa'' drugs (drugs having bitter taste) and all digestive enhancers of ''avipakva dosha'' (untransformed) are prescribed in the ''taruna jwara'' (the initial stage of ''jwara'').[142]
''Langhana'' (fasting), ''swedana'' (fomentation), ''kala'' (waiting period of eight days), ''yavagu'' (medicated gruels) and ''tikta rasa'' drugs (drugs having bitter taste) and all digestive enhancers of ''avipakva dosha'' (untransformed) are prescribed in the ''taruna jwara'' (the initial stage of ''jwara'').[142]
=== Various drinks for management of thirst ===
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Both of these are ''dipana'', (digestive stimulant), ''pachana'' (enhancing digestion), and ''jwaraghna'' (alleviators of ''jwara''). They help in cleansing the channels of circulation and promote strength, appetite, sweating and auspiciousness. [143-145]
Both of these are ''dipana'', (digestive stimulant), ''pachana'' (enhancing digestion), and ''jwaraghna'' (alleviators of ''jwara''). They help in cleansing the channels of circulation and promote strength, appetite, sweating and auspiciousness. [143-145]
=== ''Shadanga paniya'' ===
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Patient should be given water cooled after boiling it with ''musta, parpataka, ushira, chandana, udichya'' and ''nagara'' for the alleviation of thirst and ''jwara''. [145]
Patient should be given water cooled after boiling it with ''musta, parpataka, ushira, chandana, udichya'' and ''nagara'' for the alleviation of thirst and ''jwara''. [145]
=== Indication of ''vamana'' (therapeutic emesis) ===
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Note: 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.[147]
Note: 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.[147]
=== Hazards of improper ''vamana'' (therapeutic emesis) ===
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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, dyspnea, ''anaha'' (obstruction to the movement of flatus and feces) and illusion. Attempting to take out the ''anupasthita dosha'' (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 creates complications (destroys the fruit). [147-149]
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, dyspnea, ''anaha'' (obstruction to the movement of flatus and feces) and illusion. Attempting to take out the ''anupasthita dosha'' (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 creates complications (destroys the fruit). [147-149]
=== Post ''vamana'' protocol ===
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In view of above, a ''jwara'' patient should in the beginning be administered with different types of ''peya'' (thin gruels). [149-153]
In view of above, a ''jwara'' patient should in the beginning be administered with different types of ''peya'' (thin gruels). [149-153]
=== Contra-indications of ''yavagu'' ===
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In cases where ''yavagu'' administration is prohibited, the physician should administer in the beginning ''tarpana'' (nutritional diet) prepared from ''laja saktu'' (powder of roasted grains) mixed with honey, sugar and fruit juices, which have ''jwara'' alleviating properties.[155]
In cases where ''yavagu'' administration is prohibited, the physician should administer in the beginning ''tarpana'' (nutritional diet) prepared from ''laja saktu'' (powder of roasted grains) mixed with honey, sugar and fruit juices, which have ''jwara'' alleviating properties.[155]
=== Guidelines for diet, mouth cleansing and tooth brush ===
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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 ''doshas''). [160-161]
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 ''doshas''). [160-161]
=== Contra-indications of ''kashaya'' (astringents) ===
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If, decoctions of astringent drugs are administered to the patient in ''taruna jwara'' (first stage of ''jwara'') stage, then the ''doshas'' do not undergo ''paka'' (digested) and get adhered due to stickiness. This leads to the onset of ''vishama jwara'' (irregular fevers). The term ''kashaya'' has two meanings i.e. the decoction prepared by boiling the drugs and astringent taste. In the first stage of ''jwara'' (''taruna jwara''), the astringent tasted drugs are prohibited. [161-163]
If, decoctions of astringent drugs are administered to the patient in ''taruna jwara'' (first stage of ''jwara'') stage, then the ''doshas'' do not undergo ''paka'' (digested) and get adhered due to stickiness. This leads to the onset of ''vishama jwara'' (irregular fevers). The term ''kashaya'' has two meanings i.e. the decoction prepared by boiling the drugs and astringent taste. In the first stage of ''jwara'' (''taruna jwara''), the astringent tasted drugs are prohibited. [161-163]
=== ''Yusha'' (soup) indications ===
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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'', up to the tenth day. ''Amla'' (sour) things may or may not be added to these ''yusha''. [163-164]
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'', up to the tenth day. ''Amla'' (sour) things may or may not be added to these ''yusha''. [163-164]
=== Indications and contra-indications of ''ghrita'' ===
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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 ''doshas'' and promotes the strength of the body. [164-167]
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 ''doshas'' and promotes the strength of the body. [164-167]
=== Indication of milk ===
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*If the dosha are either ''baddha'' (static), or ''prachyuta'' (slightly dislodged). [167]
*If the dosha are either ''baddha'' (static), or ''prachyuta'' (slightly dislodged). [167]
=== Indication of ''virechana'' ===
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If the ''jwara'' does not subside by the therapies described before, then ''virechana'' (purgation) should be given for its alleviation provided, the patient is neither emaciated, weak, depleted of muscle tissue nor has reduced digestive power. [168-169]
If the ''jwara'' does not subside by the therapies described before, then ''virechana'' (purgation) should be given for its alleviation provided, the patient is neither emaciated, weak, depleted of muscle tissue nor has reduced digestive power. [168-169]
=== Indications of ''niruha'' (enema with decoction) ===
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Purgation (''stransana'') eliminates ''kapha'' or ''kapha pitta dosha'' from the ''pittashaya'' (lower portion of the stomach and small intestine). ''Basti'' eliminates all the three ''dosha'' lodged in the ''pakwashaya''.[169-170]
Purgation (''stransana'') eliminates ''kapha'' or ''kapha pitta dosha'' from the ''pittashaya'' (lower portion of the stomach and small intestine). ''Basti'' eliminates all the three ''dosha'' lodged in the ''pakwashaya''.[169-170]
=== Indication of ''anuvasana'' (unctuous enema) ===
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*When there is ununctuousness (''rukshata'') and ''bandhatwa'' (obstruction, compactness) in the feces. [172-173]
*When there is ununctuousness (''rukshata'') and ''bandhatwa'' (obstruction, compactness) in the feces. [172-173]
=== Indications of ''murdha-virechana'' (nasal errhines) ===
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''Murdha virechana'' 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. [173-174]
''Murdha virechana'' 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. [173-174]
=== Various external procedures ===
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''Jwara'' located in skin and of exogenous nature or types can be treated with same. [174-177]
''Jwara'' located in skin and of exogenous nature or types can be treated with same. [174-177]
=== Various dietary articles used in treatment ===
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For this purpose, ''rakta shali, shashtika'' 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. [177-179]
For this purpose, ''rakta shali, shashtika'' 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. [177-179]
=== Ten types of ''yavagu'' (gruel) in ''jwara'' ===
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*''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). [179-188]
*''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). [179-188]
=== Indications of soup ===
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''Yusha'' is wholesome for some patients of ''jwara''. This ''yusha'' may be prepared from ''mudga, masura, chanaka, kulattha'' and ''makushtha''.[188-189]
''Yusha'' is wholesome for some patients of ''jwara''. This ''yusha'' may be prepared from ''mudga, masura, chanaka, kulattha'' and ''makushtha''.[188-189]
=== Indications of vegetables ===
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The leaves and fruits of ''patola, kulaka'' (''karvellaka''), ''papachelika'' (''patha''), ''karkotaka, kathilla'' (red variety of ''punarnava'') ''shakas'' are useful in the patients of ''jwara''. [189-190]
The leaves and fruits of ''patola, kulaka'' (''karvellaka''), ''papachelika'' (''patha''), ''karkotaka, kathilla'' (red variety of ''punarnava'') ''shakas'' are useful in the patients of ''jwara''. [189-190]
=== Indication of animal meat soups ===
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Some physicians do not advise the meat soups of animals such as ''kukkuta, mayura, tittiri, krauncha'' and ''vartaka'' as they are heavy to digest and hot potency. In ''jwara'' if ''vayu'' gets aggravated because of ''langhana'', then the physician acquainted with the signs of the ''doshas'' should give the meat soup of these animals also at apropriate time.[190-194]
Some physicians do not advise the meat soups of animals such as ''kukkuta, mayura, tittiri, krauncha'' and ''vartaka'' as they are heavy to digest and hot potency. In ''jwara'' if ''vayu'' gets aggravated because of ''langhana'', then the physician acquainted with the signs of the ''doshas'' should give the meat soup of these animals also at apropriate time.[190-194]
=== ''Anupana''(beverages) ===
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Hot water should be given to drink to a thirsty person. Depending upon the ''doshas'' involved and the strength of the patient ''madya'' (wines) may be given to those patients for whom it is wholesome. [194-195]
Hot water should be given to drink to a thirsty person. Depending upon the ''doshas'' involved and the strength of the patient ''madya'' (wines) may be given to those patients for whom it is wholesome. [194-195]
=== Contra-indications in ''jwara'' ===
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So, the diet and drinks, which are wholesome to the patient of ''jwara'' have been described here. [195-196]
So, the diet and drinks, which are wholesome to the patient of ''jwara'' have been described here. [195-196]
=== Decoctions indicated in ''jwara'' ===
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The above mentioned, decoctions which are used for the alleviation of ''jwara'' are ''jwaraghna''. They stimulate the power of digestion, help in the ''pachana'' (metabolic transformation) of the ''doshas''; alleviate thirst, anorexia and cure ''mukha vairasya'' (bad taste of the mouth). [197-199]
The above mentioned, decoctions which are used for the alleviation of ''jwara'' are ''jwaraghna''. They stimulate the power of digestion, help in the ''pachana'' (metabolic transformation) of the ''doshas''; alleviate thirst, anorexia and cure ''mukha vairasya'' (bad taste of the mouth). [197-199]
=== ''Kashaya'' in ''vishama jwara'' ===
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The decoction of ''triphala, trayamana, mridvika'' and ''katu rohini'' alleviates ''pitta'' and ''shleshma'' and causes the ''anulomana'' of ''doshas''. This decoction when taken along with ''trivrita'' and ''sharkara'' cures ''jwara'' caused by the aggravation of ''pitta'' and ''shleshma''. [207-209]
The decoction of ''triphala, trayamana, mridvika'' and ''katu rohini'' alleviates ''pitta'' and ''shleshma'' and causes the ''anulomana'' of ''doshas''. This decoction when taken along with ''trivrita'' and ''sharkara'' cures ''jwara'' caused by the aggravation of ''pitta'' and ''shleshma''. [207-209]
=== Formulations used in ''sannipata jwara'' ===
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Different types of decoctions and gruels are also described in the first four chapters of [[Sutra Sthana]] which also cure ''pipasa'' (thirst) and ''jwara''. They may also be used by the physician for the treatment of ''jwara''. [215]
Different types of decoctions and gruels are also described in the first four chapters of [[Sutra Sthana]] which also cure ''pipasa'' (thirst) and ''jwara''. They may also be used by the physician for the treatment of ''jwara''. [215]
=== Advantage of ghee ===
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''Ghrita'' should be added to all those decoctions described above for the alleviation of ''jwara''. They stimulate the power of digestion and endow auspiciousness. [218]
''Ghrita'' should be added to all those decoctions described above for the alleviation of ''jwara''. They stimulate the power of digestion and endow auspiciousness. [218]
=== Various medicated ghee formulations ===
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''Ghrita'' prepared from boiling the decoction of ''bala, shvadamstra, brihati, kalasi, dhavani, sthira, nimba, parpataka, musta, trayamana'' and ''duralabha''; paste of ''tamalaki, shati, draksha, pushkarmula, meda'' and ''amalakī'', ghee and milk; is an excellent medicine for the treatment of ''jwara''. It also cures ''kshaya'' (consumption), ''kasa'' (coughs), ''shirahshula'' (headache), ''parshvashula'' (pain in the sides of chest), ''halimaka'' (a type of jaundice), ''ansabhitapa'' (burning sensation in the scapular region. [224-226]
''Ghrita'' prepared from boiling the decoction of ''bala, shvadamstra, brihati, kalasi, dhavani, sthira, nimba, parpataka, musta, trayamana'' and ''duralabha''; paste of ''tamalaki, shati, draksha, pushkarmula, meda'' and ''amalakī'', ghee and milk; is an excellent medicine for the treatment of ''jwara''. It also cures ''kshaya'' (consumption), ''kasa'' (coughs), ''shirahshula'' (headache), ''parshvashula'' (pain in the sides of chest), ''halimaka'' (a type of jaundice), ''ansabhitapa'' (burning sensation in the scapular region. [224-226]
=== Formulations used in purification therapies ===
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*''mṛdvikā'' and ''abhayā'' along with warm milk or the juice of ''drākṡā'' as ''anupāna''. [227-233]
*''mṛdvikā'' and ''abhayā'' along with warm milk or the juice of ''drākṡā'' as ''anupāna''. [227-233]
=== Formulations with medicated milk ===
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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. [234-239]
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. [234-239]
=== Medicated enemas ===
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The ''sneha'' boiled with ''chandana, aguru, kashmarya, patola, madhuka'' and ''utpala'' is exceedingly useful for the administration as ''anuvasana basti'' to cure ''jwara''. [241-253]
The ''sneha'' boiled with ''chandana, aguru, kashmarya, patola, madhuka'' and ''utpala'' is exceedingly useful for the administration as ''anuvasana basti'' to cure ''jwara''. [241-253]
=== Indications of ''shiro-virechana'' (nasal errhines) ===
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The medicated oil and the ''dhuma varti'' described for application as nasal drop and ''dhuma varti'' respectively in [[Matrashiteeya Adhyaya]], should also be used for the treatment of ''jwara''.[254-255]
The medicated oil and the ''dhuma varti'' described for application as nasal drop and ''dhuma varti'' respectively in [[Matrashiteeya Adhyaya]], should also be used for the treatment of ''jwara''.[254-255]
=== External applications ===
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Medicated ''ghrita'' called as ''Sahasra dhauta ghrita'' and medicated oil called ''chandanadya taila'' should be given for massage to the patient, as these alleviate ''jwara'' associated with burning. [256-257]
Medicated ''ghrita'' called as ''Sahasra dhauta ghrita'' and medicated oil called ''chandanadya taila'' should be given for massage to the patient, as these alleviate ''jwara'' associated with burning. [256-257]
=== ''Chandanadya taila'' ===
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The ''seka'' and ''avagaha'' (sprinkling of water and bathing) with ''madhu, aranala'' (sour gruel), milk, curd, ''ghrita'' and water cure ''daha jwara'' instantaneously, because of their cold touch.[258-259]
The ''seka'' and ''avagaha'' (sprinkling of water and bathing) with ''madhu, aranala'' (sour gruel), milk, curd, ''ghrita'' and water cure ''daha jwara'' instantaneously, because of their cold touch.[258-259]
=== Guidelines for a patient with burning sensation ===
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Diet and drinks which are cold, cooling gardens, cold wind and cold rays of the moon; alleviate ''jwara'' with burning sensation. [260-266]
Diet and drinks which are cold, cooling gardens, cold wind and cold rays of the moon; alleviate ''jwara'' with burning sensation. [260-266]
=== ''Agurvadya tailam'' ===
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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). [267]
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). [267]
=== Indications of fomentation for alleviating cold ===
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Different types of diet and drinks which cause fomentation and alleviate ''vata'' and ''kapha'', instantaneously alleviate ''sheeta jwara''. These should be administered keeping in view of the ''samsarga'' (combination of two ''doshas'') and the ''bala'' of each ''dosha''. [268-271]
Different types of diet and drinks which cause fomentation and alleviate ''vata'' and ''kapha'', instantaneously alleviate ''sheeta jwara''. These should be administered keeping in view of the ''samsarga'' (combination of two ''doshas'') and the ''bala'' of each ''dosha''. [268-271]
===Contra-indications of ''langhana'' ===
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''Langhana'' (fasting) is not useful for patients suffering from ''jwara'' caused by aggravated ''vata'', by exhaustion, in chronic fevers, in fevers caused by ''kshata'' (external and internal injuries). Such patients should be treated by ''shamana'' therapy (alleviation therapy). [272]
''Langhana'' (fasting) is not useful for patients suffering from ''jwara'' caused by aggravated ''vata'', by exhaustion, in chronic fevers, in fevers caused by ''kshata'' (external and internal injuries). Such patients should be treated by ''shamana'' therapy (alleviation therapy). [272]
=== Guidelines for improving ''agni'' (digestive strength) ===
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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. [273-283]
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. [273-283]
=== Guidelines for management in ''sannipata'' conditions ===
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''Sannipātaja jwara'' should be treated by increasing one ''dosha'', reducing the excessively aggravated one or by correcting the sites of the ''doshas'' in order, beginning with the site of ''kapha''.[283-287]
''Sannipātaja jwara'' should be treated by increasing one ''dosha'', reducing the excessively aggravated one or by correcting the sites of the ''doshas'' in order, beginning with the site of ''kapha''.[283-287]
=== Management of ''karnamulika shotha'' (inflammatoion near the root of the ears) ===
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A serious outcome of the ''sannipataja jwara'' is inflammation near the root of the ears which is a very serious condition and very few of such patients survive. Thus, efforts must be made immediately to cure it through therapeutic measures which alleviate ''kapha'' and ''pitta'' like blood letting, intake of ghee, ''pradeha'' (application of unction), ''navana'' (nasal instillation) and ''kavala graham'' (mouthful of liquid medication). [287-289]
A serious outcome of the ''sannipataja jwara'' is inflammation near the root of the ears which is a very serious condition and very few of such patients survive. Thus, efforts must be made immediately to cure it through therapeutic measures which alleviate ''kapha'' and ''pitta'' like blood letting, intake of ghee, ''pradeha'' (application of unction), ''navana'' (nasal instillation) and ''kavala graham'' (mouthful of liquid medication). [287-289]
=== Indications of blood letting ===
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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. [289-290]
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. [289-290]
=== Indication of consumption of ghee ===
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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 ghee to drink provided ''kapha'' and ''pitta dosha'' are not aggravated. [290-291]
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 ghee to drink provided ''kapha'' and ''pitta dosha'' are not aggravated. [290-291]
=== Management of ''jeerna jwara'' (chronic stage) ===
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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. [291-292]
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. [291-292]
=== Management of ''dosha'' dominance in ''vishamajwara'' ===
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The general line of treatment of ''jwaras'' should not be followed for the management of ''tṛtīyaka'' and ''chaturthaka 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 ghee, ''niruha'' and ''anuvāsana bastīs'' (medicated enemas), unctuous and hot diet and drinks. When the ''pitta dosha'' is dominant the patient should be given purgation therapy, medicated milk, ghee and articles which are bitter and cold. In state of ''kapha'' predominance, then the patient should be administered emetic therapy, ''pachana'' (therapy which promotes the digestion and metabolism), ununctuous diet and drinks, fasting and hot decoctions are useful. [292-296]
The general line of treatment of ''jwaras'' should not be followed for the management of ''tṛtīyaka'' and ''chaturthaka 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 ghee, ''niruha'' and ''anuvāsana bastīs'' (medicated enemas), unctuous and hot diet and drinks. When the ''pitta dosha'' is dominant the patient should be given purgation therapy, medicated milk, ghee and articles which are bitter and cold. In state of ''kapha'' predominance, then the patient should be administered emetic therapy, ''pachana'' (therapy which promotes the digestion and metabolism), ununctuous diet and drinks, fasting and hot decoctions are useful. [292-296]
=== Guidelines and various formulations in ''vishama jwara'' ===
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*Intake of ''agada'' (antidote like drugs).[296-309]
*Intake of ''agada'' (antidote like drugs).[296-309]
=== Spiritual therapy ===
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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 ''darshana'' (visiting) of saints immediately cures ''jwara''. [310-314]
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 ''darshana'' (visiting) of saints immediately cures ''jwara''. [310-314]
=== Management of ''jwara'' located in various ''dhatu'' ===
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*in the ''asthī'' and ''majjā dhātūs, nirūha'' and ''anuvāsana bastīs'' should be given. [315-317]
*in the ''asthī'' and ''majjā dhātūs, nirūha'' and ''anuvāsana bastīs'' should be given. [315-317]
=== Management of ''abhicharaja'' and ''abhishangaja jwara'' ===
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The ''jwara'' caused by ''shapa'' (curse), ''abhichara'' (tantric rituals with evil purpose), ''bhutabhishanga'' (affliction by micro organisms or evil spirits), ''daiva vyapashraya chikitsa'' (performance of spiritual therapies) is the most desired therapy. [317]
The ''jwara'' caused by ''shapa'' (curse), ''abhichara'' (tantric rituals with evil purpose), ''bhutabhishanga'' (affliction by micro organisms or evil spirits), ''daiva vyapashraya chikitsa'' (performance of spiritual therapies) is the most desired therapy. [317]
=== Management of ''abhighataja jwara'' ===
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''Jwara'' caused by ''abhighāta'' (external injury) gets cured by the intake and massage of ghee, blood letting, in take of rice with wholesome meat soup. If such patients of ''abhighata jwara'', are suffering from ''anaha'' (gaseous distention of abdomen) and are accustomed to alcohol, then they should be given food with alcohol and meat soup. For the treatment of ''jwara'' caused by ''kshata'' (injury like cuts, stabs etc.) and ''vraṇa'' (ulcers) line of treatment suggested for ''kshata'' and ''vrana'' should be adopted. [318-320]
''Jwara'' caused by ''abhighāta'' (external injury) gets cured by the intake and massage of ghee, blood letting, in take of rice with wholesome meat soup. If such patients of ''abhighata jwara'', are suffering from ''anaha'' (gaseous distention of abdomen) and are accustomed to alcohol, then they should be given food with alcohol and meat soup. For the treatment of ''jwara'' caused by ''kshata'' (injury like cuts, stabs etc.) and ''vraṇa'' (ulcers) line of treatment suggested for ''kshata'' and ''vrana'' should be adopted. [318-320]
=== Management of ''agantuja jwara'' due to mental factors ===
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If a patient gets ''jwara'' just by thinking about its episode, then his mind should be diverted to desirable, different and surprising incidents (''vishaya'').[320-323]
If a patient gets ''jwara'' just by thinking about its episode, then his mind should be diverted to desirable, different and surprising incidents (''vishaya'').[320-323]
=== Signs of remission of ''jwara'' ===
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In chronic stage of ''jwara'', the episodes are remitted depending upon strength of ''dosha''. The remission occurs slowly without difficulty. [324-328]
In chronic stage of ''jwara'', the episodes are remitted depending upon strength of ''dosha''. The remission occurs slowly without difficulty. [324-328]
=== Signs of completely cured ''jwara'' patient ===
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Disappearance of ''klama'' (mental fatigue) and ''santapa'' (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''.[329]
Disappearance of ''klama'' (mental fatigue) and ''santapa'' (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''.[329]
=== Precautions after being cured from ''jwara'' ===
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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]
=== ''Punaravarti jwara'' (recurrent ''jwara'') ===
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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]
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 ===
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''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. [345]
''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. [345]
=== Summary ===
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