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Line 21: − + − + − + + + + + + + + + + + + − ==([[Chikitsa Sthana]] Chapter 3, Chapter on the management of ''Jwara'') ==+ − − === Abstract === − − <div style="text-align:justify;">This chapter on ''jwara'' is specially important from the standpoint of its management. It covers various endogenous and exogenous causes of ''jwara'' with its management principles. It encompasses a wide set of concepts related to diversified pathogenesis of diseases, including variations in ''dosha'' states, their degrees in less or severe form, clinical features and their management. The stages of disease and change in treatments need special attention. The important concept of functional aspects of disease involving psychogenic factors and affliction of unknown factors causing ''jwara'' are described in detail with their psycho-spiritual therapies. Do’s and don’ts during jwara and after its remission are applicable in every disease. The etio-pathogenesis and management of recurrence of ''jwara'' denotes importance of observing prescribed codes even after being free from disease. Due to the cardinal feature of raised body temperature or a perception of it, ''jwara'' is often considered synonymous with fever. However, it is not always necessary to consider ''jwara'' disease as fever, because it covers many other principles of management of disease. Modern medicine literature describes two components of fever, one where the cause or etiology is known and the other where it is unknown and is described as FUO (Fever of Unknown Origin). Thus, there is no curative treatment of FUO is available in modern medicine. On the other hand, this chapter describes important Ayurvedic concepts of ''jwara'' or fever which are important to understand the etiology of fever and thus the management. − '''Keywords''': ''Jwara roga, Santapa, pitta'' fever, ''ushma'', heat regulation. − === Introduction ===+ − + − === Sanskrit text, Transliteration and English Translation ===+ + + Line 43:
Line 62: + − 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 81:
Line 100: + Line 145:
Line 165: − + + − + Line 168:
Line 189: − + − ==== Synonyms of ''jwara'' ====+ + + Line 182:
Line 205: + − ==== ''Prakriti'' or nature of ''jwara'' ====+ + Line 196:
Line 221: + Line 216:
Line 242: + + + − The three physical ''doshas'' and the two ''manasika doshas'' are the natural factors responsible for ''jwara'' (''prakriti'') as ''jwara'' cannot originate in a person having the balance of these three ''dosha'' (''nirdosha'' – in the state of homeostasis). Therefore, these ''sharirika'' and ''manasika doshas'' are the prakriti of ''jwara''. + − + − + − + − ==== ''Pravritti'' (origin of the disease) ==== Line 270:
Line 298: + Line 366:
Line 395: − + + − + − ==== ''Prabhava'', the sequels of the disease ====+ + Line 378:
Line 409: + Line 390:
Line 422: − + − + + + + + − + + − + − ==== Premonitory symptoms of ''jwara'' ====+ + Line 410:
Line 448: + Line 426:
Line 465: − + + − + − ==== Sites of ''jwara'' ====+ + + Line 442:
Line 484: − + + − + − ==== Cardinal feature ====+ + + Line 458:
Line 503: − + + − + − ==== Classification ====+ + Line 478:
Line 525: + Line 510:
Line 558: − + + − + Line 523:
Line 572: − + − + − ==== Clinical features of somatic and psychic ''jwara'' ====+ + Line 534:
Line 584: + Line 546:
Line 597: − + − + − + − ==== Desires of patient to diagnose ''dosha'' dominance ====+ + + + Line 562:
Line 616: − + − + − + − ==== Attenuating nature of ''vata dosha'' ====+ + + + Line 578:
Line 635: − + − + − + − ==== Features of internal and external ''jwara'' ====+ + + Line 592:
Line 651: + Line 612:
Line 672: − + − + + − + − ==== ''Prakrita jwara''(seasonal ''jwara'') ====+ + Line 650:
Line 712: + Line 714:
Line 777: − + + − + − + − + − ===== ''Vaikrita jwara'' =====+ − + Line 732:
Line 796: + − ==== Prognosis of ''jwara'' ====+ + Line 748:
Line 814: + Line 776:
Line 843: + − ===== ''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.+ − − ===== ''Asadhya'' (incurable) ''jwara'' ===== Line 793:
Line 861: − + − ==== Five types of ''jwara'' as per frequency ====+ − ===== ''Santata jwara'' =====+ + Line 828:
Line 897: + Line 892:
Line 962: − + − + + − + − + − + − ===== ''Satata jwara'' =====+ + Line 908:
Line 980: + Line 920:
Line 993: − + − + − + − ===== ''Anyedyushka jwara'' =====+ + + Line 930:
Line 1,005: + Line 942:
Line 1,018: − + − + − + − ===== ''Tritiyaka'' and ''chaturthaka jwara'' =====+ + + Line 960:
Line 1,038: + Line 988:
Line 1,067: + + + − When the ''dosha'' afflict the ''asthi dhatu'' (bone tissue) and ''majja dhatu'' (bone marrow), they cause the ''tritiyaka'' and ''chaturthaka jwara'' respectively.+ − − − + − ==== Cause of alterations in ''jwara'' episodes ====+ + Line 1,016:
Line 1,097: + Line 1,056:
Line 1,138: + + + − As a seed remains dormant in the soil and germinates at a favorable time, similarly the ''doshas'' remain in dormant condition in the ''dhatu'' and get aggravated at a favorable time. These ''dosha'' gain strength at an appropriate time and when the power of the inhibiting (disease preventing) factors has subsided, then the ''tritiyaka'' and ''chaturthaka jwara'' manifest. + − − − + − + − + − + − + + + + Line 1,081:
Line 1,167: − + − + + + + + Line 1,095:
Line 1,185: − + − + − + − ==== ''Dhatugata jwara'' ====+ + + Line 1,135:
Line 1,227: + Line 1,207:
Line 1,300: − + + − + − + − + − + − + − + − + − + − + − ==== Clinical features of ''jwara'' due to combination of two ''dosha'' ====+ + Line 1,249:
Line 1,344: + Line 1,297:
Line 1,393: − + − + + − + − + − + − + − + − + − + − ==== ''Sannipataja jwara'' ====+ + Line 1,395:
Line 1,493: + Line 1,555:
Line 1,654: − + + − + − + − + − + − + − + − + − + − + − + − + − + − + Line 1,584:
Line 1,684: − + Line 1,590:
Line 1,690: − + + − ==== Prognosis of ''sannipata jwara'' ====+ + Line 1,601:
Line 1,703: + Line 1,617:
Line 1,720: + + + − If there is obstruction (or non – elimination) of the ''dosha'', the ''agnis'' are completely destroyed and if all the signs and symptoms are fully manifested, then ''sannipata jwara'' is incurable; otherwise it is treatable with difficulty. + − + − − ==== Classification of ''agantuja jwara'' ====+ + + Line 1,635:
Line 1,742: − + + − + − ==== ''Abhighataja jwara'' (due to injury or trauma) ====+ + Line 1,647:
Line 1,756: + Line 1,663:
Line 1,773: − + − + − + − ==== ''Abhishangaja, abhishapaja'' and ''abhicharaja jwara'' ====+ + + Line 1,727:
Line 1,839: + Line 1,843:
Line 1,956: − + − + + Line 1,871:
Line 1,985: − + − + − ==== General patho-physiology of ''jwara'' ====+ + Line 1,888:
Line 2,003: + Line 1,916:
Line 2,032: + + + + + + − 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 ==== − − + Line 1,932:
Line 2,051: − + + − + − ==== Clinical features of ''Ama Jwara'' (first stage of ''jwara'') ====+ + Line 1,948:
Line 2,069: + Line 1,972:
Line 2,094: − + + − + Line 1,983:
Line 2,106: − + − ==== Clinical features of ''pachyamana jwara'' (second stage of ''jwara'') ====+ + + Line 1,997:
Line 2,122: − + + − + − ==== Clinical features of ''nirama jwara'' (third stage of ''jwara'') ====+ + + Line 2,013:
Line 2,141: − + − + − + − ==== Precaution at initial stage of ''jwara'' ====+ + + + Line 2,029:
Line 2,160: − + + − + − ==== Contra-indications of ''langhana'' (fasting) ====+ + + Line 2,045:
Line 2,179: − + − + − + − ==== Benefits of ''langhana'' (fasting) in ''jwara'' ====+ + + Line 2,057:
Line 2,193: + Line 2,073:
Line 2,210: + + + − + − + − ''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'' ==== + Line 2,091:
Line 2,231: + − + − ==== Various drinks for management of thirst ====+ + Line 2,103:
Line 2,245: + Line 2,119:
Line 2,262: − + + − + − + − + − + − ==== ''Shadanga paniya'' ====+ + + Line 2,141:
Line 2,287: − + + − + − ==== Indication of ''vamana'' (therapeutic emesis) ====+ + + Line 2,157:
Line 2,306: + + + − If the ''jwara'' is predominantly caused by vitiated ''kapha dosha'', located in the ''amashaya'' (stomach) and is in a stage of ''utklesha'' (in a stage of being on the verge of coming out of its place), then it should be eliminated by the administration of emetics. + − + − + − + − ==== Hazards of improper ''vamana'' (therapeutic emesis) ==== Line 2,171:
Line 2,322: + Line 2,187:
Line 2,339: − + − + − + − ==== Post ''vamana'' protocol ====+ + + Line 2,209:
Line 2,363: + Line 2,245:
Line 2,400: − + + − + − + − ==== Contra-indications of ''yavagu'' ====+ + Line 2,261:
Line 2,418: + Line 2,273:
Line 2,431: − + − + + + + + Line 2,287:
Line 2,449: − + + − + − ==== Guidelines for diet, mouth cleansing and tooth brush ==== + + Line 2,307:
Line 2,471: + Line 2,339:
Line 2,504: − + − + + + + + Line 2,353:
Line 2,522: − + − + − + − ==== Contra-indications of ''kashaya'' (astringents) ====+ + + Line 2,365:
Line 2,536: + Line 2,381:
Line 2,553: − + − + − + − ==== ''Yusha'' (soup) indications ====+ + + + Line 2,397:
Line 2,572: − + + − + − ==== Indications and contra-indications of ''ghrita'' ====+ + Line 2,413:
Line 2,590: + Line 2,437:
Line 2,615: + + + − Thereafter, in case of less aggravation of ''kapha dosha'' and excess aggravation of ''vata'' and ''pitta dosha'', and in whom the ''dosha'' have reached the ''pakva'' stage (having no ''ama ansha''), ghee should be given to the patients. It is like ''amrita'' (nectar) for them.+ − Ghee should not be given to ''jwara'' patient even after the tenth day, if the ''kapha dosha'' still predominates and if the signs and symptoms of well accomplished ''langhana'' have not appeared. In such case ''kashaya'' should be administered to the patient till the body becomes light.+ − + − + − + − ==== Indication of milk ==== + Line 2,457:
Line 2,638: − + + − + − + − + − ==== Indication of ''virechana'' ====+ + + Line 2,476:
Line 2,660: − + − + − + − ==== Indications of ''niruha'' (enema with decoction) ====+ + + Line 2,492:
Line 2,678: + Line 2,516:
Line 2,703: + + + − Neither ''vamana'' (emesis) nor ''virechana'' (purgation) is useful for patients emaciated by fever. It is thus desirable to remove their malas by the administration of milk or ''niruha'' (ununctuous type of medicated enema prepared by decoctions etc.) + − ''Niruha basti'' administered when the dosha are in ''paripakva'' stage immediately promotes the strength and the power of digestion, alleviates fever and causes happiness and brings relish for food.+ − + − + − + − ==== Indication of ''anuvasana'' (unctuous enema) ==== + Line 2,536:
Line 2,726: − + − + − + + − + − ==== Indications of ''murdha-virechana'' (nasal errhines) ====+ + + Line 2,555:
Line 2,748: − + + − + − ==== Various external procedures ====+ + Line 2,571:
Line 2,766: + Line 2,595:
Line 2,791: − + + Line 2,601:
Line 2,798: − + − ==== Various dietary articles used in treatment ====+ + Line 2,611:
Line 2,809: + Line 2,627:
Line 2,826: − + + − + − ==== Ten types of ''yavagu'' (gruel) in ''jwara'' ====+ + Line 2,669:
Line 2,870: + Line 2,741:
Line 2,943: − + + Line 2,752:
Line 2,955: − + − ==== Indications of soup ====+ + + Line 2,766:
Line 2,971: − + + − + − ==== Indications of vegetables ====+ + + Line 2,782:
Line 2,990: − + + − + − ==== Indication of animal meat soups ====+ + Line 2,802:
Line 3,012: + Line 2,834:
Line 3,045: − + + − + − + − ==== ''Anupana''(beverages) ====+ + + Line 2,852:
Line 3,066: − + − + − + − ==== Contra-indications in ''jwara'' ====+ + + Line 2,862:
Line 3,078: + Line 2,874:
Line 3,091: − + − + + − + − ==== Decoctions indicated in ''jwara'' ====+ + Line 2,891:
Line 3,110: + Line 2,913:
Line 3,133: − + + Line 2,920:
Line 3,141: − + − + − ==== ''Kashaya'' in ''vishama jwara'' ====+ + Line 2,937:
Line 3,159: + Line 2,965:
Line 3,188: − + + Line 2,973:
Line 3,197: + + Line 2,987:
Line 3,213: + Line 3,015:
Line 3,242: − + + Line 3,023:
Line 3,251: + + Line 3,033:
Line 3,263: + Line 3,053:
Line 3,284: + + + − The decoction of either ''jati, amalaka'' and ''musta'' or that of ''dhanavayavasakam'' along with ''guda'' (jaggery) should be given to the patient suffering from ''jwara'' where the ''doshas'' are in ''vibaddha'' state (adhered to ''dhatus'').+ − + − + − + − ==== Formulations used in ''sannipata jwara'' ==== Line 3,079:
Line 3,312: + Line 3,119:
Line 3,353: − + + + + + Line 3,135:
Line 3,373: − + + − + − ==== Advantage of ghee ====+ + Line 3,147:
Line 3,387: + Line 3,163:
Line 3,404: − + − + + + + + Line 3,177:
Line 3,422: − + + − + − ==== Various medicated ghee formulations ====+ − + Line 3,194:
Line 3,440: + Line 3,218:
Line 3,465: − + + + + Line 3,228:
Line 3,478: + Line 3,244:
Line 3,495: − + + + + Line 3,258:
Line 3,512: + Line 3,282:
Line 3,537: − + + − + − ==== Formulations used in purification therapies ====+ + Line 3,314:
Line 3,571: + Line 3,370:
Line 3,628: + + + − Elimination therapies (of ''doshas''), both in upward and downward routes should be administered at appropriate time, to a patient suffering from ''jwara'', having more aggravated ''doshas''. Details of these methods and the formulations used for them will be discussed in the [[Kalpa Sthana]]. + − − ''Vamana'' performed by hot water and ''madana'' mixed with either ''pippali, kalinga'' or ''madhuka'' alleviates ''jwara''. Line 3,387:
Line 3,646: − + − ==== Formulations with medicated milk ====+ + Line 3,413:
Line 3,673: + Line 3,461:
Line 3,722: − + + Line 3,472:
Line 3,734: − + − + − ==== Medicated enemas ====+ + Line 3,533:
Line 3,796: + Line 3,645:
Line 3,909: + + + − ''Niruha'' and ''anuvasana'' types of ''bastis'' (medicated enemas) which will be described in the [[Siddhi Sthana]] should be administered when the ''doshas'' are lodged in the ''pakvashaya'', for the treatment of ''jwara''.+ − − Line 3,656:
Line 3,921: − + − + − + − + − ==== Indications of ''shiro-virechana'' (nasal errhines) ====+ + Line 3,671:
Line 3,937: + Line 3,687:
Line 3,954: − + − + + − + − ==== External applications ====+ + Line 3,701:
Line 3,970: + Line 3,717:
Line 3,987: − + + − + − ==== ''Chandanadya taila'' ====+ + Line 3,738:
Line 4,010: + Line 3,768:
Line 4,041: − + + Line 3,776:
Line 4,050: − + − ==== Guidelines for a patient with burning sensation ====+ + Line 3,808:
Line 4,083: + Line 3,868:
Line 4,144: − + + Line 3,876:
Line 4,153: − + − ==== ''Agurvadya tailam'' ====+ + Line 3,884:
Line 4,162: + Line 3,896:
Line 4,175: − + + Line 3,904:
Line 4,184: − + − ==== Indications of fomentation for alleviating cold ====+ + Line 3,924:
Line 4,205: + Line 3,960:
Line 4,242: − + + Line 3,967:
Line 4,250: − + − + − ====Contra-indications of ''langhana'' ====+ + + Line 3,982:
Line 4,267: − + − + − + − ==== Guidelines for improving ''agni'' (digestive strength) ====+ + + Line 4,028:
Line 4,315: + Line 4,112:
Line 4,400: + + + − + − The ''malās'' of the seven ''dhatus'' get metabolized in seven days. Therefore, generally on the eighth day the ''jwara'' becomes ''nirama'' (free from the accumulated metabolic waste product).+ − + − + − 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 ==== Line 4,138:
Line 4,428: + Line 4,170:
Line 4,461: − + − + + − + − + − + − + − + − + − ==== Management of ''karnamulika shotha'' (inflammatoion near the root of the ears) ====+ + Line 4,191:
Line 4,484: + Line 4,207:
Line 4,501: − + − + − + − ==== Indications of blood letting ====+ + + + Line 4,223:
Line 4,520: − + + − + − ==== Indication of consumption of ghee ====+ + + Line 4,239:
Line 4,539: − + − + − + − ==== Management of ''jeerna jwara'' (chronic stage) ====+ + + + Line 4,255:
Line 4,558: − + + − + − ==== Management of ''dosha'' dominance in ''vishamajwara'' ====+ + Line 4,275:
Line 4,580: + Line 4,307:
Line 4,613: − + − + − + − ==== Guidelines and various formulations in ''vishama jwara'' ====+ + + Line 4,367:
Line 4,675: + Line 4,479:
Line 4,788: − + + − + Line 4,499:
Line 4,809: − + − ==== Spiritual therapy ====+ + Line 4,521:
Line 4,832: + Line 4,559:
Line 4,871: − + + Line 4,567:
Line 4,880: − + − ==== Management of ''jwara'' located in various ''dhatu'' ====+ + Line 4,577:
Line 4,891: + Line 4,595:
Line 4,910: − + − + − + − + − + − + − + − ==== Management of ''abhicharaja'' and ''abhishangaja jwara'' ====+ + + + Line 4,615:
Line 4,933: − + + − + − ==== Management of ''abhighataja jwara'' ====+ + + + + + + − + + − + − ==== Management of ''agantuja jwara'' due to mental factors ====+ + + + + + + + + Line 4,673:
Line 5,007: + + + − + + Line 4,690:
Line 5,028: + + + − ==== Signs of remission of ''jwara'' ====+ − ज्वरप्रमोक्षे पुरुषः कूजन् वमति चेष्टते| + + + + + + + + − + + + + + + + + + + + − The clinical features manifested at the time of remission of (''sannipata jwara'') are – the patient produces ''kujana'' (rumbling) sound, vomiting, abnormal movements of the limbs (''cheshta''), heavy breathing or difficulty in breathing, discoloration, ''svinna anga'' (sweating), trembling (''vepate''), frequent fainting (''lihyate muhuḥ''), delirium, the body becoming very hot and cold at times, unconsciousness, more rise of temperature, angry appearance and forceful passage of liquid stools mixed with ''doshas'' with sound.+ − If a severe condition of ''jwara'' with excessively aggravated ''doshas'' and recent onset, is treated with appropriate therapy, then ''dosha paka'' occurs. Because of this, the sudden remission of ''jwara'' occurs with difficulty (''daruna moksha''). + + + + − 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 ==== − − विगतक्लमसन्तापमव्यथं विमलेन्द्रियम्| + + + − + + + + + − ==== Precautions after being cured from ''jwara'' ====+ − सज्वरो ज्वरमुक्तश्च विदाहीनि गुरूणि च| + + + + + + + + + − + + + + + − ==== ''Punaravarti jwara'' (recurrent ''jwara'') ====+ − असञ्जातबलो यस्तु ज्वरमुक्तो निषेवते| + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − 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.+ − 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.+ − + − + − + − ==== Guidelines for management ==== + Line 4,911:
Line 5,323: − + + + + + Line 4,922:
Line 5,338: − + + − + − ==== Summary ====+ + Line 4,931:
Line 5,349: + Line 4,941:
Line 5,360: − + + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + + + + + − + − + − *Pravritti (pravRutti; प्रवृत्ति ) – the origin of the disease − *Prabhava (prabhAva; प्रभाव) – the manifestation of the disease − *Adhishthana (Adhiśthāna; अधिष्ठानं) - place of manifestation of the disease, or the place of residing or the location − *Atma Lakshana (Ātma lakṡaṇa; आत्मलक्षण) - clinical features which are invariably associated with this disease − *Vimunchatah (vimu~jcataH ; विमुञ्चतः) - getting cured, − *Prashant (prashAnta ; प्रशान्त ) - being alleviated − *Aahuti (āhūtī ; आहूती) - pouring of ghee and other substances considered sacred in the sacrificial fire − *Yagya (Yajña; यज्ञ ) - Ritual of sacrifice in which sacrifices are made in a small holy fire along with hymn chanting − *Parigraha (parigraha; परिग्रह) - Feeling of attachment and greed − *Sheela (shIla; शील) – the general behavior and conduct of the person − *Saumya (saumya; सौम्य) – one in a modest form, not very fierce, in context of jwara it is the kind of jwara which is predominated by kapha dosha or is cold in nature − *Agneya (āgneya; आग्नेय) – predominated by heat or pitta dosha − *Antarvegi (antarvegi; अन्तर्वेगी)- that which is presenting with more features of doshas circulating within the body tissues, more related to koshtha; is diffic ult to treat. − *Bahirvegi (Bahirvegi; बहिर्वेगो) – the form in which the doshas are circulating in the shakha and hence the features are more evident − *Prakrita (prAkRut; प्राकृत) – the one which is natural; here it means dosha aggravation occuring naturally according to the seasons − *Vaikrita (vaikRuta; वैकृत)- unseasonal, the aggravation of dosha in a time which is not its natural aggravating time. − *Nishpratyaneeka (niShpratyanIka; निष्प्रत्यनीक) - having no opponent or which can’t be inhibited. The doshās involved in the the manifestation of santata type of jwara are very similar in property to the season (kāla), dhātūs (dushya), and the physical constitution of the patient (prakṛtī) due to which it is having no opponent − *Suduhsah (suduHsahaH; सुदुःसहः )- that which is unbearable. − *Sapratyaneeka (sapratyanIka; सप्रत्यनीक) – that which can be counteracted. − *Gatabalaah (gatabalAH; गतबलाः) - losing one’s strength; here the doshas after aggravation present with the clinical features and in that case the doshās get consumed and lose their strength − *Shookai (shUkai; शूकै ) - sharp edged thorns or bristles like the covering of the cereals − *Paridagdha (paridagdhA; परिदग्धा) - the tongue of the patient appears burn’t (blackish) at the margins − *Kharasparsha - (kharasparshA; खरस्पर्शा ) is rough in touch − *Srastaangata (srastA~ggatA; स्रस्ताङ्गता) - excessive prostration − *Bhuta (bhUta; भूत) - evil spirits or germs − *Abhichaara (abhicAra; अभिचार) - evil tāntric rituals − *(AbhishAp; अभिशापा) – curse or bad spell − *Tandra (tandrA; तन्द्रा) - drowsiness − *Moha (moha; मोह ) – increased attachment such as lust, state of confusion, unconsciousness, − *Pralaapa (pralApa; प्रलाप) - delirium − *Vibaddha (Vibaddha; विबद्ध) - obstruction or non – elimination − *Vyaamishra (vyAmishra; व्यामिश्र) – that which is of mixed type − *yogavāhī (yogavAhi; योगवाहि) – one which accentuates the properties of others − *jwarasyAmasya ( jwarasyAmasya; र्ज्वरस्यामस्य) - The āma jwara or the first stage of jwara in which the body is predominated by dosha having ama. − *Pachyamaanasya (pacyamAnasya; पच्यमानस्य) the stage of fevers in which the ama is being digested, resultantly the obstruction of the srotasas gets relieved and the features start presenting in a more bahirvegi manner − *Niraama jwara (nirAmajwara; निरामज्वर) – the condition when the patient’s body becomes free from the āma − *Ashtaaho (aShTAho; अष्टाहो ) - the 8th day of the fever when usually the body becomes free from the effect of ama − *Kashaaya (kaShAya; कषाय) - medicines having astringent taste − *Vijwara (Vijwara; विज्वर) - jwara subsides − *Anupasthita doshanam (anupasthitadoShANAM; अनुपस्थितदोषाणां) - the doshās have not reached the stage of utklesha (verge of coming out) and thus are not presenting themselves for being removed out of the body. +
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{{#seo:
|title=Jwara Chikitsa
|titlemode=append
|keywords=Jwara roga, Santapa, pitta fever, ushma, heat regulation, Ayurveda, charak samhita, Indian system of medicine.
|description=Chikitsa Sthana Chapter 3. Management of Jwara
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|type=article
}}
<big>'''[[Chikitsa Sthana]] Chapter 3. Management of Jwara (different types of fever) '''</big>
{{Infobox
{{Infobox
|title = Rasayana Chikitsa
|title = Jwara Chikitsa
|label1 = Section/Chapter
|label1 = Section/Chapter
|data1 = [[Chikitsa Sthana]] Chapter 3
|data1 = [[Chikitsa Sthana]] Chapter 3
|label2 = Preceding Chapter
|label2 = Preceding Chapter
|data2 = [[Vajikarana]]
|data2 = [[Vajikarana Chikitsa]]
|label3= Succeeding Chapter
|label3= Succeeding Chapter
|label5 = Other Sections
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|header3 =
|data6 = Khandel S.K.,Rai S.
|label7 = Reviewer
|data7 = Chandola H.M.
|label8 = Editors
|data8 = Baghel M.S., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
|label9 = Year of publication
|data9 = 2020
|label10 = Publisher
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]
|label11 = DOI
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.004 10.47468/CSNE.2020.e01.s06.004]
}}
}}
<big>'''Abstract'''</big>
<p style="text-align:justify;">This chapter on ''jwara'' is specially important from the standpoint of its management. It covers various endogenous and exogenous causes of ''jwara'' with its management principles. It encompasses a wide set of concepts related to diversified pathogenesis of diseases, including variations in ''[[dosha]]'' states, their degrees in less or severe form, clinical features and their management. The stages of disease and change in treatments need special attention. The important concept of functional aspects of disease involving psychogenic factors and affliction of unknown factors causing ''jwara'' are described in detail with their psycho-spiritual therapies. Do’s and don’ts during jwara and after its remission are applicable in every disease. The etio-pathogenesis and management of recurrence of ''jwara'' denotes importance of observing prescribed codes even after being free from disease. Due to the cardinal feature of raised body temperature or a perception of it, ''jwara'' is often considered synonymous with fever. However, it is not always necessary to consider ''jwara'' disease as fever, because it covers many other principles of management of disease. Modern medicine literature describes two components of fever, one where the cause or etiology is known and the other where it is unknown and is described as FUO (Fever of Unknown Origin). Thus, there is no curative treatment of FUO is available in modern medicine. On the other hand, this chapter describes important Ayurvedic concepts of ''jwara'' or fever which are important to understand the etiology of fever and thus the management. </p>
'''Keywords''': ''Jwara roga, Santapa, [[pitta]]'' fever, ''ushma'', heat regulation.
== Introduction ==
The first two chapters of [[Chikitsa Sthana]] describe ''rasayana'' and ''vajikarana'' to serve the first purpose of preservation, promotion, and rejuvenation of health. The second purpose – the treatment of disease - is dealt in subsequent chapters of this ''sthana''. [[Jwara Chikitsa]] has been dealt first because Ayurveda holds that ''jwara'' is not merely the increase in body temperature (fever) but also a feeling of malaise, unease and discomfort, and involves the ''deha, indriya'',and ''mana'' (physical body, sensory organs, and mind). While the balanced state of ''vata, pitta,'' and ''kapha'' manifest health by rhythmic circulation of fluids, digestion, metabolism, and nutrition respectively, their imbalance manifest as pain, increase in body heat, and inflammations. ''Jwara'' is an imbalanced state of ''pitta'', which damages the physiology of digestion and metabolism. Inappropriately digested food transforms into a substance called ''amavisha'' which is a predisposing cause of many diseases. The initial manifestation of stagnated ''amavisha'' in ''rasa dhatu'' (plasma) is ''jwara''. Thus, ''jwara'' is an important indication for the circulating ''amavisha'' and requires early treatment before its progression.
The first two chapters of [[Chikitsa Sthana]] describe ''[[rasayana]]'' and ''[[vajikarana]]'' to serve the first purpose of preservation, promotion, and rejuvenation of health. The second purpose – the treatment of disease - is dealt in subsequent chapters of this ''sthana''. [[Jwara Chikitsa]] has been dealt first because [[Ayurveda]] holds that ''jwara'' is not merely the increase in body temperature (fever) but also a feeling of malaise, unease and discomfort, and involves the ''deha, [[indriya]]'',and ''mana'' (physical body, sensory organs, and mind). While the balanced state of ''[[vata]], [[pitta]],'' and ''[[kapha]]'' manifest health by rhythmic circulation of fluids, digestion, metabolism, and nutrition respectively, their imbalance manifest as pain, increase in body heat, and inflammations. ''Jwara'' is an imbalanced state of ''[[pitta]]'', which damages the physiology of digestion and metabolism. Inappropriately digested food transforms into a substance called ''amavisha'' which is a predisposing cause of many diseases. The initial manifestation of stagnated ''amavisha'' in ''[[rasa dhatu]]'' (plasma) is ''jwara''. Thus, ''jwara'' is an important indication for the circulating ''amavisha'' and requires early treatment before its progression.
This chapter of [[Jwara Chikitsa]] establishes many guiding principles for treatment of various diseases described later in this section. These are classification, types, association with body tissues, and identification of progression, precautions and specific order of treatment. Causes and symptoms of recurrence and their remedies are widely described in this chapter.
This chapter of [[Jwara Chikitsa]] establishes many guiding principles for treatment of various diseases described later in this section. These are classification, types, association with body tissues, and identification of progression, precautions and specific order of treatment. Causes and symptoms of recurrence and their remedies are widely described in this chapter.
</div>
</div>
== Sanskrit text, Transliteration and English Translation ==
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अथातो ज्वरचिकित्सितं व्याख्यास्यामः||१||
अथातो ज्वरचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
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athātō jwaracikitsitaṁ vyākhyāsyāmaḥ||1||
athātō jwaracikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
</div></div>
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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विज्वरं ज्वरसन्देहं पर्यपृच्छत् पुनर्वसुम्|
विज्वरं ज्वरसन्देहं पर्यपृच्छत् पुनर्वसुम्|
ज्वराधिकारे यद्वाच्यं तत् सौम्य! निखिलं शृणु||१०||
ज्वराधिकारे यद्वाच्यं तत् सौम्य! निखिलं शृणु||१०||
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vijwaraṁ jwarasandēhaṁ paryapr̥cchat punarvasum|
vijwaraṁ jwarasandēhaṁ paryapr̥cchat punarvasum|
jwaradhikAre yadvAcyaM tat saumya! nikhilaM shRuNu||10||
jwaradhikAre yadvAcyaM tat saumya! nikhilaM shRuNu||10||
</div></div>
<div style="text-align:justify;">
Punarvasu, who was free from all types of diseases (''jwara'') and was having complete peace of mind, was sitting in a lonely place; where Agnivesha approached him and asked his queries about ''jwara'' with a modest ''namaskar'' (greeting, with hands folded).
Punarvasu, who was free from all types of diseases (''jwara'') and was having complete peace of mind, was sitting in a lonely place; where Agnivesha approached him and asked his queries about ''jwara'' with a modest ''namaskar'' (greeting, with hands folded).
Oh lord! You have already stated earlier that (in [[Nidana Sthana]]) “''jwara'' afflicts the body, senses and the mind, is the first disease to be manifested, and is the principal and the most powerful disease.” This enemy of human beings is invariably associated with the birth and death of creatures. Therefore, kindly elucidate the following points for the benefit of the humanity –
Oh lord! You have already stated earlier that (in [[Nidana Sthana]]) “''jwara'' afflicts the body, senses and the mind, is the first disease to be manifested, and is the principal and the most powerful disease.” This enemy of human beings is invariably associated with the birth and death of creatures. Therefore, kindly elucidate the following points for the benefit of the humanity –
*''Prakriti'' or the nature of the disease
*''[[Prakriti]]'' or the nature of the disease
*Pravritti or origin of the disease
*Pravritti or origin of the disease
*''Prabhava'', the sequels of the disease
*''Prabhava'', the sequels of the disease
*The therapies which should be administered in order to alleviate this reattack of this fever;
*The therapies which should be administered in order to alleviate this reattack of this fever;
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]
</div>
=== Synonyms of ''jwara'' ===
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ज्वरो विकारो रोगश्च व्याधिरातङ्क एव च|
ज्वरो विकारो रोगश्च व्याधिरातङ्क एव च|
एकोऽर्थो नामपर्यायैर्विविधैरभिधीयते||११||
एकोऽर्थो नामपर्यायैर्विविधैरभिधीयते||११||
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jvarō vikārō rōgaśca vyādhirātaṅka ēva ca|
jvarō vikārō rōgaśca vyādhirātaṅka ēva ca|
eko~artho nAmaparyAyairvividhairabhidhIyate||11||
eko~artho nAmaparyAyairvividhairabhidhIyate||11||
</div></div>
''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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तस्य प्रकृतिरुद्दिष्टा दोषाः शारीरमानसाः|
तस्य प्रकृतिरुद्दिष्टा दोषाः शारीरमानसाः|
इत्यस्य प्रकृतिः प्रोक्ता, ...|१४|
इत्यस्य प्रकृतिः प्रोक्ता, ...|१४|
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tasya prakr̥tiruddiṣṭā dōṣāḥ śārīramānasāḥ|
tasya prakr̥tiruddiṣṭā dōṣāḥ śārīramānasāḥ|
ityasya prakRutiH proktA, ...|14|
ityasya prakRutiH proktA, ...|14|
</div></div>
<div style="text-align:justify;">
The three physical ''[[dosha]]s'' and the two ''manasika [[dosha]]s'' are the natural factors responsible for ''jwara'' (''[[prakriti]]'') as ''jwara'' cannot originate in a person having the balance of these three ''[[dosha]]'' (''nirdosha'' – in the state of homeostasis). Therefore, these ''sharirika'' and ''manasika [[dosha]]s'' are the prakriti of ''jwara''.
''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]
</div>
''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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... प्रवृत्तिस्तु परिग्रहात्|
... प्रवृत्तिस्तु परिग्रहात्|
जन्मादौ निधने च त्वमपचारान्तरेषु च||२५||
जन्मादौ निधने च त्वमपचारान्तरेषु च||२५||
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... pravr̥ttistu parigrahāt|
... pravr̥ttistu parigrahāt|
janmAdau nidhane ca tvamapacArAntareShu ca||25||
janmAdau nidhane ca tvamapacArAntareShu ca||25||
</div></div>
<div style="text-align:justify;">
The origin of ''jwara'' is because of the tendency for greed or attachment (''parigraha''). It has been described earlier in the [[Nidana Sthana]] that the origin of ''jwara'' resulted from the ferocious wrath of Rudra (Lord Shiva).
The origin of ''jwara'' is because of the tendency for greed or attachment (''parigraha''). It has been described earlier in the [[Nidana Sthana]] that the origin of ''jwara'' resulted from the ferocious wrath of Rudra (Lord Shiva).
During the ''Treta Yuga'' (second age) Lord Shiva took a vow of not manifesting anger or wrath for one thousand celestial years. During this time the ''asuras'' (the demons) indulged in the creating obstruction, playing 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]
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=== ''Prabhava'', the sequels of the disease ===
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सन्तापः सारुचिस्तृष्णा साङ्गमर्दो हृदि व्यथा|
सन्तापः सारुचिस्तृष्णा साङ्गमर्दो हृदि व्यथा|
प्रकृतिश्च प्रवृत्तिश्च प्रभावश्च प्रदर्शितः|२७|
प्रकृतिश्च प्रवृत्तिश्च प्रभावश्च प्रदर्शितः|२७|
<div class="mw-collapsible-content">
santāpaḥ sārucistr̥ṣṇā sāṅgamardō hr̥di vyathā|
santāpaḥ sārucistr̥ṣṇā sāṅgamardō hr̥di vyathā|
prakRutishca pravRuttishca prabhAvashca pradarshitaH|27|
prakRutishca pravRuttishca prabhAvashca pradarshitaH|27|
</div></div>
''Santapa'' (feeling of heat or raised temperature), ''aruchi'' (anorexia), ''trishna'' (morbid thirst), ''angamarda'' (body ache), ''hrid vyatha'' (pain in the cardiac region) – these are the invariable manifestations of ''jwara''. At the time of birth and death, ''jwara'' is manifested in the form of tamas (''moha''- altered state of consciousness). In this way the ''prakriti'' (nature), ''pravritti'' (origin) and the ''prabhava'' (invariable manifestations) of ''jwara'' are described. [26-27]
<div style="text-align:justify;">
''Santapa'' (feeling of heat or raised temperature), ''aruchi'' (anorexia), ''trishna'' (morbid thirst), ''angamarda'' (body ache), ''hrid vyatha'' (pain in the cardiac region) – these are the invariable manifestations of ''jwara''. At the time of birth and death, ''jwara'' is manifested in the form of tamas (''moha''- altered state of consciousness). In this way the ''[[prakriti]]'' (nature), ''pravritti'' (origin) and the ''prabhava'' (invariable manifestations) of ''jwara'' are described. [26-27]
</div>
<div class="mw-collapsible mw-collapsed">
निदाने कारणान्यष्टौ पूर्वोक्तानि विभागशः||२७||
निदाने कारणान्यष्टौ पूर्वोक्तानि विभागशः||२७||
<div class="mw-collapsible-content">
nidānē kāraṇānyaṣṭau pūrvōktāni vibhāgaśaḥ||27||
nidānē kāraṇānyaṣṭau pūrvōktāni vibhāgaśaḥ||27||
nidAne kAraNAnyaShTau pUrvoktAni vibhAgashaH||27||
nidAne kAraNAnyaShTau pUrvoktAni vibhAgashaH||27||
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Premonitory symptoms of ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
आलस्यं नयने सास्रे जृम्भणं गौरवं क्रमः|
आलस्यं नयने सास्रे जृम्भणं गौरवं क्रमः|
शीलवैकृतमल्पं च ज्वरलक्षणमग्रजम्||२९||
शीलवैकृतमल्पं च ज्वरलक्षणमग्रजम्||२९||
<div class="mw-collapsible-content">
ālasyaṁ nayanē sāsrē jr̥mbhaṇaṁ gauravaṁ kramaḥ|
ālasyaṁ nayanē sāsrē jr̥mbhaṇaṁ gauravaṁ kramaḥ|
shIlavaikRutamalpaM ca jwaralakShaNamagrajam||29||
shIlavaikRutamalpaM ca jwaralakShaNamagrajam||29||
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Sites of ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
केवलं समनस्कं च ज्वराधिष्ठानमुच्यते|
केवलं समनस्कं च ज्वराधिष्ठानमुच्यते|
शरीरं, बलकालस्तु निदाने सम्प्रदर्शितः||३०||
शरीरं, बलकालस्तु निदाने सम्प्रदर्शितः||३०||
<div class="mw-collapsible-content">
kēvalaṁ samanaskaṁ ca jvarādhiṣṭhānamucyatē|
kēvalaṁ samanaskaṁ ca jvarādhiṣṭhānamucyatē|
sharIraM, balakAlastu nidAne sampradarshitaH||30||
sharIraM, balakAlastu nidAne sampradarshitaH||30||
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Cardinal feature ===
<div class="mw-collapsible mw-collapsed">
ज्वरप्रत्यात्मिकं लिङ्गं सन्तापो देहमानसः|
ज्वरप्रत्यात्मिकं लिङ्गं सन्तापो देहमानसः|
ज्वरेणाविशता भूतं न हि किञ्चिन्न तप्यते||३१||
ज्वरेणाविशता भूतं न हि किञ्चिन्न तप्यते||३१||
<div class="mw-collapsible-content">
jwarapratyātmikaṁ liṅgaṁ santāpō dēhamānasaḥ|
jwarapratyātmikaṁ liṅgaṁ santāpō dēhamānasaḥ|
jvareNAvishatA bhUtaM na hi ki~jcinna tapyate||31||
jvareNAvishatA bhUtaM na hi ki~jcinna tapyate||31||
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Classification ===
<div class="mw-collapsible mw-collapsed">
द्विविधो विधिभेदेन ज्वरः शारीरमानसः|
द्विविधो विधिभेदेन ज्वरः शारीरमानसः|
भिन्नः कारणभेदेन पुनरष्टविधो ज्वरः||३५||
भिन्नः कारणभेदेन पुनरष्टविधो ज्वरः||३५||
<div class="mw-collapsible-content">
dvividhō vidhibhēdēna jwaraḥ śārīramānasaḥ|
dvividhō vidhibhēdēna jwaraḥ śārīramānasaḥ|
bhinnaH kAraNabhedena punaraShTavidho jwaraH||35||
bhinnaH kAraNabhedena punaraShTavidho jwaraH||35||
</div></div>
<div style="text-align:justify;">
''Jwara'' is classified into two types each on the basis of the following criteria –
''Jwara'' is classified into two types each on the basis of the following criteria –
*''Sharira'' (physical) and ''manasa'' (mental)
*''Sharira'' (physical) and ''[[manas]]a'' (mental)
*''Saumya'' (predominated by cold) and ''agneya'' (predominated by heat)
*''Saumya'' (predominated by cold) and ''agneya'' (predominated by heat)
*''Antarvega'' (internal) and ''bahirvega'' (external)
*''Antarvega'' (internal) and ''bahirvega'' (external)
#''Tritiyaka''
#''Tritiyaka''
#''Chaturthaka''.
#''Chaturthaka''.
Depending upon the ''ashraya'' (site of manifestation in the body) among the seven ''dhatus'' (body tissues) ''jwara'' is again classified into seven categories.
Depending upon the ''ashraya'' (site of manifestation in the body) among the seven ''[[dhatu]]s'' (body tissues) ''jwara'' is again classified into seven categories.
''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]
</div>
=== Clinical features of somatic and psychic ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
शारीरो जायते पूर्वं देहे, मनसि मानसः|
शारीरो जायते पूर्वं देहे, मनसि मानसः|
इन्द्रियाणां च वैकृत्यं ज्ञेयं सन्तापलक्षणम्|३७|
इन्द्रियाणां च वैकृत्यं ज्ञेयं सन्तापलक्षणम्|३७|
<div class="mw-collapsible-content">
śārīrō jāyatē pūrvaṁ dēhē, manasi mānasaḥ|
śārīrō jāyatē pūrvaṁ dēhē, manasi mānasaḥ|
indriyANAM ca vaikRutyaM j~jeyaM santApalakShaNam|37|
indriyANAM ca vaikRutyaM j~jeyaM santApalakShaNam|37|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
=== Desires of patient to diagnose ''[[dosha]]'' dominance ===
<div class="mw-collapsible mw-collapsed">
वातपित्तात्मकः शीतमुष्णं वातकफात्मकः||३७||
वातपित्तात्मकः शीतमुष्णं वातकफात्मकः||३७||
इच्छत्युभयमेतत्तु ज्वरो व्यामिश्रलक्षणः|३८|
इच्छत्युभयमेतत्तु ज्वरो व्यामिश्रलक्षणः|३८|
<div class="mw-collapsible-content">
vātapittātmakaḥ śītamuṣṇaṁ vātakaphātmakaḥ||37||
vātapittātmakaḥ śītamuṣṇaṁ vātakaphātmakaḥ||37||
icchatyubhayametattu jvaro vyAmishralakShaNaH|38|
icchatyubhayametattu jvaro vyAmishralakShaNaH|38|
</div></div>
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]
<div style="text-align:justify;">
A patient suffering from ''[[vata]][[pitta]]ja'' 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 ''[[dosha]]s'' get mixed then such patient manifests both the kinds of symptoms. [37-38]
</div>
=== Attenuating nature of ''[[vata]] [[dosha]]'' ===
<div class="mw-collapsible mw-collapsed">
योगवाहः परं वायुः संयोगादुभयार्थकृत्||३८||
योगवाहः परं वायुः संयोगादुभयार्थकृत्||३८||
दाहकृत्तेजसा युक्तः, शीतकृत् सोमसंश्रयात्|३९|
दाहकृत्तेजसा युक्तः, शीतकृत् सोमसंश्रयात्|३९|
<div class="mw-collapsible-content">
yōgavāhaḥ paraṁ vāyuḥ saṁyōgādubhayārthakr̥t||38||
yōgavāhaḥ paraṁ vāyuḥ saṁyōgādubhayārthakr̥t||38||
dAhakRuttejasA yuktaH, shItakRut somasaMshrayAt|39|
dAhakRuttejasA yuktaH, shItakRut somasaMshrayAt|39|
</div></div>
''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]
<div style="text-align:justify;">
''[[Vata dosha]]'' is exceedingly ''yogavahi'' (which accentuates the properties of others) in nature. It produces both type of effects on combination with the two ''[[dosha]]s''. On combining with ''[[teja]]s'' it produces burning sensation while in combination with ''soma'' it produces cooling effect. [38-39]
</div>
=== Features of internal and external ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
अन्तर्दाहोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||३९||
अन्तर्दाहोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||३९||
बहिर्वेगस्य लिङ्गानि सुखसाध्यत्वमेव च||४१||
बहिर्वेगस्य लिङ्गानि सुखसाध्यत्वमेव च||४१||
<div class="mw-collapsible-content">
antardāhō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||39||
antardāhō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||39||
bahirvegasya li~ggAni sukhasAdhyatvameva ca||41||
bahirvegasya li~ggAni sukhasAdhyatvameva ca||41||
</div></div>
Excessive burning sensation inside the body, morbid thirst, delirium, dyspnea, giddiness, pain in bones and joints, absence of sweating, non-excretion of ''doshas'' and the feces – are the clinical features of ''antarvegi jwara'' (internal manifestation of ''jwara'').
<div style="text-align:justify;">
Excessive burning sensation inside the body, morbid thirst, delirium, dyspnea, giddiness, pain in bones and joints, absence of sweating, non-excretion of ''[[dosha]]s'' and the feces – are the clinical features of ''antarvegi jwara'' (internal manifestation of ''jwara'').
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]
</div>
=== ''Prakrita jwara''(seasonal ''jwara'') ===
<div class="mw-collapsible mw-collapsed">
प्राकृतः सुखसाध्यस्तु वसन्तशरदुद्भवः|
प्राकृतः सुखसाध्यस्तु वसन्तशरदुद्भवः|
हेतवो विविधास्तस्य निदाने सम्प्रदर्शिताः||४९||
हेतवो विविधास्तस्य निदाने सम्प्रदर्शिताः||४९||
<div class="mw-collapsible-content">
prākr̥taḥ sukhasādhyastu vasantaśaradudbhavaḥ|
prākr̥taḥ sukhasādhyastu vasantaśaradudbhavaḥ|
hetavo vividhAstasya nidAne sampradarshitAH||49||
hetavo vividhAstasya nidAne sampradarshitAH||49||
</div></div>
<div style="text-align:justify;">
''Jwara'' manifesting in the ''vasanta'' or spring season and ''sharada'' or autumn season is called ''prakrita'' (seasonal) ''jwara'' and is easily curable.
''Jwara'' manifesting in the ''vasanta'' or spring season and ''sharada'' or autumn season is called ''prakrita'' (seasonal) ''jwara'' and is easily curable.
''Pitta'' gets aggravated during autumn season because of its inherent hot properties and hot environment. ''Kapha'' gets accumulated in winters and gets aggravated during spring season.
''[[Pitta]]'' gets aggravated during autumn season because of its inherent hot properties and hot environment. ''[[Kapha]]'' gets accumulated in winters and gets aggravated during spring season.
The water and drugs (including the eatables) become sour in ''vipaka'' (taste that emerges after digestion) during the rainy season, which results in the accumulation of ''pitta''. This accumulated ''pitta'' gets aggravated or excited (by the hot sunrays) during the autumn season. This can immediately produce ''jwara'' in which ''kapha dosha'' is secondarily associated. As ''vasanta'' is the part of ''visarga kala'' (the time of year when, body has good strength imparted by nature), no problem is created by fasting.
The water and drugs (including the eatables) become sour in ''vipaka'' (taste that emerges after digestion) during the rainy season, which results in the accumulation of ''[[pitta]]''. This accumulated ''[[pitta]]'' gets aggravated or excited (by the hot sunrays) during the autumn season. This can immediately produce ''jwara'' in which ''[[kapha dosha]]'' is secondarily associated. As ''vasanta'' is the part of ''visarga kala'' (the time of year when, body has good strength imparted by nature), no problem is created by fasting.
During ''hemanta'' (early winter) the water and drugs (including eatables) become sweet in taste, which helps in accumulation of ''kapha''. This ''kapha'' gets aggravated during the subsequent spring season due to the strong sunrays (which melt this ''kapha''). Therefore, ''jwara'' caused by ''kapha'' is manifested during the spring season. The spring is the part of the ''adana kala'' (the time when the strength of the creatures is the least as the nature withdraws the strength) and in the ''jwara'' caused in this period ''vata'' and ''pitta dosha'' constitute the secondary associates.
During ''hemanta'' (early winter) the water and drugs (including eatables) become sweet in taste, which helps in accumulation of ''[[kapha]]''. This ''[[kapha]]'' gets aggravated during the subsequent spring season due to the strong sunrays (which melt this ''[[kapha]]''). Therefore, ''jwara'' caused by ''[[kapha]]'' is manifested during the spring season. The spring is the part of the ''adana kala'' (the time when the strength of the creatures is the least as the nature withdraws the strength) and in the ''jwara'' caused in this period ''[[vata]]'' and ''[[pitta dosha]]'' constitute the secondary associates.
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
*''paitika jwara'' occurring in seasons other than autumn and
*''paitika jwara'' occurring in seasons other than autumn and
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]
</div>
=== Prognosis of ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
बलवत्स्वल्पदोषेषु ज्वरः साध्योऽनुपद्रवः|
बलवत्स्वल्पदोषेषु ज्वरः साध्योऽनुपद्रवः|
असाध्यो बलवान् यश्च केशसीमन्तकृज्ज्वरः|५३|
असाध्यो बलवान् यश्च केशसीमन्तकृज्ज्वरः|५३|
<div class="mw-collapsible-content">
balavatsvalpadōṣēṣu jwaraḥ sādhyō'nupadravaḥ|
balavatsvalpadōṣēṣu jwaraḥ sādhyō'nupadravaḥ|
asAdhyo balavAn yashca keshasImantakRujjwaraH|53|
asAdhyo balavAn yashca keshasImantakRujjwaraH|53|
</div></div>
==== ''Sadhya'' (curable) ''jwara'' ====
<div style="text-align:justify;">
''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]
</div>
=== Five types of ''jwara'' as per frequency ===
==== ''Santata jwara'' ====
<div class="mw-collapsible mw-collapsed">
स्रोतोभिर्विसृता दोषा गुरवो रसवाहिभिः||५३||
स्रोतोभिर्विसृता दोषा गुरवो रसवाहिभिः||५३||
क्रियाक्रमविधौ युक्तः प्रायः प्रागपतर्पणैः|६१|
क्रियाक्रमविधौ युक्तः प्रायः प्रागपतर्पणैः|६१|
<div class="mw-collapsible-content">
srōtōbhirvisr̥tā dōṣā guravō rasavāhibhiḥ||53||
srōtōbhirvisr̥tā dōṣā guravō rasavāhibhiḥ||53||
kriyAkramavidhau yuktaH prAyaH prAgapatarpaNaiH|61|
kriyAkramavidhau yuktaH prAyaH prAgapatarpaNaiH|61|
</div></div>
The aggravated ''dosha'' circulate through the channels carrying ''rasa'' (the first nutritional dhatu equivalent to plasma) and spread all over the body and gets stagnated, causes ''santata jwara''. This ''santata jwara'' is extremely difficult to treat and manifests its symptoms very quickly. In this type the patient either gets cured (on the pacification of ''dosha'') or killed (on the further aggravation of ''dosha'') on the 10th, 12th or 7th day.
<div style="text-align:justify;">
The aggravated ''[[dosha]]'' circulate through the channels carrying ''[[rasa]]'' (the first nutritional dhatu equivalent to plasma) and spread all over the body and gets stagnated, causes ''santata jwara''. This ''santata jwara'' is extremely difficult to treat and manifests its symptoms very quickly. In this type the patient either gets cured (on the pacification of ''[[dosha]]'') or killed (on the further aggravation of ''[[dosha]]'') on the 10th, 12th or 7th day.
The ''dosha'' involved in the manifestation of ''santata jwara'' is in accordance with season (''kala''), vitiated factors (''dushya''), and the physical constitution of the patient (''prakriti'') due to which it is ''nispratyanika'' (having no opponent / which cannot be inhibited). Thus, it is known to be unbearable.
The ''[[dosha]]'' involved in the manifestation of ''santata jwara'' is in accordance with season (''[[kala]]''), vitiated factors (''[[dushya]]''), and the physical constitution of the patient (''[[prakriti]]'') due to which it is ''nispratyanika'' (having no opponent / which cannot be inhibited). Thus, it is known to be unbearable.
Additionally, the other ''dhatu'', urine, stool and ''vata'' etc. ''dosha'', also get affected simultaneously in this fever. If the involved factors like ''rasa'' are purified optimally the fever gets subsided in either 7 or 10 or 12 days, otherwise, the fever kills the patient within that period.
Additionally, the other ''[[dhatu]]'', urine, stool and ''[[vata]]'' etc. ''[[dosha]]'', also get affected simultaneously in this fever. If the involved factors like ''[[rasa]]'' are purified optimally the fever gets subsided in either 7 or 10 or 12 days, otherwise, the fever kills the patient within that period.
If, some of the 12 constituents of this fever get purified, while some others remain unpurified, then the fever goes in latent stage on the 12th day and reappears on the 13th day and may persist for longer duration. In this way, a physician should understand the causes and features of this type of fever and should initiate the treatment only after a proper understanding of these factors, mostly by the methods beginning with ''apatarpana''. [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]
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==== ''Satata jwara'' ====
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रक्तधात्वाश्रयः प्रायो दोषः सततकं ज्वरम्||६१||
रक्तधात्वाश्रयः प्रायो दोषः सततकं ज्वरम्||६१||
अहोरात्रे सततको द्वौ कालावनुवर्तते||६२||
अहोरात्रे सततको द्वौ कालावनुवर्तते||६२||
<div class="mw-collapsible-content">
raktadhātvāśrayaḥ prāyō dōṣaḥ satatakaṁ jwaram||61||
raktadhātvāśrayaḥ prāyō dōṣaḥ satatakaṁ jwaram||61||
ahorAtre satatako dvau kAlAvanuvartate||62||
ahorAtre satatako dvau kAlAvanuvartate||62||
</div></div>
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]
<div style="text-align:justify;">
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]
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==== ''Anyedyushka jwara'' ====
<div class="mw-collapsible mw-collapsed">
कालप्रकृतिदूष्याणां प्राप्यैवान्यतमाद्बलम्|
कालप्रकृतिदूष्याणां प्राप्यैवान्यतमाद्बलम्|
सप्रत्यनीको जनयत्येककालमहर्निशि|
सप्रत्यनीको जनयत्येककालमहर्निशि|
<div class="mw-collapsible-content">
kālaprakr̥tidūṣyāṇāṁ prāpyaivānyatamādbalam|
kālaprakr̥tidūṣyāṇāṁ prāpyaivānyatamādbalam|
sapratyanIko janayatyekakAlamaharnishi|
sapratyanIko janayatyekakAlamaharnishi|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
==== ''Tritiyaka'' and ''chaturthaka jwara'' ====
<div class="mw-collapsible mw-collapsed">
दोषोऽस्थिमज्जगः कुर्यात्तृतीयकचतुर्थकौ||६४||
दोषोऽस्थिमज्जगः कुर्यात्तृतीयकचतुर्थकौ||६४||
दिनद्वयं यो विश्रम्य प्रत्येति स चतुर्थकः||६७||
दिनद्वयं यो विश्रम्य प्रत्येति स चतुर्थकः||६७||
<div class="mw-collapsible-content">
dōṣō'sthimajjagaḥ kuryāttr̥tīyakacaturthakau||64||
dōṣō'sthimajjagaḥ kuryāttr̥tīyakacaturthakau||64||
dinadvayaM yo vishramya pratyeti sa caturthakaH||67||
dinadvayaM yo vishramya pratyeti sa caturthakaH||67||
</div></div>
<div style="text-align:justify;">
When the ''[[dosha]]'' afflict the ''[[asthi dhatu]]'' (bone tissue) and ''[[majja dhatu]]'' (bone marrow), they cause the ''tritiyaka'' and ''chaturthaka jwara'' respectively.
Some scholars opine that the different types of ''jwara'' viz the ''anyedushaka, tritiyaka'' and ''chaturthaka jwara'' manifest because of the affliction of the some alternate ''[[dhatu]]'' by the ''[[dosha]]''. ''Anyedushyaka jwara'' is caused by the affliction of ''[[rakta dhatu]]'' (blood) also. ''Tritiyaka jwara'' manifests when the ''[[dosha]]'' afflict the ''[[mamsa dhatu]]'' (muscular tissues). ''[[Dosha]]'' lodging in the channels of circulation of ''[[medo dhatu]]'' cause ''chaturthaka jwara''.
Some scholars opine that the different types of ''jwara'' viz the ''anyedushaka, tritiyaka'' and ''chaturthaka jwara'' manifest because of the affliction of the some alternate ''dhatu'' by the ''dosha''. ''Anyedushyaka jwara'' is caused by the affliction of ''rakta dhatu'' (blood) also. ''Tritiyaka jwara'' manifests when the ''dosha'' afflict the ''mansa dhatu'' (muscular tissues). ''Dosha'' lodging in the channels of circulation of ''medo dhatu'' cause ''chaturthaka jwara''.
''Anyedushka jwara'' occurs every day, while ''tritiyaka jwara'' occurs after a gap of one day and ''chaurthaka'' occurs after two days gap. [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]
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=== Cause of alterations in ''jwara'' episodes ===
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अधिशेते यथा भूमिं बीजं काले च रोहति|
अधिशेते यथा भूमिं बीजं काले च रोहति|
जङ्घाभ्यां श्लैष्मिकः पूर्वं शिरस्तोऽनिलसम्भवः||७२||
जङ्घाभ्यां श्लैष्मिकः पूर्वं शिरस्तोऽनिलसम्भवः||७२||
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adhiśētē yathā bhūmiṁ bījaṁ kālē ca rōhati|
adhiśētē yathā bhūmiṁ bījaṁ kālē ca rōhati|
ja~gghAbhyAM shlaiShmikaH pUrvaM shirasto~anilasambhavaH||72||
ja~gghAbhyAM shlaiShmikaH pUrvaM shirasto~anilasambhavaH||72||
</div></div>
<div style="text-align:justify;">
As a seed remains dormant in the soil and germinates at a favorable time, similarly the ''[[dosha]]s'' remain in dormant condition in the ''[[dhatu]]'' and get aggravated at a favorable time. These ''[[dosha]]'' gain strength at an appropriate time and when the power of the inhibiting (disease preventing) factors has subsided, then the ''tritiyaka'' and ''chaturthaka jwara'' manifest.
The ''[[dosha]]'' lose their strength after manifesting their signs and symptoms of aggravation and get lodged in their respective places. They again get aggravated and afflict the person with ''jwara''.
The ''dosha'' lose their strength after manifesting their signs and symptoms of aggravation and get lodged in their respective places. They again get aggravated and afflict the person with ''jwara''.
The ''tritiyaka jwara'' manifests in three types –
The ''tritiyaka jwara'' manifests in three types –
*When the ''kapha'' and ''pitta dosha'' are aggravated then it afflicts the ''trika pradesh'' (sacral region)
*When the ''[[kapha]]'' and ''[[pitta dosha]]'' are aggravated then it afflicts the ''trika pradesh'' (sacral region)
*When the ''vata'' and ''kapha dosha'' are aggravated then the back (''prishtha'') region are affected
*When the ''[[vata]]'' and ''[[kapha dosha]]'' are aggravated then the back (''prishtha'') region are affected
*The head region is affected in the case of aggravation of ''vata'' and ''pitta dosha''.
*The head region is affected in the case of aggravation of ''[[vata]]'' and ''[[pitta dosha]]''.
Similarly ''chaturthaka jwara'' is also of two types –
Similarly ''chaturthaka jwara'' is also of two types –
*Calf region is afflicted in the in the beginning by the vitiation of ''kapha''
*Calf region is afflicted in the in the beginning by the vitiation of ''[[kapha]]''
*Head region is afflicted in the beginning by the vitiation of ''vata''. [70-72]
*Head region is afflicted in the beginning by the vitiation of ''[[vata]]''. [70-72]
</div>
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विषमज्वर एवान्यश्चतुर्थकविपर्ययः|
विषमज्वर एवान्यश्चतुर्थकविपर्ययः|
त्रिविधो धातुरेकैको द्विधातुस्थः करोति यम्||७३||
त्रिविधो धातुरेकैको द्विधातुस्थः करोति यम्||७३||
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viṣamajwara ēvānyaścaturthakaviparyayaḥ|
viṣamajwara ēvānyaścaturthakaviparyayaḥ|
trividho dhAturekaiko dvidhAtusthaH karoti yam||73||
trividho dhAturekaiko dvidhAtusthaH karoti yam||73||
</div></div>
''Chaturthaka viparyaya jwara'' is another variety of ''vishama jwara''. Each of the three ''dosha'' i.e. ''vata, pitta'' and ''kapha'' cause this disease by afflicting the two dhatu viz ''asthi'' (bone) and ''majja'' (bone marrow).[73]
<div style="text-align:justify;">
''Chaturthaka viparyaya jwara'' is another variety of ''vishama jwara''. Each of the three ''[[dosha]]'' i.e. ''[[vata]], [[pitta]]'' and ''[[kapha]]'' cause this disease by afflicting the two dhatu viz ''[[asthi]]'' (bone) and ''[[majja]]'' (bone marrow).[73]
</div>
<div class="mw-collapsible mw-collapsed">
प्रायशः सन्निपातेन दृष्टः पञ्चविधो ज्वरः|
प्रायशः सन्निपातेन दृष्टः पञ्चविधो ज्वरः|
सन्निपाते तु यो भूयान् स दोषः परिकीर्तितः||७४||
सन्निपाते तु यो भूयान् स दोषः परिकीर्तितः||७४||
<div class="mw-collapsible-content">
prāyaśaḥ sannipātēna dr̥ṣṭaḥ pañcavidhō jwaraḥ|
prāyaśaḥ sannipātēna dr̥ṣṭaḥ pañcavidhō jwaraḥ|
sannipAte tu yo bhUyAn sa doShaH parikIrtitaH||74||
sannipAte tu yo bhUyAn sa doShaH parikIrtitaH||74||
</div></div>
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]
<div style="text-align:justify;">
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 ''[[dosha]]s'' is generally attributed as the causative factors. [74]
</div>
=== ''Dhatugata jwara'' ===
<div class="mw-collapsible mw-collapsed">
ऋत्वहोरात्रदोषाणां मनसश्च बलाबलात्|
ऋत्वहोरात्रदोषाणां मनसश्च बलाबलात्|
अस्थिमज्जगतः कृच्छ्रः शुक्रस्थो नैव सिद्ध्यति||८३||
अस्थिमज्जगतः कृच्छ्रः शुक्रस्थो नैव सिद्ध्यति||८३||
<div class="mw-collapsible-content">
r̥tvahōrātradōṣāṇāṁ manasaśca balābalāt|
r̥tvahōrātradōṣāṇāṁ manasaśca balābalāt|
asthimajjagataH kRucchraH shukrastho naiva siddhyati||83||
asthimajjagataH kRucchraH shukrastho naiva siddhyati||83||
</div></div>
<div style="text-align:justify;">
Manifestation of ''jwara'' at a particular time or a change in the time of manifestation takes place due to following factors:
Manifestation of ''jwara'' at a particular time or a change in the time of manifestation takes place due to following factors:
''Jwara'' occurs according to the strength or weakness of factors like ''dosha'', seasons, day, night, mental status and ''artha'' (deeds of previous life).
''Jwara'' occurs according to the strength or weakness of factors like ''[[dosha]]'', seasons, day, night, mental status and ''artha'' (deeds of previous life).
Manifestation of ''jwara'' in the different ''dhatu'' (body tissues):
Manifestation of ''jwara'' in the different ''dhatu'' (body tissues):
#When the vitiated ''dosha'' are located in the ''rasa dhatu'', the clinical features manifesting are – heaviness, miserable feeling, anxiety, exhaustion, vomiting, anorexia, increase in external temperature, body ache and yawning.
#When the vitiated ''[[dosha]]'' are located in the ''[[rasa dhatu]]'', the clinical features manifesting are – heaviness, miserable feeling, anxiety, exhaustion, vomiting, anorexia, increase in external temperature, body ache and yawning.
#The vitiated ''doshas'' causing ''jwara'' are located in the ''rakta dhatu'', the clinical features are – Increase in body temperature, eruptions, thirst, frequent spitting mixed with blood burning sensation, discoloration, giddiness, intoxication and incoherent speech.
#The vitiated ''[[dosha]]s'' causing ''jwara'' are located in the ''[[rakta dhatu]]'', the clinical features are – Increase in body temperature, eruptions, thirst, frequent spitting mixed with blood burning sensation, discoloration, giddiness, intoxication and incoherent speech.
#Burning sensation inside the body, thirst, unconsciousness, weakness, diarrhea, foul smell from the body and throwing movement of the limbs are the features manifesting when the ''doshas'' causing ''jwara'' are lodged in the ''mamsa dhatu''.
#Burning sensation inside the body, thirst, unconsciousness, weakness, diarrhea, foul smell from the body and throwing movement of the limbs are the features manifesting when the ''[[dosha]]s'' causing ''jwara'' are lodged in the ''[[mamsa dhatu]]''.
#Vitiated ''dosha'' located in the ''medo dhatu'' present with the following clinical features – excessive sweating, thirst, incoherent speech, frequent emesis, inability to tolerate the smell of one’s own body, wet feeling in the body and anorexia.
#Vitiated ''[[dosha]]'' located in the ''[[meda dhatu]]'' present with the following clinical features – excessive sweating, thirst, incoherent speech, frequent emesis, inability to tolerate the smell of one’s own body, wet feeling in the body and anorexia.
#Vitiated ''dosha'' located in the ''asthi dhatu'' cause the following clinical features – diarrhea, emesis, pain in the bones, production of ''kujana'' (a sort of cooing sound) throwing movement of the body and limbs.
#Vitiated ''[[dosha]]'' located in the ''[[asthi dhatu]]'' cause the following clinical features – diarrhea, emesis, pain in the bones, production of ''kujana'' (a sort of cooing sound) convulsive movements of the body and limbs.
#When the vitiated ''dosha'' are located in the ''majja dhatu'' then the following signs and symptoms appear – hiccup, bronchitis, cough, feeling of entering into darkness frequently, cutting pain in the vital organs (''marmas''), feeling of cold externally and internal burning sensation.
#When the vitiated ''dosha'' are located in the ''majja dhatu'' then the following signs and symptoms appear – hiccup, bronchitis, cough, feeling of entering into darkness frequently, cutting pain in the vital organs (''marmas''), feeling of cold externally and internal burning sensation.
#Vitiated ''dosha'' causing ''jwara'' located in the ''sukra dhatu'' cause ejaculation and destruction of ''shukra'' resulting in the extinction of life along with ''vayu, agni'' and ''soma'' of the subtle body (''sukshma sharira'').
#Vitiated ''[[dosha]]'' causing ''[[jwara]]'' located in the ''[[sukra dhatu]]'' cause ejaculation and destruction of ''[[shukra]]'' resulting in the extinction of life along with ''vayu, agni'' and ''soma'' of the subtle body (''sukshma sharira'').
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 ''[[dosha]]s'' are located in the ''[[rasa]], [[rakta]], [[mamsa]]'' and ''[[meda 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]
</div>
=== Clinical features of ''jwara'' due to combination of two ''[[dosha]]'' ===
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हेतुभिर्लक्षणैश्चोक्तः पूर्वमष्टविधो ज्वरः|
हेतुभिर्लक्षणैश्चोक्तः पूर्वमष्टविधो ज्वरः|
इत्येते द्वन्द्वजाः प्रोक्ताः ...|८९|
इत्येते द्वन्द्वजाः प्रोक्ताः ...|८९|
<div class="mw-collapsible-content">
hētubhirlakṣaṇaiścōktaḥ pūrvamaṣṭavidhō jwaraḥ|
hētubhirlakṣaṇaiścōktaḥ pūrvamaṣṭavidhō jwaraḥ|
ityete dvandvajAH proktAH ...|89|
ityete dvandvajAH proktAH ...|89|
</div></div>
Signs and symptoms of ''jwara'' by combination of ''vata'' and ''pitta'':
<div style="text-align:justify;">
Signs and symptoms of ''jwara'' by combination of ''[[vata]]'' and ''[[pitta]]'':
In [[Nidana Sthana]] the eight varieties of ''jwara'' along with their causative factors, signs and symptoms have been described in brief. Now their signs and symptoms will be described in detail:
In [[Nidana Sthana]] the eight varieties of ''jwara'' along with their causative factors, signs and symptoms have been described in brief. Now their signs and symptoms will be described in detail:
Headache, breaking pain in joints, burning sensation, horripilation, dryness of throat and mouth, nausea, thirst, fainting, giddiness, anorexia, sleeplessness, talkativeness and yawning – all these are the signs and symptoms of ''jwara'' by combination of ''vata'' and ''pitta''.
Headache, breaking pain in joints, burning sensation, horripilation, dryness of throat and mouth, nausea, thirst, fainting, giddiness, anorexia, sleeplessness, talkativeness and yawning – all these are the signs and symptoms of ''jwara'' by combination of ''[[vata]]'' and ''[[pitta]]''.
Signs and symptoms of ''jwara'' by combination of ''vata'' and ''kapha'':
Signs and symptoms of ''jwara'' by combination of ''[[vata]]'' and ''[[kapha]]'':
Feeling cold, heaviness, drowsiness, timidity, pain in joints, feeling of stiffness of head (''sirograha''), coryza, cough, impaired sweating and moderate rise in temperature are the signs and symptoms of ''jwara'' caused by ''vata'' and ''kapha''.
Feeling cold, heaviness, drowsiness, timidity, pain in joints, feeling of stiffness of head (''sirograha''), coryza, cough, impaired sweating and moderate rise in temperature are the signs and symptoms of ''jwara'' caused by ''[[vata]]'' and ''[[kapha]]''.
Signs and symptoms of ''jwara'' by combination of ''kapha'' and ''pitta'':
Signs and symptoms of ''jwara'' by combination of ''[[kapha]]'' and ''[[pitta]]'':
Frequently changing sensation of hot and cold, frequent increased or decreased sweating, delusions, cough, anorexia, thirst, elimination of phlegm and bile, coating and bitterness in the mouth and drowsiness – all are the clinical features of ''jwara'' caused by ''kapha'' and ''pitta''.
Frequently changing sensation of hot and cold, frequent increased or decreased sweating, delusions, cough, anorexia, thirst, elimination of phlegm and bile, coating and bitterness in the mouth and drowsiness – all are the clinical features of ''jwara'' caused by ''[[kapha]]'' and ''[[pitta]]''.
Thus, here the features of different types of ''jwara'' caused by the simultaneous vitiation of two ''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]
</div>
=== ''Sannipataja jwara'' ===
<div class="mw-collapsible mw-collapsed">
... सन्निपातज उच्यते||८९||
... सन्निपातज उच्यते||८९||
चिरात् पाकश्च दोषाणां सन्निपातज्वराकृतिः|१०९|
चिरात् पाकश्च दोषाणां सन्निपातज्वराकृतिः|१०९|
<div class="mw-collapsible-content">
... sannipātaja ucyatē||89||
... sannipātaja ucyatē||89||
cirAt pAkashca doShANAM sannipAtajwarakRutiH|109|
cirAt pAkashca doShANAM sannipAtajwarakRutiH|109|
</div></div>
<div style="text-align:justify;">
Description of ''sannipataja jwara'' (caused by combined ''tridosha''):
Description of ''sannipataja jwara'' (caused by combined ''tridosha''):
The ''sannipataja'' variety of ''jwara'', has thirteen sub types have been described in [[Nidana Sthana]]. Now the clinical features of each type will be described separately:
The ''sannipataja'' variety of ''jwara'', has thirteen sub types have been described in [[Nidana Sthana]]. Now the clinical features of each type will be described separately:
*''Sannipataja jwara'' in which ''vata'' and ''pitta'' are codominant while ''kapha'' is recessive has the following clinical features – giddiness, thirst, burning sensation, heaviness and excessive headache. [91]
*''Sannipataja jwara'' in which ''[[vata]]'' and ''[[pitta]]'' are codominant while ''[[kapha]]'' is recessive has the following clinical features – giddiness, thirst, burning sensation, heaviness and excessive headache. [91]
*''Sannipataja jwara'' in which ''vata'' and ''kapha'' are codominant while ''pitta'' is recessive has the following clinical features – Coldness, cough, anorexia, drowsiness, thirst, burning sensation and pain. [92]
*''Sannipataja jwara'' in which ''[[vata]]'' and ''[[kapha]]'' are codominant while ''[[pitta]]'' is recessive has the following clinical features – Coldness, cough, anorexia, drowsiness, thirst, burning sensation and pain. [92]
*''Sannipataja jwara'' in which ''pitta'' and ''kapha'' are codominant while ''vata'' is recessive has the following clinical features – Emesis, coldness, frequent burning sensation, thirst, unconsciousness and pain in the bones. [93]
*''Sannipataja jwara'' in which ''[[pitta]]'' and ''[[kapha]]'' are codominant while ''[[vata]]'' is recessive has the following clinical features – Emesis, coldness, frequent burning sensation, thirst, unconsciousness and pain in the bones. [93]
*''Sannipataja jwara'' in which vitiated ''vata'' predominates over the other two ''doshas'' presents with the following signs and symptoms **pain in the joints, bones and head; delirium, heaviness, giddiness, thirst and dryness of the throat as well as the mouth [94]
*''Sannipataja jwara'' in which vitiated ''[[vata]]'' predominates over the other two ''[[dosha]]s'' presents with the following signs and symptoms **pain in the joints, bones and head; delirium, heaviness, giddiness, thirst and dryness of the throat as well as the mouth [94]
*''Sannipataja jwara'' in which vitiated ''pitta'' predominates over the other two ''doshas'' presents with the following signs and symptoms – blood in stool and urine, burning sensation, vomiting, ''arati'' (disliking for doing any work), giddiness, drowsiness and cough. [95]
*''Sannipataja jwara'' in which vitiated ''[[pitta]]'' predominates over the other two ''[[dosha]]s'' presents with the following signs and symptoms – blood in stool and urine, burning sensation, vomiting, ''arati'' (disliking for doing any work), giddiness, drowsiness and cough. [95]
*''Sannipataja jwara'' in which vitiated ''kapha'' predominates over the other two ''doshas'' presents with the following signs and symptoms – laziness, anorexia, nausea, burning sensation, vomiting, ''arati'' (restlessness), giddiness, drowsiness and cough. [96]
*''Sannipataja jwara'' in which vitiated ''[[kapha]]'' predominates over the other two ''[[dosha]]s'' presents with the following signs and symptoms – laziness, anorexia, nausea, burning sensation, vomiting, ''arati'' (restlessness), giddiness, drowsiness and cough. [96]
*''Sannipataja jwara'' in which vitiated ''kapha'' is excessively vitiated, ''pitta'' moderately vitiated and ''vata'' is less vitiated presents with the following clinical features – coryza, vomiting, laziness, drowsiness, anorexia and weak digestion. [97]
*''Sannipataja jwara'' in which vitiated ''[[kapha]]'' is excessively vitiated, ''[[pitta]]'' moderately vitiated and ''[[vata]]'' is less vitiated presents with the following clinical features – coryza, vomiting, laziness, drowsiness, anorexia and weak digestion. [97]
*''Sannipataja jwara'' in which vitiated ''pitta'' is excessively vitiated, ''kapha'' moderately vitiated and ''vata'' is less vitiated presents with the following clinical features – yellowish discoloration of urine and eyes, burning sensation, thirst, giddiness and anorexia. [98]
*''Sannipataja jwara'' in which vitiated ''[[pitta]]'' is excessively vitiated, ''[[kapha]]'' moderately vitiated and ''[[vata]]'' is less vitiated presents with the following clinical features – yellowish discoloration of urine and eyes, burning sensation, thirst, giddiness and anorexia. [98]
*''Sannipataja jwara'' in which vitiated ''vata'' is excessively vitiated, ''kapha'' moderately vitiated and ''pitta'' is less vitiated presents with the following clinical features – headache, trembling, breathlessness, delirium, vomiting and anorexia. [99]
*''Sannipataja jwara'' in which vitiated ''[[vata]]'' is excessively vitiated, ''[[kapha]]'' moderately vitiated and ''[[pitta]]'' is less vitiated presents with the following clinical features – headache, trembling, breathlessness, delirium, vomiting and anorexia. [99]
*''Sannipataja jwara'' in which vitiated ''kapha'' is excessively vitiated, ''vata'' moderately vitiated and ''pitta'' is less vitiated presents with the following clinical features – coldness, heaviness, drowsiness, delirium and excessive pain in bones as well as head. [100]
*''Sannipataja jwara'' in which vitiated ''[[kapha]]'' is excessively vitiated, ''[[vata]]'' moderately vitiated and ''[[pitta]]'' is less vitiated presents with the following clinical features – coldness, heaviness, drowsiness, delirium and excessive pain in bones as well as head. [100]
*''Sannipataja jwara'' in which vitiated ''vata'' is excessively vitiated, ''pitta'' moderately vitiated and ''kapha'' is less vitiated presents with the following clinical features – dyspnoea, cough, coryza, dryness of the mouth and excessive pain in the flanks. [101]
*''Sannipataja jwara'' in which vitiated ''[[vata]]'' is excessively vitiated, ''[[pitta]]'' moderately vitiated and ''[[kapha]]'' is less vitiated presents with the following clinical features – dyspnoea, cough, coryza, dryness of the mouth and excessive pain in the flanks. [101]
*''Sannipataja jwara'' in which vitiated ''pitta'' is excessively vitiated, ''vata'' moderately vitiated and ''kapha'' is less vitiated presents with the following clinical features – diarrhea, weak digestion, thirst, burning sensation, anorexia and giddiness. [102]
*''Sannipataja jwara'' in which vitiated ''[[pitta]]'' is excessively vitiated, ''[[vata]]'' moderately vitiated and ''[[kapha]]'' is less vitiated presents with the following clinical features – diarrhea, weak digestion, thirst, burning sensation, anorexia and giddiness. [102]
*In ''sannipataja jwara'' with all the three ''doshas'' vitiated to the same extent, following signs and symptoms are observed:
*In ''sannipataja jwara'' with all the three ''[[dosha]]s'' vitiated to the same extent, following signs and symptoms are observed:
**Patient has feeling of burning sensation sometimes and sometimes feeling of cold
**Patient has feeling of burning sensation sometimes and sometimes feeling of cold
**Pain in the bones, joints and head
**Pain in the bones, joints and head
**Swaying movements of head, thirst, sleeplessness and pain in the cardiac region
**Swaying movements of head, thirst, sleeplessness and pain in the cardiac region
**Sweat, urine and stool reduced in amount with delayed evacuation.
**Sweat, urine and stool reduced in amount with delayed evacuation.
**Body is not excessively emaciated (due to accumulated ''dosha'')
**Body is not excessively emaciated (due to accumulated ''[[dosha]]'')
**Constant ''kujana'' (cooing sound)
**Constant ''kujana'' (cooing sound)
**Urticaria and bluish – black or reddish circular patches appear on the skin
**Urticaria and bluish – black or reddish circular patches appear on the skin
**Inflammation of ''srotasa''
**Inflammation of ''srotasa''
**Heaviness in the abdomen
**Heaviness in the abdomen
**The ''doshas'' undergo ''paka'' after a very long time (conversion into the healthy state of the ''doshas'' do not occur early). [103-109]
**The ''[[dosha]]s'' undergo ''paka'' after a very long time (conversion into the healthy state of the ''[[dosha]]s'' do not occur early). [103-109]
</div>
=== Prognosis of ''sannipata jwara'' ===
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दोषे विबद्धे नष्टेऽग्नौ सर्वसम्पूर्णलक्षणः||१०९||
दोषे विबद्धे नष्टेऽग्नौ सर्वसम्पूर्णलक्षणः||१०९||
संसर्गसन्निपातानां तया चोक्तं स्वलक्षणम्|१११|
संसर्गसन्निपातानां तया चोक्तं स्वलक्षणम्|१११|
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dōṣē vibaddhē naṣṭē'gnau sarvasampūrṇalakṣaṇaḥ||109||
dōṣē vibaddhē naṣṭē'gnau sarvasampūrṇalakṣaṇaḥ||109||
saMsargasannipAtAnAM tayA coktaM svalakShaNam|111|
saMsargasannipAtAnAM tayA coktaM svalakShaNam|111|
</div></div>
<div style="text-align:justify;">
If there is obstruction (or non – elimination) of the ''[[dosha]]'', the ''agnis'' are completely destroyed and if all the signs and symptoms are fully manifested, then ''sannipata jwara'' is incurable; otherwise it is treatable with difficulty.
The clinical features of ''jwaras'' caused by the individual ''[[dosha]]s [[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]
</div>
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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आगन्तुरष्टमो यस्तु स निर्दिष्टश्चतुर्विधः||१११||
आगन्तुरष्टमो यस्तु स निर्दिष्टश्चतुर्विधः||१११||
अभिघाताभिषङ्गाभ्यामभिचाराभिशापतः|
अभिघाताभिषङ्गाभ्यामभिचाराभिशापतः|
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āganturaṣṭamō yastu sa nirdiṣṭaścaturvidhaḥ||111||
āganturaṣṭamō yastu sa nirdiṣṭaścaturvidhaḥ||111||
abhighAtAbhiSha~ggAbhyAmabhicArAbhishApataH|
abhighAtAbhiSha~ggAbhyAmabhicArAbhishApataH|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== ''Abhighataja jwara'' (due to injury or trauma) ===
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शस्त्रलोष्टकशाकाष्ठमुष्ट्यरत्नितलद्विजैः||११२||
शस्त्रलोष्टकशाकाष्ठमुष्ट्यरत्नितलद्विजैः||११२||
सव्यथाशोफवैवर्ण्यं करोति सरुजं ज्वरम्|११४|
सव्यथाशोफवैवर्ण्यं करोति सरुजं ज्वरम्|११४|
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śastralōṣṭakaśākāṣṭhamuṣṭyaratnitaladvijaiḥ||112||
śastralōṣṭakaśākāṣṭhamuṣṭyaratnitaladvijaiḥ||112||
savyathAshophavaivarNyaM karoti sarujaM jvaram|114|
savyathAshophavaivarNyaM karoti sarujaM jvaram|114|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
=== ''Abhishangaja, abhishapaja'' and ''abhicharaja jwara'' ===
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कामशोकभयक्रोधैरभिषक्तस्य यो ज्वरः||११४||
कामशोकभयक्रोधैरभिषक्तस्य यो ज्वरः||११४||
हेत्वौषधविशिष्टाश्च भवन्त्यागन्तवो ज्वराः|१२९|
हेत्वौषधविशिष्टाश्च भवन्त्यागन्तवो ज्वराः|१२९|
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kāmaśōkabhayakrōdhairabhiṣaktasya yō jvaraḥ||114||
kāmaśōkabhayakrōdhairabhiṣaktasya yō jvaraḥ||114||
hētvauṣadhaviśiṣṭāśca bhavantyāgantavō jvarāḥ|129|
hētvauṣadhaviśiṣṭāśca bhavantyāgantavō jvarāḥ|129|
</div></div>
'''''Abhishangaja jwara''''': ''Jwara'' caused by the affliction of passion, grief, fear, anger and evil spirits including germs is called ''abhishangaja jwara''. ''Vata'' gets aggravated by passion, grief and fear, while pitta is aggravated by anger and all the three ''doshas'' are afflicted by ''bhootas'' (evil spirits or germs). Simultaneously, the signs and symptoms of the respective type of ''bhoota'' are described here. In the ''bhutadhikara'' section, the characteristic features of eight types of ''bhoota'' are described.
<div style="text-align:justify;">
'''''Abhishangaja jwara''''': ''Jwara'' caused by the affliction of passion, grief, fear, anger and evil spirits including germs is called ''abhishangaja jwara''. ''[[Vata]]'' gets aggravated by passion, grief and fear, while [[pitta]] is aggravated by anger and all the three ''[[dosha]]s'' are afflicted by ''bhootas'' (evil spirits or germs). Simultaneously, the signs and symptoms of the respective type of ''bhoota'' are described here. In the ''bhutadhikara'' section, the characteristic features of eight types of ''bhoota'' are described.
Some ''acharyas'' opine that the ''jwara'' caused by the contact of the poisonous air of the toxic plants and other such toxins is called ''abhishangaja jwara''. This type of ''jwara'' gets cured by the administration of antidotes of this poison.
Some ''acharyas'' opine that the ''jwara'' caused by the contact of the poisonous air of the toxic plants and other such toxins is called ''abhishangaja jwara''. This type of ''jwara'' gets cured by the administration of antidotes of this poison.
The specific features of ''kama'' etc. as described in the context of ''jwara'' are also applicable to other diseases caused by these factors (as ''unmada'' etc.).
The specific features of ''kama'' etc. as described in the context of ''jwara'' are also applicable to other diseases caused by these factors (as ''unmada'' etc.).
In ''kama jwara'' etc. the mind is first afflicted by passion etc. but the ''jwara'' does not manifest until the ''doshas'' as ''vata, pitta, kapha'' of the body are not vitiated. Similarly, the vitiation of the ''doshas'' in the body also does not gain enough strength to produce ''jwara'' unless the mind is afflicted by these factors (''kama, chinta'' etc.)
In ''kama jwara'' etc. the mind is first afflicted by passion etc. but the ''jwara'' does not manifest until the ''[[dosha]]s'' as ''[[vata]], [[pitta]], [[kapha]]'' of the body are not vitiated. Similarly, the vitiation of the ''[[dosha]]s'' in the body also does not gain enough strength to produce ''jwara'' unless the mind is afflicted by these factors (''kama, chinta'' etc.)
The ''jwara'' caused by external causes are at first independent but later they get mixed up with the signs and symptoms of ''nija jwara'' (endogenous fevers). However, these ''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]
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=== General patho-physiology of ''jwara'' ===
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संसृष्टाः सन्निपतिताः पृथग्वा कुपिता मलाः||१२९||
संसृष्टाः सन्निपतिताः पृथग्वा कुपिता मलाः||१२९||
भवत्यत्युष्णसर्वाङ्गो ज्वरितस्तेन चोच्यते|१३२|
भवत्यत्युष्णसर्वाङ्गो ज्वरितस्तेन चोच्यते|१३२|
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saṁsr̥ṣṭāḥ sannipatitāḥ pr̥thagvā kupitā malāḥ||129||
saṁsr̥ṣṭāḥ sannipatitāḥ pr̥thagvā kupitā malāḥ||129||
bhavatyatyuShNasarvA~ggo jvaritastena cocyate|132|
bhavatyatyuShNasarvA~ggo jvaritastena cocyate|132|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Cause of lack of sweating ===
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स्रोतसां सन्निरुद्धत्वात् स्वेदं ना नाधिगच्छति||१३२||
स्रोतसां सन्निरुद्धत्वात् स्वेदं ना नाधिगच्छति||१३२||
स्वस्थानात् प्रच्युते चाग्नौ प्रायशस्तरुणेज्वरे|१३३|
स्वस्थानात् प्रच्युते चाग्नौ प्रायशस्तरुणेज्वरे|१३३|
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srōtasāṁ sanniruddhatvāt svēdaṁ nā nādhigacchati||132||
srōtasāṁ sanniruddhatvāt svēdaṁ nā nādhigacchati||132||
svasthAnAt pracyute cAgnau prAyashastaruNejvare|133|
svasthAnAt pracyute cAgnau prAyashastaruNejvare|133|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Clinical features of ''Ama Jwara'' (first stage of ''jwara'') ===
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अरुचिश्चाविपाकश्च गुरुत्वमुदरस्य च||१३३||
अरुचिश्चाविपाकश्च गुरुत्वमुदरस्य च||१३३||
न विड् जीर्णा न च ग्लानिर्ज्वरस्यामस्य लक्षणम्|
न विड् जीर्णा न च ग्लानिर्ज्वरस्यामस्य लक्षणम्|
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aruciścāvipākaśca gurutvamudarasya ca||133||
aruciścāvipākaśca gurutvamudarasya ca||133||
na viD jIrNA na ca glAnirjvarasyAmasya lakShaNam|
na viD jIrNA na ca glAnirjvarasyAmasya lakShaNam|
</div></div>
<div style="text-align:justify;">
The ''ama jwara'' (first stage of ''jwara'') presents with the following clinical features –
The ''ama jwara'' (first stage of ''jwara'') presents with the following clinical features –
*Anorexia, indigestion, heaviness in the stomach
*Anorexia, indigestion, heaviness in the stomach
*Feeling of heaviness and accumulation of impurities in cardiac region, drowsiness and laziness
*Feeling of heaviness and accumulation of impurities in cardiac region, drowsiness and laziness
*Continuous, fever with acute onset.
*Continuous, fever with acute onset.
*Non-elimination of the dosha along with mala or waste products
*Non-elimination of the [[dosha]] along with [[mala]] or waste products
*Excess salivation, nausea, loss of appetite, and tastelessness in the mouth
*Excess salivation, nausea, loss of appetite, and tastelessness in the mouth
*Rigidity, numbness and heaviness of the body
*Rigidity, numbness and heaviness of the body
*Improper formation of stool
*Improper formation of stool
*Absence of muscle emaciation [133-136]
*Absence of muscle emaciation [133-136]
</div>
=== Clinical features of ''pachyamana jwara'' (second stage of ''jwara'') ===
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ज्वरवेगोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||१३६||
ज्वरवेगोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||१३६||
मलप्रवृत्तिरुत्क्लेशः पच्यमानस्य लक्षणम्|१३७|
मलप्रवृत्तिरुत्क्लेशः पच्यमानस्य लक्षणम्|१३७|
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jvaravēgō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||136||
jvaravēgō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||136||
malapravRuttirutkleshaH pacyamAnasya lakShaNam|137|
malapravRuttirutkleshaH pacyamAnasya lakShaNam|137|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Clinical features of ''nirama jwara'' (third stage of ''jwara'') ===
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क्षुत् क्षामता लघुत्वं च गात्राणां ज्वरमार्दवम्||१३७||
क्षुत् क्षामता लघुत्वं च गात्राणां ज्वरमार्दवम्||१३७||
दोषप्रवृत्तिरष्टाहो निरामज्वरलक्षणम्|१३८|
दोषप्रवृत्तिरष्टाहो निरामज्वरलक्षणम्|१३८|
<div class="mw-collapsible-content">
kṣut kṣāmatā laghutvaṁ ca gātrāṇāṁ jvaramārdavam||137||
kṣut kṣāmatā laghutvaṁ ca gātrāṇāṁ jvaramārdavam||137||
doShapravRuttiraShTAho nirAmajvaralakShaNam|138|
doShapravRuttiraShTAho nirAmajvaralakShaNam|138|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
=== Precaution at initial stage of ''jwara'' ===
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नवज्वरे दिवास्वप्नस्नानाभ्यङ्गान्नमैथुनम्||१३८||
नवज्वरे दिवास्वप्नस्नानाभ्यङ्गान्नमैथुनम्||१३८||
क्रोधप्रवातव्यायामान् कषायांश्च विवर्जयेत्|१३९|
क्रोधप्रवातव्यायामान् कषायांश्च विवर्जयेत्|१३९|
<div class="mw-collapsible-content">
navajvarē divāsvapnasnānābhyaṅgānnamaithunam||138||
navajvarē divāsvapnasnānābhyaṅgānnamaithunam||138||
krodhapravAtavyAyAmAn kaShAyAMshca vivarjayet|139|
krodhapravAtavyAyAmAn kaShAyAMshca vivarjayet|139|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Contra-indications of ''langhana'' (fasting) ===
<div class="mw-collapsible mw-collapsed">
ज्वरे लङ्घनमेवादावुपदिष्टमृते ज्वरात्||१३९||
ज्वरे लङ्घनमेवादावुपदिष्टमृते ज्वरात्||१३९||
क्षयानिलभयक्रोधकामशोकश्रमोद्भवात् |१४०|
क्षयानिलभयक्रोधकामशोकश्रमोद्भवात् |१४०|
<div class="mw-collapsible-content">
jvarē laṅghanamēvādāvupadiṣṭamr̥tē jvarāt||139||
jvarē laṅghanamēvādāvupadiṣṭamr̥tē jvarāt||139||
kShayAnilabhayakrodhakAmashokashramodbhavAt |140|
kShayAnilabhayakrodhakAmashokashramodbhavAt |140|
</div></div>
''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]
<div style="text-align:justify;">
''[[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]
</div>
=== Benefits of ''[[langhana]]'' (fasting) in ''jwara'' ===
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लङ्घनेन क्षयं नीते दोषे सन्धुक्षितेऽनले||१४०||
लङ्घनेन क्षयं नीते दोषे सन्धुक्षितेऽनले||१४०||
बलाधिष्ठानमारोग्यं यदर्थोऽयं क्रियाक्रमः|१४२|
बलाधिष्ठानमारोग्यं यदर्थोऽयं क्रियाक्रमः|१४२|
<div class="mw-collapsible-content">
laṅghanēna kṣayaṁ nītē dōṣē sandhukṣitē'nalē||140||
laṅghanēna kṣayaṁ nītē dōṣē sandhukṣitē'nalē||140||
balAdjhiShThAnamArogyaM yadartho~ayaM kriyAkramaH|142|
balAdjhiShThAnamArogyaM yadartho~ayaM kriyAkramaH|142|
</div></div>
<div style="text-align:justify;">
''[[Langhana]]'' reduces the aggravated ''[[dosha]]'' and stimulates the ''agni'', as a result of which ''jwara'' subsides and the body becomes light and the person’s appetite is restored.
''Langhana'' reduces the aggravated ''dosha'' and stimulates the ''agni'', as a result of which ''jwara'' subsides and the body becomes light and the person’s appetite is restored.
''[[Langhana]]'' should be performed to the extent that it does not hamper the vitality 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]
</div>
=== Management principle of ''jwara'' ===
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लङ्घनं स्वेदनं कालो यवाग्वस्तिक्तको रसः||१४२||
लङ्घनं स्वेदनं कालो यवाग्वस्तिक्तको रसः||१४२||
पाचनान्यविपक्वानां दोषाणां तरुणे ज्वरे|१४३|
पाचनान्यविपक्वानां दोषाणां तरुणे ज्वरे|१४३|
<div class="mw-collapsible-content">
laṅghanaṁ svēdanaṁ kālō yavāgvastiktakō rasaḥ||142||
laṅghanaṁ svēdanaṁ kālō yavāgvastiktakō rasaḥ||142||
pAcanAnyavipakvAnAM doShANAM taruNe jvare|143|
pAcanAnyavipakvAnAM doShANAM taruNe jvare|143|
</div></div>
''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 ===
<div class="mw-collapsible mw-collapsed">
तृष्यते सलिलं चोष्णं दद्याद्वातकफज्वरे ||१४३||
तृष्यते सलिलं चोष्णं दद्याद्वातकफज्वरे ||१४३||
स्रोतसां शोधनं बल्यं रुचिस्वेदकरं शिवम्|१४५|
स्रोतसां शोधनं बल्यं रुचिस्वेदकरं शिवम्|१४५|
<div class="mw-collapsible-content">
tr̥ṣyatē salilaṁ cōṣṇaṁ dadyādvātakaphajvarē ||143||
tr̥ṣyatē salilaṁ cōṣṇaṁ dadyādvātakaphajvarē ||143||
srotasAM shodhanaM balyaM rucisvedakaraM shivam|145|
srotasAM shodhanaM balyaM rucisvedakaraM shivam|145|
</div></div>
<div style="text-align:justify;">
If the patient of ''jwara'' feels thirsty, he should be given :
If the patient of ''jwara'' feels thirsty, he should be given :
Hot water to drink if the ''jwara'' caused by aggravation of ''vata'' and ''kapha'';
Hot water to drink if the ''jwara'' caused by aggravation of ''[[vata]]'' and ''[[kapha]]'';
If the ''jwara'' is ''pitta'' dominant or if it occurs as a result of intake of alcohol, water boiled with bitter drugs and then cooled, is given.
If the ''jwara'' is ''[[pitta]]'' dominant or if it occurs as a result of intake of alcohol, water boiled with bitter drugs and then cooled, is given.
Both of these are ''dipana'', (digestive stimulant), ''pachana'' (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]
</div>
=== ''Shadanga paniya'' ===
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मुस्तपर्पटकोशीरचन्दनोदीच्यनागरैः||१४५||
मुस्तपर्पटकोशीरचन्दनोदीच्यनागरैः||१४५||
शृतशीतं जलं दद्यात् पिपासाज्वरशान्तये|१४६|
शृतशीतं जलं दद्यात् पिपासाज्वरशान्तये|१४६|
<div class="mw-collapsible-content">
mustaparpaṭakōśīracandanōdīcyanāgaraiḥ||145||
mustaparpaṭakōśīracandanōdīcyanāgaraiḥ||145||
shRutashItaM jalaM dadyAt pipAsAjvarashAntaye|146|
shRutashItaM jalaM dadyAt pipAsAjvarashAntaye|146|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Indication of ''[[vamana]]'' (therapeutic emesis) ===
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कफप्रधानानुत्क्लिष्टान् दोषानामाशयस्थितान्||१४६||
कफप्रधानानुत्क्लिष्टान् दोषानामाशयस्थितान्||१४६||
बुद्ध्वा ज्वरकरान् काले वम्यानां वमनैर्हरेत्|१४७|
बुद्ध्वा ज्वरकरान् काले वम्यानां वमनैर्हरेत्|१४७|
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kaphapradhānānutkliṣṭān dōṣānāmāśayasthitān||146||
kaphapradhānānutkliṣṭān dōṣānāmāśayasthitān||146||
buddhvA jvarakarAn kAle vamyAnAM vamanairharet|147|
buddhvA jvarakarAn kAle vamyAnAM vamanairharet|147|
</div></div>
<div style="text-align:justify;">
If the ''jwara'' is predominantly caused by vitiated ''[[kapha dosha]]'', located in the ''amashaya'' (stomach) and is in a stage of ''utklesha'' (in a stage of being on the verge of coming out of its place), then it should be eliminated by the administration of emetics.
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]
</div>
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) ===
<div class="mw-collapsible mw-collapsed">
अनुपस्थितदोषाणां वमनं तरुणेज्वरे||१४७||
अनुपस्थितदोषाणां वमनं तरुणेज्वरे||१४७||
दोषाः फलानामामानां स्वरसा इव सात्ययाः|१४९|
दोषाः फलानामामानां स्वरसा इव सात्ययाः|१४९|
<div class="mw-collapsible-content">
anupasthitadōṣāṇāṁ vamanaṁ taruṇējvarē||147||
anupasthitadōṣāṇāṁ vamanaṁ taruṇējvarē||147||
doShAH phalAnAmAmAnAM svarasA iva sAtyayAH|149|
doShAH phalAnAmAmAnAM svarasA iva sAtyayAH|149|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
=== Post ''[[vamana]]'' protocol ===
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वमितं लङ्घितं काले यवागूभिरुपाचरेत्||१४९||
वमितं लङ्घितं काले यवागूभिरुपाचरेत्||१४९||
ज्वरघ्न्यो ज्वरसात्म्यत्वात्तस्मात् पेयाभिरादितः||१५३||
ज्वरघ्न्यो ज्वरसात्म्यत्वात्तस्मात् पेयाभिरादितः||१५३||
<div class="mw-collapsible-content">
vamitaṁ laṅghitaṁ kālē yavāgūbhirupācarēt||149||
vamitaṁ laṅghitaṁ kālē yavāgūbhirupācarēt||149||
jvaraghnyo jvarasAtmyatvAttasmAt peyAbhirAditaH||153||
jvaraghnyo jvarasAtmyatvAttasmAt peyAbhirAditaH||153||
</div></div>
<div style="text-align:justify;">
The patient after being given emesis and kept on fasting should be administered ''yavagu'' (a gruel preparation) prepared by boiling with the drugs mentioned further, in appropriate time. Before administering ''yavagu'', the patient should be given ''manda'' (extremely thin gruel). This should be continued by the wise for either six days or till the ''jwara'' becomes mild.
The patient after being given emesis and kept on fasting should be administered ''yavagu'' (a gruel preparation) prepared by boiling with the drugs mentioned further, in appropriate time. Before administering ''yavagu'', the patient should be given ''manda'' (extremely thin gruel). This should be continued by the wise for either six days or till the ''jwara'' becomes mild.
As the addition of ''samidha'' (fuel) accelerates the fire, similarly the digestive fire also becomes stimulated by the consumption of gruels. These gruels are inherently light for digestion and they further stimulate the ''agni'' due to the addition of drugs to it.
As the addition of ''samidha'' (fuel) accelerates the fire, similarly the digestive fire also becomes stimulated by the consumption of gruels. These gruels are inherently light for digestion and they further stimulate the ''agni'' due to the addition of drugs to it.
These help in ''anulomana'' (elimination through the downward movement) of flatus, urine, feces and ''doshas''. Being liquid and hot they also cause sweating. Being watery in nature they also alleviate thirst. Due to their nourishing property as a diet, they sustain the ''prana'' (vitality) and cause lightness of the body because of their laxative property. They bring down the ''jwara'' and are also wholesome for the ''jwara'' patients.
These help in ''anulomana'' (elimination through the downward movement) of flatus, urine, feces and ''[[dosha]]s''. Being liquid and hot they also cause sweating. Being watery in nature they also alleviate thirst. Due to their nourishing property as a diet, they sustain the ''prana'' (vitality) and cause lightness of the body because of their laxative property. They bring down the ''jwara'' and are also wholesome for the ''jwara'' patients.
In view of above, a ''jwara'' patient should in the beginning be administered with different types of ''peya'' (thin gruels). [149-153]
In view of above, a ''jwara'' patient should in the beginning be administered with different types of ''peya'' (thin gruels). [149-153]
</div>
=== Contra-indications of ''yavagu'' ===
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ज्वरानुपचरेद्धीमानृते मद्यसमुत्थितात्|
ज्वरानुपचरेद्धीमानृते मद्यसमुत्थितात्|
ऊर्ध्वगे रक्तपित्ते च यवागूर्न हिता ज्वरे|१५५|
ऊर्ध्वगे रक्तपित्ते च यवागूर्न हिता ज्वरे|१५५|
<div class="mw-collapsible-content">
jvarānupacarēddhīmānr̥tē madyasamutthitāt|
jvarānupacarēddhīmānr̥tē madyasamutthitāt|
Urdhvage raktapitte ca yavAgUrna hitA jvare|155|
Urdhvage raktapitte ca yavAgUrna hitA jvare|155|
</div></div>
However, these gruels are contraindicated in the fevers caused by intake of alcohol, in alcoholism, for persons addicted to alcohol, in summer seasons, when there is predominance of ''pitta'' and ''kapha'' and in ''urdhwaga rakta–pitta'' (a disease characterized by bleeding from the different upper channels of the body).[154]
<div style="text-align:justify;">
However, these gruels are contraindicated in the fevers caused by intake of alcohol, in alcoholism, for persons addicted to alcohol, in summer seasons, when there is predominance of ''[[pitta]]'' and ''[[kapha]]'' and in ''urdhwaga rakta–pitta'' (a disease characterized by bleeding from the different upper channels of the body).[154]
</div>
<div class="mw-collapsible mw-collapsed">
तत्र तर्पणमेवाग्रे प्रयोज्यं लाजसक्तुभिः||१५५||
तत्र तर्पणमेवाग्रे प्रयोज्यं लाजसक्तुभिः||१५५||
ज्वरापहैः फलरसैर्युक्तं समधुशर्करम्|१५६|
ज्वरापहैः फलरसैर्युक्तं समधुशर्करम्|१५६|
<div class="mw-collapsible-content">
tatra tarpaṇamēvāgrē prayōjyaṁ lājasaktubhiḥ||155||
tatra tarpaṇamēvāgrē prayōjyaṁ lājasaktubhiḥ||155||
jvarApahaiH phalarasairyuktaM samadhusharkaram|156|
jvarApahaiH phalarasairyuktaM samadhusharkaram|156|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Guidelines for diet, mouth cleansing and tooth brush ===
<div class="mw-collapsible mw-collapsed">
ततः सात्म्यबलापेक्षी भोजयेज्जीर्णतर्पणम्||१५६||
ततः सात्म्यबलापेक्षी भोजयेज्जीर्णतर्पणम्||१५६||
मस्त्विक्षुरसमद्याद्यैर्यथाहारमवाप्नुयात्|१६०|
मस्त्विक्षुरसमद्याद्यैर्यथाहारमवाप्नुयात्|१६०|
<div class="mw-collapsible-content">
tataḥ sātmyabalāpēkṣī bhōjayējjīrṇatarpaṇam||156||
tataḥ sātmyabalāpēkṣī bhōjayējjīrṇatarpaṇam||156||
mastvikShurasamadyAdyairyathAhAramavApnuyAt|160|
mastvikShurasamadyAdyairyathAhAramavApnuyAt|160|
</div></div>
Depending upon the habituation (''satmya'') and the strength of the patient, after digestion of the ''tarpana'', patient is administered thin soup of ''mudga'' (green gram) or meat of wild animals. During food time, the patient’s teeth should be cleaned with the twig of plants, which should be such that their taste can counteract the taste of the patient’s mouth and is relishing to the patient. Such kind of cleaning of teeth makes the patient feel freshness in his mouth, develops appetite for food and drinks and becomes capable of appreciating the taste of food to be taken. The mouth should be cleaned several times with water after cleaning with twigs. Thereafter the patient should be given ''mastu'' (thin butter milk), sugarcane juice, alcoholic drinks etc. with suitable and appropriate diet.[156-159]
<div style="text-align:justify;">
Depending upon the habituation (''[[satmya]]'') and the strength of the patient, after digestion of the ''tarpana'', patient is administered thin soup of ''mudga'' (green gram) or meat of wild animals. During food time, the patient’s teeth should be cleaned with the twig of plants, which should be such that their taste can counteract the taste of the patient’s mouth and is relishing to the patient. Such kind of cleaning of teeth makes the patient feel freshness in his mouth, develops appetite for food and drinks and becomes capable of appreciating the taste of food to be taken. The mouth should be cleaned several times with water after cleaning with twigs. Thereafter the patient should be given ''mastu'' (thin butter milk), sugarcane juice, alcoholic drinks etc. with suitable and appropriate diet.[156-159]
</div>
<div class="mw-collapsible mw-collapsed">
पाचनं शमनीयं वा कषायं पाययेद्भिषक्||१६०||
पाचनं शमनीयं वा कषायं पाययेद्भिषक्||१६०||
ज्वरितं षडहेऽतीते लघ्वन्नप्रतिभोजितम्|१६१|
ज्वरितं षडहेऽतीते लघ्वन्नप्रतिभोजितम्|१६१|
<div class="mw-collapsible-content">
pācanaṁ śamanīyaṁ vā kaṣāyaṁ pāyayēdbhiṣak||160||
pācanaṁ śamanīyaṁ vā kaṣāyaṁ pāyayēdbhiṣak||160||
jvaritaM ShaDahe~atIte laghvannapratibhojitam|161|
jvaritaM ShaDahe~atIte laghvannapratibhojitam|161|
</div></div>
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]
<div style="text-align:justify;">
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 ''[[dosha]]s''). [160-161]
</div>
=== Contra-indications of ''kashaya'' (astringents) ===
<div class="mw-collapsible mw-collapsed">
स्तभ्यन्ते न विपच्यन्ते कुर्वन्ति विषमज्वरम्||१६१||
स्तभ्यन्ते न विपच्यन्ते कुर्वन्ति विषमज्वरम्||१६१||
यः कषायकषायः स्यात् स वर्ज्यस्तरुणज्वरे|१६३|
यः कषायकषायः स्यात् स वर्ज्यस्तरुणज्वरे|१६३|
<div class="mw-collapsible-content">
stabhyantē na vipacyantē kurvanti viṣamajvaram||161||
stabhyantē na vipacyantē kurvanti viṣamajvaram||161||
yaH kaShAyakaShAyaH syAt sa varjyastaruNajvare|163|
yaH kaShAyakaShAyaH syAt sa varjyastaruNajvare|163|
</div></div>
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]
<div style="text-align:justify;">
If, decoctions of astringent drugs are administered to the patient in ''taruna jwara'' (first stage of ''jwara'') stage, then the ''[[dosha]]s'' 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]
</div>
=== ''Yusha'' (soup) indications ===
<div class="mw-collapsible mw-collapsed">
यूषैरम्लैरनम्लैर्वा जाङ्गलैर्वा रसैर्हितैः||१६३||
यूषैरम्लैरनम्लैर्वा जाङ्गलैर्वा रसैर्हितैः||१६३||
दशाहं यावदश्नीयाल्लघ्वन्नं ज्वरशान्तये|१६४|
दशाहं यावदश्नीयाल्लघ्वन्नं ज्वरशान्तये|१६४|
<div class="mw-collapsible-content">
yūṣairamlairanamlairvā jāṅgalairvā rasairhitaiḥ||163||
yūṣairamlairanamlairvā jāṅgalairvā rasairhitaiḥ||163||
dashAhaM yAvadashnIyAllaghvannaM jvarashAntaye|164|
dashAhaM yAvadashnIyAllaghvannaM jvarashAntaye|164|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Indications and contra-indications of ''ghrita'' ===
<div class="mw-collapsible mw-collapsed">
अत ऊर्ध्वं कफे मन्दे वातपित्तोत्तरे ज्वरे||१६४||
अत ऊर्ध्वं कफे मन्दे वातपित्तोत्तरे ज्वरे||१६४||
बलं ह्यलं निग्रहाय दोषाणां, बलकृच्च तत् |१६७|
बलं ह्यलं निग्रहाय दोषाणां, बलकृच्च तत् |१६७|
<div class="mw-collapsible-content">
ata ūrdhvaṁ kaphē mandē vātapittōttarē jvarē||164||
ata ūrdhvaṁ kaphē mandē vātapittōttarē jvarē||164||
balaM hyalaM nigrahAya doShANAM, balakRucca tat |167|
balaM hyalaM nigrahAya doShANAM, balakRucca tat |167|
</div></div>
<div style="text-align:justify;">
Thereafter, in case of less aggravation of ''[[kapha dosha]]'' and excess aggravation of ''[[vata]]'' and ''[[pitta dosha]]'', and in whom the ''[[dosha]]'' have reached the ''pakva'' stage (having no ''ama ansha''), ghee should be given to the patients. It is like ''amrita'' (nectar) for them.
Ghee should not be given to ''jwara'' patient even after the tenth day, if the ''[[kapha dosha]]'' still predominates and if the signs and symptoms of well accomplished ''[[langhana]]'' have not appeared. In such case ''kashaya'' should be administered to the patient till the body becomes light.
Till the features of ''[[langhana]]'' appear in the body, the patient should be given light to digest food along with the meat soup of wild animals and birds. This destroys the strength of the ''[[dosha]]s'' and promotes the strength of the body. [164-167]
</div>
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 ===
<div class="mw-collapsible mw-collapsed">
दाहतृष्णापरीतस्य वातपित्तोत्तरं ज्वरम्||१६७||
दाहतृष्णापरीतस्य वातपित्तोत्तरं ज्वरम्||१६७||
बद्धप्रच्युतदोषं वा निरामं पयसा जयेत्|१६८|
बद्धप्रच्युतदोषं वा निरामं पयसा जयेत्|१६८|
<div class="mw-collapsible-content">
dāhatr̥ṣṇāparītasya vātapittōttaraṁ jvaram||167||
dāhatr̥ṣṇāparītasya vātapittōttaraṁ jvaram||167||
baddhapracyutadoShaM vA nirAmaM payasA jayet|168|
baddhapracyutadoShaM vA nirAmaM payasA jayet|168|
</div></div>
<div style="text-align:justify;">
A patient with the following conditions should be given milk in ''nirama'' stage in the body –
A patient with the following conditions should be given milk in ''nirama'' stage in the body –
*When the patient has excessive burning sensation and thirst
*When the patient has excessive burning sensation and thirst
*If ''vata'' and ''pitta dosha'' predominate the patient is suffering from ''jwara''
*If ''[[vata]]'' and ''[[pitta dosha]]'' predominate the patient is suffering from ''jwara''
*If the dosha are either ''baddha'' (static), or ''prachyuta'' (slightly dislodged). [167]
*If the [[dosha]] are either ''baddha'' (static), or ''prachyuta'' (slightly dislodged). [167]
</div>
=== Indication of ''[[virechana]]'' ===
<div class="mw-collapsible mw-collapsed">
क्रियाभिराभिः प्रशमं न प्रयाति यदा ज्वरः||१६८||
क्रियाभिराभिः प्रशमं न प्रयाति यदा ज्वरः||१६८||
अक्षीणबलमांसाग्नेः शमयेत्तं विरेचनैः|१६९|
अक्षीणबलमांसाग्नेः शमयेत्तं विरेचनैः|१६९|
<div class="mw-collapsible-content">
kriyābhirābhiḥ praśamaṁ na prayāti yadā jvaraḥ||168||
kriyābhirābhiḥ praśamaṁ na prayāti yadā jvaraḥ||168||
akShINabalamAMsAgneH shamayettaM virecanaiH|169|
akShINabalamAMsAgneH shamayettaM virecanaiH|169|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
=== Indications of ''niruha'' (enema with decoction) ===
<div class="mw-collapsible mw-collapsed">
ज्वरक्षीणस्य न हितं वमनं न विरेचनम्||१६९||
ज्वरक्षीणस्य न हितं वमनं न विरेचनम्||१६९||
स्रंसनं त्रीन्मलान् बस्तिर्हरेत् पक्वाशयस्थितान्|१७२|
स्रंसनं त्रीन्मलान् बस्तिर्हरेत् पक्वाशयस्थितान्|१७२|
<div class="mw-collapsible-content">
jvarakṣīṇasya na hitaṁ vamanaṁ na virēcanam||169||
jvarakṣīṇasya na hitaṁ vamanaṁ na virēcanam||169||
sraMsanaM trInmalAn bastirharet pakvAshayasthitAn|172|
sraMsanaM trInmalAn bastirharet pakvAshayasthitAn|172|
</div></div>
<div style="text-align:justify;">
Neither ''[[vamana]]'' (emesis) nor ''[[virechana]]'' (purgation) is useful for patients emaciated by fever. It is thus desirable to remove their malas by the administration of milk or ''niruha'' (ununctuous type of medicated enema prepared by decoctions etc.)
''Niruha [[basti]]'' administered when the [[dosha]] are in ''paripakva'' stage immediately promotes the strength and the power of digestion, alleviates fever and causes happiness and brings relish for food.
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]
</div>
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) ===
<div class="mw-collapsible mw-collapsed">
ज्वरे पुराणे सङ्क्षीणे कफपित्ते दृढाग्नये||१७२||
ज्वरे पुराणे सङ्क्षीणे कफपित्ते दृढाग्नये||१७२||
रूक्षबद्धपुरीषाय प्रदद्यादनुवासनम्|१७३|
रूक्षबद्धपुरीषाय प्रदद्यादनुवासनम्|१७३|
<div class="mw-collapsible-content">
jvarē purāṇē saṅkṣīṇē kaphapittē dr̥ḍhāgnayē||172||
jvarē purāṇē saṅkṣīṇē kaphapittē dr̥ḍhāgnayē||172||
rUkShabaddhapurIShAya pradadyAdanuvAsanam|173|
rUkShabaddhapurIShAya pradadyAdanuvAsanam|173|
</div></div>
In chronic types of fever (''jirna jwara'') ''anuvasana'' type of ''basti'' (medicated enema with oils) should be given in the following conditions –
<div style="text-align:justify;">
*When ''kapha'' and ''pitta'' are alleviated
In chronic types of fever (''jirna jwara'') ''anuvasana'' type of ''[[basti]]'' (medicated enema with oils) should be given in the following conditions –
*When ''[[kapha]]'' and ''[[pitta]]'' are alleviated
*When there is strong power of digestion
*When there is strong power of digestion
*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]
</div>
=== Indications of ''murdha-virechana'' (nasal errhines) ===
<div class="mw-collapsible mw-collapsed">
गौरवे शिरसः शूले विबद्धेष्विन्द्रियेषु च||१७३||
गौरवे शिरसः शूले विबद्धेष्विन्द्रियेषु च||१७३||
जीर्णज्वरे रुचिकरं कुर्यान्मूर्धविरेचनम्|१७४|
जीर्णज्वरे रुचिकरं कुर्यान्मूर्धविरेचनम्|१७४|
<div class="mw-collapsible-content">
gauravē śirasaḥ śūlē vibaddhēṣvindriyēṣu ca||173||
gauravē śirasaḥ śūlē vibaddhēṣvindriyēṣu ca||173||
jIrNajvare rucikaraM kuryAnmUrdhavirecanam|174|
jIrNajvare rucikaraM kuryAnmUrdhavirecanam|174|
</div></div>
<div style="text-align:justify;">
''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]
</div>
=== Various external procedures ===
<div class="mw-collapsible mw-collapsed">
अभ्यङ्गांश्च प्रदेहांश्च परिषेकावगाहने||१७४||
अभ्यङ्गांश्च प्रदेहांश्च परिषेकावगाहने||१७४||
त्वङ्मात्रशेषा येषां च भवत्यागन्तुरन्वयः|१७७|
त्वङ्मात्रशेषा येषां च भवत्यागन्तुरन्वयः|१७७|
<div class="mw-collapsible-content">
abhyaṅgāṁśca pradēhāṁśca pariṣēkāvagāhanē||174||
abhyaṅgāṁśca pradēhāṁśca pariṣēkāvagāhanē||174||
tva~gmAtrasheShA yeShAM ca bhavatyAganturanvayaH|177|
tva~gmAtrasheShA yeShAM ca bhavatyAganturanvayaH|177|
</div></div>
<div style="text-align:justify;">
''Abhyanga'' (massage), ''pradeha'' (unguentum), ''parisheka'' (sprinkling of water), and ''avagahana'' (bathing) should be done in patients of ''jirna jwara'' (chronic fevers) considering the types of ''jwara'' with their hot and cold types. By these measures the ''bahirmargagata'' (located in the external tissues) ''jwara'' gets alleviated instantaneously. There is a feeling of ease in the body along with the promotion of strength and complexion.
''Abhyanga'' (massage), ''pradeha'' (unguentum), ''parisheka'' (sprinkling of water), and ''avagahana'' (bathing) should be done in patients of ''jirna jwara'' (chronic fevers) considering the types of ''jwara'' with their hot and cold types. By these measures the ''bahirmargagata'' (located in the external tissues) ''jwara'' gets alleviated instantaneously. There is a feeling of ease in the body along with the promotion of strength and complexion.
''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]
</div>
=== Various dietary articles used in treatment ===
<div class="mw-collapsible mw-collapsed">
इति क्रियाक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१७७||
इति क्रियाक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१७७||
यवाग्वोदनलाजार्थे ज्वरितानां ज्वरापहाः|१७९|
यवाग्वोदनलाजार्थे ज्वरितानां ज्वरापहाः|१७९|
<div class="mw-collapsible-content">
iti kriyākramaḥ siddhō jvaraghnaḥ samprakāśitaḥ||177||
iti kriyākramaḥ siddhō jvaraghnaḥ samprakāśitaḥ||177||
yavAgvodanalAjArthe jvaritAnAM jvarApahAH|179|
yavAgvodanalAjArthe jvaritAnAM jvarApahAH|179|
</div></div>
<div style="text-align:justify;">
Proper line of treatment for the alleviation of ''jwara'' has been described above, the ingredients used for therapies in accordance to the above stated line of treatment has been described further.
Proper line of treatment for the alleviation of ''jwara'' has been described above, the ingredients used for therapies in accordance to the above stated line of treatment has been described further.
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]
</div>
=== Ten types of ''yavagu'' (gruel) in ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
लाजपेयां सुखजरां पिप्पलीनागरैः शृताम्||१७९||
लाजपेयां सुखजरां पिप्पलीनागरैः शृताम्||१७९||
नागरामलकैः सिद्धां घृतभृष्टां ज्वरापहाम्|१८८|
नागरामलकैः सिद्धां घृतभृष्टां ज्वरापहाम्|१८८|
<div class="mw-collapsible-content">
lājapēyāṁ sukhajarāṁ pippalīnāgaraiḥ śr̥tām||179||
lājapēyāṁ sukhajarāṁ pippalīnāgaraiḥ śr̥tām||179||
nAgarAmalakaiH siddhAM ghRutabhRuShTAM jvarApahAm|188|
nAgarAmalakaiH siddhAM ghRutabhRuShTAM jvarApahAm|188|
</div></div>
<div style="text-align:justify;">
*The ''peya'' prepared with ''laja'' (fried paddy) and boiled with ''pippali'' and ''nagara'' is light to digest and should be given to the patient in the beginning of the ''jwara'' when the digestive power is reduced. However, it should be ascertained before administration that the patient is desirous for food before administration.
*The ''peya'' prepared with ''laja'' (fried paddy) and boiled with ''pippali'' and ''nagara'' is light to digest and should be given to the patient in the beginning of the ''jwara'' when the digestive power is reduced. However, it should be ascertained before administration that the patient is desirous for food before administration.
*If there is movement of bowel and the patient is desirous of sour things, then the ''peya'' described above should be made sour by adding ''dadima'' and should be given along with ''nagara''.
*If there is movement of bowel and the patient is desirous of sour things, then the ''peya'' described above should be made sour by adding ''dadima'' and should be given along with ''nagara''.
*''Peya'' boiled with ''bala, vrikshamla, kolamla, kalashi'' (''simha pucchi''), ''dhavani'' (''kantakari'') and ''bilva'' should be given to a patient suffering from ''jwara'' associated with sawing pain. (cutting pain).
*''Peya'' boiled with ''bala, vrikshamla, kolamla, kalashi'' (''simha pucchi''), ''dhavani'' (''kantakari'') and ''bilva'' should be given to a patient suffering from ''jwara'' associated with sawing pain. (cutting pain).
*''Peya'' prepared by boiling with ''nagara'' and ''amalaka'' fried with ghee and mixed with sugar is ''jwaraghna'' (alleviates ''jwara''). It should be given to a patient suffering from ''asweda'' (absence of sweating), ''anidra'' (sleeplessness) and ''trishna'' (morbid thirst). [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]
</div>
=== Indications of soup ===
<div class="mw-collapsible mw-collapsed">
मुद्गान्मसूरांश्चणकान् कुलत्थान् समकुष्टकान्||१८८||
मुद्गान्मसूरांश्चणकान् कुलत्थान् समकुष्टकान्||१८८||
यूषार्थे यूषसात्म्यानां ज्वरितानां प्रदापयेत्|१८९|
यूषार्थे यूषसात्म्यानां ज्वरितानां प्रदापयेत्|१८९|
<div class="mw-collapsible-content">
mudgānmasūrāṁścaṇakān kulatthān samakuṣṭakān||188||
mudgānmasūrāṁścaṇakān kulatthān samakuṣṭakān||188||
yUShArthe yUShasAtmyAnAM jvaritAnAM pradApayet|189|
yUShArthe yUShasAtmyAnAM jvaritAnAM pradApayet|189|
</div></div>
<div style="text-align:justify;">
''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]
</div>
=== Indications of vegetables ===
<div class="mw-collapsible mw-collapsed">
पटोलपत्रं सफलं कुलकं पापचेलिकम्||१८९||
पटोलपत्रं सफलं कुलकं पापचेलिकम्||१८९||
कर्कोटकं कठिल्लं च विद्याच्छाकं ज्वरे हितम्|१९०|
कर्कोटकं कठिल्लं च विद्याच्छाकं ज्वरे हितम्|१९०|
<div class="mw-collapsible-content">
paṭōlapatraṁ saphalaṁ kulakaṁ pāpacēlikam||189||
paṭōlapatraṁ saphalaṁ kulakaṁ pāpacēlikam||189||
karkoTakaM kaThillaM ca vidyAcchAkaM jvare hitam|190|
karkoTakaM kaThillaM ca vidyAcchAkaM jvare hitam|190|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Indication of animal meat soups ===
<div class="mw-collapsible mw-collapsed">
लावान् कपिञ्जलानेणांश्चकोरानुपचक्रकान्||१९०||
लावान् कपिञ्जलानेणांश्चकोरानुपचक्रकान्||१९०||
भिषङ्मात्राविकल्पज्ञो दद्यात्तानपि कालवित्|१९४|
भिषङ्मात्राविकल्पज्ञो दद्यात्तानपि कालवित्|१९४|
<div class="mw-collapsible-content">
lāvān kapiñjalānēṇāṁścakōrānupacakrakān||190||
lāvān kapiñjalānēṇāṁścakōrānupacakrakān||190||
bhiSha~gmAtrAvikalpaj~jo [1] dadyAttAnapi kAlavit|194|
bhiSha~gmAtrAvikalpaj~jo [1] dadyAttAnapi kAlavit|194|
</div></div>
<div style="text-align:justify;">
The soup prepared from ''lava, kapinjala'' (white variety of ''tittiri''), ''ena'' (''krishna sara''), ''chakora, upachakraka'' (a variety of ''chakora''), ''kuranga, kala puccha'' (a type of ''harina''), ''harina'' (coppery coloured dear), ''priashata'' (spotted deer) and ''shasha'' (rabbit) are alleviators of ''jwara'' and hence should be given to the patients of ''jwara'' for whom meat is wholesome. These meat soups may be made slightly sour or taken as such. The wise physician should administer these soups at appropriate time.
The soup prepared from ''lava, kapinjala'' (white variety of ''tittiri''), ''ena'' (''krishna sara''), ''chakora, upachakraka'' (a variety of ''chakora''), ''kuranga, kala puccha'' (a type of ''harina''), ''harina'' (coppery coloured dear), ''priashata'' (spotted deer) and ''shasha'' (rabbit) are alleviators of ''jwara'' and hence should be given to the patients of ''jwara'' for whom meat is wholesome. These meat soups may be made slightly sour or taken as such. The wise physician should administer these soups at appropriate time.
Some physicians do not advise the meat soups of animals such as ''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 ''[[dosha]]s'' should give the meat soup of these animals also at apropriate time.[190-194]
</div>
=== ''Anupana''(beverages) ===
<div class="mw-collapsible mw-collapsed">
घर्माम्बु चानुपानार्थं तृषिताय प्रदापयेत्||१९४||
घर्माम्बु चानुपानार्थं तृषिताय प्रदापयेत्||१९४||
मद्यं वा मद्यसात्म्याय यथादोषं यथाबलम्|१९५|
मद्यं वा मद्यसात्म्याय यथादोषं यथाबलम्|१९५|
<div class="mw-collapsible-content">
gharmāmbu cānupānārthaṁ tr̥ṣitāya pradāpayēt||194||
gharmāmbu cānupānārthaṁ tr̥ṣitāya pradāpayēt||194||
madyaM vA madyasAtmyAya yathAdoShaM yathAbalam|195|
madyaM vA madyasAtmyAya yathAdoShaM yathAbalam|195|
</div></div>
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]
<div style="text-align:justify;">
Hot water should be given to drink to a thirsty person. Depending upon the ''[[dosha]]s'' involved and the strength of the patient ''madya'' (wines) may be given to those patients for whom it is wholesome. [194-195]
</div>
=== Contra-indications in ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
गुरूष्णस्निग्धमधुरान् कषायांश्च नवज्वरे||१९५||
गुरूष्णस्निग्धमधुरान् कषायांश्च नवज्वरे||१९५||
अन्नपानक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१९६||
अन्नपानक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१९६||
<div class="mw-collapsible-content">
gurūṣṇasnigdhamadhurān kaṣāyāṁśca navajvarē||195||
gurūṣṇasnigdhamadhurān kaṣāyāṁśca navajvarē||195||
annapAnakramaH siddho jvaraghnaH samprakAshitaH||196||
annapAnakramaH siddho jvaraghnaH samprakAshitaH||196||
</div></div>
Food ingredients, which are heavy to digest, hot in potency, with unctuous property, sweet and astringent taste should preferably be avoided in a patient suffering from ''nava jwara'' (the patient of first stage of ''jwara'') in order to facilitate the ''paka'' of the ''doshas''.
<div style="text-align:justify;">
Food ingredients, which are heavy to digest, hot in potency, with unctuous property, sweet and astringent taste should preferably be avoided in a patient suffering from ''nava jwara'' (the patient of first stage of ''jwara'') in order to facilitate the ''paka'' of the ''[[dosha]]s''.
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]
</div>
=== Decoctions indicated in ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
अत ऊर्ध्वं प्रवक्ष्यन्ते कषाया ज्वरनाशनाः|
अत ऊर्ध्वं प्रवक्ष्यन्ते कषाया ज्वरनाशनाः|
तृष्णारुचिप्रशमना मुखवैरस्यनाशनाः|२००|
तृष्णारुचिप्रशमना मुखवैरस्यनाशनाः|२००|
<div class="mw-collapsible-content">
ata ūrdhvaṁ pravakṣyantē kaṣāyā jvaranāśanāḥ|
ata ūrdhvaṁ pravakṣyantē kaṣāyā jvaranāśanāḥ|
tRuShNAruciprashamanA mukhavairasyanAshanAH|200|
tRuShNAruciprashamanA mukhavairasyanAshanAH|200|
</div></div>
<div style="text-align:justify;">
Now, we will describe the ''kashayas'' (decoctions), which alleviate ''jwara''. These are as follows:
Now, we will describe the ''kashayas'' (decoctions), which alleviate ''jwara''. These are as follows:
*''Musta'' and ''parpataka'' can be taken either in the form of decoction (''pakya'') or ''shita kashaya'' (soaking the drugs for overnight period in water and then filtering the content and using the filtrate).
*''Musta'' and ''parpataka'' can be taken either in the form of decoction (''pakya'') or ''shita kashaya'' (soaking the drugs for overnight period in water and then filtering the content and using the filtrate).
*The decoction of ''patha'' and ''ushira'' along with ''udichya''.
*The decoction of ''patha'' and ''ushira'' along with ''udichya''.
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 ''[[dosha]]s''; alleviate thirst, anorexia and cure ''mukha vairasya'' (bad taste of the mouth). [197-199]
</div>
=== ''Kashaya'' in ''vishama jwara'' ===
<div class="mw-collapsible mw-collapsed">
कलिङ्गकाः पटोलस्य पत्रं कटुकरोहिणी||२००||
कलिङ्गकाः पटोलस्य पत्रं कटुकरोहिणी||२००||
सन्ततं सततान्येद्युस्तृतीयकचतुर्थकान्||२०३||
सन्ततं सततान्येद्युस्तृतीयकचतुर्थकान्||२०३||
<div class="mw-collapsible-content">
kaliṅgakāḥ paṭōlasya patraṁ kaṭukarōhiṇī||200||
kaliṅgakāḥ paṭōlasya patraṁ kaṭukarōhiṇī||200||
santataM satatAnyedyustRutIyakacaturthakAn||203||
santataM satatAnyedyustRutIyakacaturthakAn||203||
</div></div>
<div style="text-align:justify;">
The five types of ''jwara'' named the ''santata, satata, anyedyushka, tritiyaka'' and ''chaturthaka'' are quickly cured by the five types of decoctions made from drugs described below:
The five types of ''jwara'' named the ''santata, satata, anyedyushka, tritiyaka'' and ''chaturthaka'' are quickly cured by the five types of decoctions made from drugs described below:
#''Kiratatikta, amrita, chandana, vishva bheshaja''; and
#''Kiratatikta, amrita, chandana, vishva bheshaja''; and
#''Guduchi, amalaka'' and ''musta''. [200-203]
#''Guduchi, amalaka'' and ''musta''. [200-203]
</div>
<div class="mw-collapsible mw-collapsed">
वत्सकारग्वधौ पाठां षड्ग्रन्थां कटुरोहिणीम्|
वत्सकारग्वधौ पाठां षड्ग्रन्थां कटुरोहिणीम्|
पीत्वा निशिस्थितं जन्तुर्ज्वराच्छीघ्रं विमुच्यते|२०७|
पीत्वा निशिस्थितं जन्तुर्ज्वराच्छीघ्रं विमुच्यते|२०७|
<div class="mw-collapsible-content">
vatsakāragvadhau pāṭhāṁ ṣaḍgranthāṁ kaṭurōhiṇīm|
vatsakāragvadhau pāṭhāṁ ṣaḍgranthāṁ kaṭurōhiṇīm|
pItvA nishisthitaM janturjvarAcchIghraM vimucyate|207|
pItvA nishisthitaM janturjvarAcchIghraM vimucyate|207|
</div></div>
<div style="text-align:justify;">
The decoction or ''shita kashaya'' of the following drugs should be taken by a person for curing ''jwara:''
The decoction or ''shita kashaya'' of the following drugs should be taken by a person for curing ''jwara:''
The ''shita kashaya'' of ''madhuka, musta, mrudvika, kashmarya, parushaka, trayamana, ushira, triphala,'' and ''katu rohini'', prepared by keeping overnight, immediately cures the ''jwara'' of living beings. [204-207]
The ''shita kashaya'' of ''madhuka, musta, mrudvika, kashmarya, parushaka, trayamana, ushira, triphala,'' and ''katu rohini'', prepared by keeping overnight, immediately cures the ''jwara'' of living beings. [204-207]
</div>
<div class="mw-collapsible mw-collapsed">
जात्यामलकमुस्तानि तद्वद्धन्वयवासकम्||२०७||
जात्यामलकमुस्तानि तद्वद्धन्वयवासकम्||२०७||
त्रिवृताशर्करायुक्तः पित्तश्लेष्मज्वरापहः||२०९||
त्रिवृताशर्करायुक्तः पित्तश्लेष्मज्वरापहः||२०९||
<div class="mw-collapsible-content">
jātyāmalakamustāni tadvaddhanvayavāsakam||207||
jātyāmalakamustāni tadvaddhanvayavāsakam||207||
trivRutAsharkarAyuktaH pittashleShmajvarApahaH||209||
trivRutAsharkarAyuktaH pittashleShmajvarApahaH||209||
</div></div>
<div style="text-align:justify;">
The decoction of either ''jati, amalaka'' and ''musta'' or that of ''dhanavayavasakam'' along with ''guda'' (jaggery) should be given to the patient suffering from ''jwara'' where the ''[[dosha]]s'' are in ''vibaddha'' state (adhered to ''[[dhatu]]s'').
The decoction of ''triphala, trayamana, mridvika'' and ''katu rohini'' alleviates ''[[pitta]]'' and ''shleshma'' and causes the ''anulomana'' of ''[[dosha]]s''. This decoction when taken along with ''trivrita'' and ''sharkara'' cures ''jwara'' caused by the aggravation of ''[[pitta]]'' and ''shleshma''. [207-209]
</div>
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'' ===
<div class="mw-collapsible mw-collapsed">
बृहत्यौ वत्सकं मुस्तं देवदारु महौषधम्|
बृहत्यौ वत्सकं मुस्तं देवदारु महौषधम्|
कासादिषु च सर्वेषु दद्यात् सोपद्रवेषु च||२१४||
कासादिषु च सर्वेषु दद्यात् सोपद्रवेषु च||२१४||
<div class="mw-collapsible-content">
br̥hatyau vatsakaṁ mustaṁ dēvadāru mahauṣadham|
br̥hatyau vatsakaṁ mustaṁ dēvadāru mahauṣadham|
kAsAdiShu ca sarveShu dadyAt sopadraveShu ca||214||
kAsAdiShu ca sarveShu dadyAt sopadraveShu ca||214||
</div></div>
<div style="text-align:justify;">
A decoction prepared from both the varities of ''bruhati, vatsaka, musta, devadaru, mahaushadha,'' and ''kolavalli'' cures ''sannipata jwara''. ''Shati, pushkaramula, vyaghri, shringi, duralabha, guduchi, nagara, patha, kirata, katurohini'' - all together are called by the name of ''shatyadi varga''. The decoction made from these drugs helps in curing ''sannipāta jwara'' along with ''kasa'' (coughs), ''hrid graham'' (a kind of heart disease), ''parshva arti'' (pain in the flanks), ''shvasa'' (breathlessness) and ''tandra'' (drowsiness).
A decoction prepared from both the varities of ''bruhati, vatsaka, musta, devadaru, mahaushadha,'' and ''kolavalli'' cures ''sannipata jwara''. ''Shati, pushkaramula, vyaghri, shringi, duralabha, guduchi, nagara, patha, kirata, katurohini'' - all together are called by the name of ''shatyadi varga''. The decoction made from these drugs helps in curing ''sannipāta jwara'' along with ''kasa'' (coughs), ''hrid graham'' (a kind of heart disease), ''parshva arti'' (pain in the flanks), ''shvasa'' (breathlessness) and ''tandra'' (drowsiness).
Both the varieties of ''brihati, paushkar, bhaargi, shathi, shringī, duraalabha,'' seeds of ''vatsaka, patola'' and ''katu rohini'' – are together called the ''brihatyadi gana'' and the decoction made from it cures the ''sannipata jwara''. And is also useful in complications like ''kasa''. [210-214]
Both the varieties of ''brihati, paushkar, bhaargi, shathi, shringī, duraalabha,'' seeds of ''vatsaka, patola'' and ''katu rohini'' – are together called the ''brihatyadi gana'' and the decoction made from it cures the ''sannipata jwara''. And is also useful in complications like ''kasa''. [210-214]
</div>
<div class="mw-collapsible mw-collapsed">
कषायाश्च यवाग्वश्च पिपासाज्वरनाशनाः|
कषायाश्च यवाग्वश्च पिपासाज्वरनाशनाः|
निर्दिष्टा भेषजाध्याये भिषक्तानपि योजयेत्||२१५||
निर्दिष्टा भेषजाध्याये भिषक्तानपि योजयेत्||२१५||
<div class="mw-collapsible-content">
kaṣāyāśca yavāgvaśca pipāsājvaranāśanāḥ|
kaṣāyāśca yavāgvaśca pipāsājvaranāśanāḥ|
nirdiShTA bheShajAdhyAye bhiShaktAnapi yojayet||215||
nirdiShTA bheShajAdhyAye bhiShaktAnapi yojayet||215||
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Advantage of ghee ===
<div class="mw-collapsible mw-collapsed">
ज्वराः कषायैर्वमनैर्लङ्घनैर्लघुभोजनैः|
ज्वराः कषायैर्वमनैर्लङ्घनैर्लघुभोजनैः|
यः स्यादनुबलो धातुः स्नेहवध्यः स चानिलः||२१७||
यः स्यादनुबलो धातुः स्नेहवध्यः स चानिलः||२१७||
<div class="mw-collapsible-content">
jvarāḥ kaṣāyairvamanairlaṅghanairlaghubhōjanaiḥ|
jvarāḥ kaṣāyairvamanairlaṅghanairlaghubhōjanaiḥ|
yaH syAdanubalo dhAtuH snehavadhyaH [1] sa cAnilaH||217||
yaH syAdanubalo dhAtuH snehavadhyaH [1] sa cAnilaH||217||
</div></div>
If in a person of ununctuous disposition, jwara doesn’t get cured by the use of decoctions, emesis, fasting and by light diet, then ''jwara'' in such a person should be cured by the use of medicated ''ghrita'' (ghee). ''Jwara'' is manifested by ununctuous state of ''tejasa'' in such a person and a patient suffering from ''jwara'' further develops ununctuousness due to the action of this ''tejasa'' (''pitta''). The ''vata'' gets aggravated due to the action of this ''tejasa'' and it can be corrected by the use of some unctuous material like ''ghrita''. [216-217]
<div style="text-align:justify;">
If in a person of ununctuous disposition, jwara doesn’t get cured by the use of decoctions, emesis, fasting and by light diet, then ''jwara'' in such a person should be cured by the use of medicated ''ghrita'' (ghee). ''Jwara'' is manifested by ununctuous state of ''tejasa'' in such a person and a patient suffering from ''jwara'' further develops ununctuousness due to the action of this ''tejasa'' (''[[pitta]]''). The ''[[vata]]'' gets aggravated due to the action of this ''tejasa'' and it can be corrected by the use of some unctuous material like ''ghrita''. [216-217]
</div>
<div class="mw-collapsible mw-collapsed">
कषायाः सर्व एवैते सर्पिषा सह योजिताः|
कषायाः सर्व एवैते सर्पिषा सह योजिताः|
प्रयोज्या ज्वरशान्त्यर्थमग्निसन्धुक्षणाः शिवाः||२१८||
प्रयोज्या ज्वरशान्त्यर्थमग्निसन्धुक्षणाः शिवाः||२१८||
<div class="mw-collapsible-content">
kaṣāyāḥ sarva ēvaitē sarpiṣā saha yōjitāḥ|
kaṣāyāḥ sarva ēvaitē sarpiṣā saha yōjitāḥ|
prayojyA jvarashAntyarthamagnisandhukShaNAH shivAH||218||
prayojyA jvarashAntyarthamagnisandhukShaNAH shivAH||218||
</div></div>
<div style="text-align:justify;">
''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]
</div>
=== Various medicated ghee formulations ===
<div class="mw-collapsible mw-collapsed">
पिप्पल्यश्चन्दनं मुस्तमुशीरं कटुरोहिणी|
पिप्पल्यश्चन्दनं मुस्तमुशीरं कटुरोहिणी|
अंसाभितापमाग्निं च विषमं सन्नियच्छति||२२१||
अंसाभितापमाग्निं च विषमं सन्नियच्छति||२२१||
<div class="mw-collapsible-content">
pippalyaścandanaṁ mustamuśīraṁ kaṭurōhiṇī|
pippalyaścandanaṁ mustamuśīraṁ kaṭurōhiṇī|
aMsAbhitApamAgniM ca viShamaM sanniyacchati||221||
aMsAbhitApamAgniM ca viShamaM sanniyacchati||221||
</div></div>
<div style="text-align:justify;">
Medicated ''ghrita'' prepared by boiling with ''pipali, chandana, musta, katurohini, kalingaka, tamalaki'' (''bhumyamalaki''), ''sariva, ativisha, sthira, draksha, amalaka, bilva, trayamana'' and ''nidigdhika'' cure chronic types of ''jwara'' instantaneously. 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) and ''vishama agni'' (irregularity in the power of digestion). [219-221]
Medicated ''ghrita'' prepared by boiling with ''pipali, chandana, musta, katurohini, kalingaka, tamalaki'' (''bhumyamalaki''), ''sariva, ativisha, sthira, draksha, amalaka, bilva, trayamana'' and ''nidigdhika'' cure chronic types of ''jwara'' instantaneously. 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) and ''vishama agni'' (irregularity in the power of digestion). [219-221]
</div>
<div class="mw-collapsible mw-collapsed">
वासां गुडूचीं त्रिफलां त्रायमाणां यवासकम्|
वासां गुडूचीं त्रिफलां त्रायमाणां यवासकम्|
कल्कीकृतैश्च विपचेद्धृतं जीर्णज्वरापहम्||२२३||
कल्कीकृतैश्च विपचेद्धृतं जीर्णज्वरापहम्||२२३||
<div class="mw-collapsible-content">
vāsāṁ guḍūcīṁ triphalāṁ trāyamāṇāṁ yavāsakam|
vāsāṁ guḍūcīṁ triphalāṁ trāyamāṇāṁ yavāsakam|
kalkIkRutaishca vipaceddhRutaM jIrNajvarApaham||223||
kalkIkRutaishca vipaceddhRutaM jIrNajvarApaham||223||
</div></div>
<div style="text-align:justify;">
''Ghrita'' prepared from the decoction made by boiling ''vasa, guduchi, triphala, trayamana'' and ''yavasaka'', milk in double the quantity, paste of ''pippali, musta, mridvika, chandana, utpala'' and ''nagara'' cures chronic fevers.[222-223]
''Ghrita'' prepared from the decoction made by boiling ''vasa, guduchi, triphala, trayamana'' and ''yavasaka'', milk in double the quantity, paste of ''pippali, musta, mridvika, chandana, utpala'' and ''nagara'' cures chronic fevers.[222-223]
</div>
<div class="mw-collapsible mw-collapsed">
बलां श्वदंष्ट्रां बृहतीं कलसीं धावनीं स्थिराम्|
बलां श्वदंष्ट्रां बृहतीं कलसीं धावनीं स्थिराम्|
क्षयकासशिरःशूलपार्श्वशूलांसतापनुत् ||२२६||
क्षयकासशिरःशूलपार्श्वशूलांसतापनुत् ||२२६||
<div class="mw-collapsible-content">
balāṁ śvadaṁṣṭrāṁ br̥hatīṁ kalasīṁ dhāvanīṁ sthirām|
balāṁ śvadaṁṣṭrāṁ br̥hatīṁ kalasīṁ dhāvanīṁ sthirām|
kShayakAsashiraHshUlapArshvashUlAMsatApanut ||226||
kShayakAsashiraHshUlapArshvashUlAMsatApanut ||226||
</div></div>
<div style="text-align:justify;">
''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]
</div>
=== Formulations used in purification therapies ===
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ज्वरिभ्यो बहुदोषेभ्य ऊर्ध्वं चाधश्च बुद्धिमान्|
ज्वरिभ्यो बहुदोषेभ्य ऊर्ध्वं चाधश्च बुद्धिमान्|
पयोऽनुपानमुष्णं वा पीत्वा द्राक्षारसं नरः||२३३||
पयोऽनुपानमुष्णं वा पीत्वा द्राक्षारसं नरः||२३३||
<div class="mw-collapsible-content">
jvaribhyō bahudōṣēbhya ūrdhvaṁ cādhaśca buddhimān|
jvaribhyō bahudōṣēbhya ūrdhvaṁ cādhaśca buddhimān|
payo~anupAnamuShNaM vA pItvA drAkShArasaM naraH||233||
payo~anupAnamuShNaM vA pItvA drAkShArasaM naraH||233||
</div></div>
<div style="text-align:justify;">
Elimination therapies (of ''[[dosha]]s''), both in upward and downward routes should be administered at appropriate time, to a patient suffering from ''jwara'', having more aggravated ''[[dosha]]s''. Details of these methods and the formulations used for them will be discussed in the [[Kalpa Sthana]].
''[[Vamana]]'' performed by hot water and ''madana'' mixed with either ''pippali, kalinga'' or ''madhuka'' alleviates ''jwara''.
Emetic therapy given by administering water mixed with honey, sugar cane juice, water mixed with rock salt, alcoholic drinks and ''tarpaṇa'' (roasted corn flour eaten mixed with water) is also useful in ''jwara''.
Emetic therapy given by administering water mixed with honey, sugar cane juice, water mixed with rock salt, alcoholic drinks and ''tarpaṇa'' (roasted corn flour eaten mixed with water) is also useful in ''jwara''.
*''tṛvrita'' and ''trāyamāṇa'' along with milk
*''tṛvrita'' and ''trāyamāṇa'' along with milk
*''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]
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=== Formulations with medicated milk ===
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कासाच्छ्वासाच्छिरःशूलात्पार्श्वशूलाच्चिरज्वरात्|
कासाच्छ्वासाच्छिरःशूलात्पार्श्वशूलाच्चिरज्वरात्|
पेयं तदुष्णं शीतं वा यथास्वं भेषजैः शृतम्||२३९||
पेयं तदुष्णं शीतं वा यथास्वं भेषजैः शृतम्||२३९||
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kāsācchvāsācchiraḥśūlātpārśvaśūlāccirajvarāt|
kāsācchvāsācchiraḥśūlātpārśvaśūlāccirajvarāt|
peyaM taduShNaM shItaM vA yathAsvaM bheShajaiH shRutam||239||
peyaM taduShNaM shItaM vA yathAsvaM bheShajaiH shRutam||239||
</div></div>
<div style="text-align:justify;">
A patient suffering from ''chira jwara'' (chronic type of fevers), ''kasa, shvāsa, shirahshula'' and ''parshvashula'' gets cured by taking milk boiled with ''panchamula'' (''bilva'' and ''shyonaka, gambhari, patala'' and ''ganikarika'').
A patient suffering from ''chira jwara'' (chronic type of fevers), ''kasa, shvāsa, shirahshula'' and ''parshvashula'' gets cured by taking milk boiled with ''panchamula'' (''bilva'' and ''shyonaka, gambhari, patala'' and ''ganikarika'').
Milk boiled by adding water four times cures ''jwara''.
Milk boiled by adding water four times cures ''jwara''.
''Dharoshna'' milk (freshly milked from the cow, when its still hot) immediately cures ''jwara'' caused by the aggravation of ''vata'' and ''pitta''.
''Dharoshna'' milk (freshly milked from the cow, when its still hot) immediately cures ''jwara'' caused by the aggravation of ''[[vata]]'' and ''[[pitta]]''.
All types of chronic fevers are alleviated by milk. It can be taken either hot, cold or after boiling with drugs appropriate to the kind of fever. [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]
</div>
=== Medicated enemas ===
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प्रयोजयेज्ज्वरहरान्निरूहान् सानुवासनान्|
प्रयोजयेज्ज्वरहरान्निरूहान् सानुवासनान्|
सिद्धः स्नेहो ज्वरहरः स्नेहबस्तिः प्रशस्यते||२५३||
सिद्धः स्नेहो ज्वरहरः स्नेहबस्तिः प्रशस्यते||२५३||
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prayōjayējjvaraharānnirūhān sānuvāsanān|
prayōjayējjvaraharānnirūhān sānuvāsanān|
siddhaH sneho jvaraharaH snehabastiH prashasyate||253||
siddhaH sneho jvaraharaH snehabastiH prashasyate||253||
</div></div>
<div style="text-align:justify;">
''Niruha'' and ''anuvasana'' types of ''[[basti]]s'' (medicated enemas) which will be described in the [[Siddhi Sthana]] should be administered when the ''[[dosha]]s'' are lodged in the ''pakvashaya'', for the treatment of ''jwara''.
''Patola, arishtha'' leaves, ''ushira, chaturangula, hribera, rohini, tikta, shvadanshtrā, madana, sthira'' and ''bala'' – these drugs should be boiled in milk by adding water which should be taken in equal the quantity of milk. This should be boiled till the amount equal to that of milk is left. To this mixture honey and ''ghrita'' should be added along with the ''kalka'' of ''madana, musta, pippali, madhuka'' and ''vatsaka''. This portion should be administered in the form of enema for the cure ''jwara''. When the ''margas'' (channels) are clean, the ''[[dosha]]s'' are eliminated and the ''[[dhatu]]s'' are refreshed. Then the pain in the body disappears and the body becomes light and instantaneously free from fever.
''Patola, arishtha'' leaves, ''ushira, chaturangula, hribera, rohini, tikta, shvadanshtrā, madana, sthira'' and ''bala'' – these drugs should be boiled in milk by adding water which should be taken in equal the quantity of milk. This should be boiled till the amount equal to that of milk is left. To this mixture honey and ''ghrita'' should be added along with the ''kalka'' of ''madana, musta, pippali, madhuka'' and ''vatsaka''. This portion should be administered in the form of enema for the cure ''jwara''. When the ''margas'' (channels) are clean, the ''doshas'' are eliminated and the ''dhatus'' are refreshed. Then the pain in the body disappears and the body becomes light and instantaneously free from fever.
A decoction prepared from ''aragvadha, ushira,'' fruits of ''madana, shalaparni, prishniparni, mashaparni'' and ''mudgaparni'', mixed with the paste of ''priyangu, madana, musta, shatavha'' and ''madhuyashti'' should be used as an enema, for the cure of ''jwara''.
A decoction prepared from ''aragvadha, ushira,'' fruits of ''madana, shalaparni, prishniparni, mashaparni'' and ''mudgaparni'', mixed with the paste of ''priyangu, madana, musta, shatavha'' and ''madhuyashti'' should be used as an enema, for the cure of ''jwara''.
A small quantity of rock salt should also be added to this decoction along with honey and ''ghrita'' and used as ''niruha'' type of medicated enema for the alleviation of ''jwara'' as it promotes strength, sweating and taste appreciation.
A small quantity of rock salt should also be added to this decoction along with honey and ''ghrita'' and used as ''niruha'' type of medicated enema for the alleviation of ''jwara'' as it promotes strength, sweating and taste appreciation.
A medicated ''ghrita'' prepared from the paste of ''jeevanti, madhuka, meda, pippali, madana, vacha, riddhi, rasna, bala, vishva, shatapushpa'' and ''shatavari,'' boiled with milk, water, ''ghrita'' and oil, should be used as ''anuvasana basti'' for the treatment of ''jwara''.
A medicated ''ghrita'' prepared from the paste of ''jeevanti, madhuka, meda, pippali, madana, vacha, riddhi, rasna, bala, vishva, shatapushpa'' and ''shatavari,'' boiled with milk, water, ''ghrita'' and oil, should be used as ''anuvasana [[basti]]'' for the treatment of ''jwara''.
The ''sneha'' (''ghrita'' and oil) boiled with ''paṭola, pichumarda, guduchi, madhuka'' and ''madana'' should also be used as ''anuvasana basti'' for the treatment of ''jwara''.
The ''sneha'' (''ghrita'' and oil) boiled with ''paṭola, pichumarda, guduchi, madhuka'' and ''madana'' should also be used as ''anuvasana [[basti]]'' for the treatment of ''jwara''.
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]
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=== Indications of ''shiro-virechana'' (nasal errhines) ===
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यदुक्तं भेषजाध्याये विमाने रोगभेषजे|
यदुक्तं भेषजाध्याये विमाने रोगभेषजे|
मात्राशितीये निर्दिष्टाः प्रयोज्यास्ता ज्वरेष्वपि||२५५||
मात्राशितीये निर्दिष्टाः प्रयोज्यास्ता ज्वरेष्वपि||२५५||
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yaduktaṁ bhēṣajādhyāyē vimānē rōgabhēṣajē|
yaduktaṁ bhēṣajādhyāyē vimānē rōgabhēṣajē|
mAtrAshitIye nirdiShTAH prayojyAstA jvareShvapi||255||
mAtrAshitIye nirdiShTAH prayojyAstA jvareShvapi||255||
</div></div>
Drugs for ''shirovirechana'' therapy (module of taking out the ''doshas'' from the ''uttamānga - shira'') are already described in the ''Bheshaja Chatushka'' of [[Sutra Sthana]] and [[Rogabhishagjitiya Vimana]] of [[Vimana Sthana]]. A physician well versed in these treatment modules should apply them for the treatment of ''jwara''.
<div style="text-align:justify;">
Drugs for ''shirovirechana'' therapy (module of taking out the ''[[dosha]]s'' from the ''uttamānga - shira'') are already described in the ''Bheshaja Chatushka'' of [[Sutra Sthana]] and [[Rogabhishagjitiya Vimana]] of [[Vimana Sthana]]. A physician well versed in these treatment modules should apply them for the treatment of ''jwara''.
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]
</div>
=== External applications ===
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अभ्यङ्गांश्च प्रदेहांश्च परिषेकांश्च कारयेत्|
अभ्यङ्गांश्च प्रदेहांश्च परिषेकांश्च कारयेत्|
दाहज्वरप्रशमनं दद्यादभ्यञ्जनं भिषक्||२५७||
दाहज्वरप्रशमनं दद्यादभ्यञ्जनं भिषक्||२५७||
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abhyaṅgāṁśca pradēhāṁśca pariṣēkāṁśca kārayēt|
abhyaṅgāṁśca pradēhāṁśca pariṣēkāṁśca kārayēt|
dAhajvaraprashamanaM dadyAdabhya~jjanaM bhiShak||257||
dAhajvaraprashamanaM dadyAdabhya~jjanaM bhiShak||257||
</div></div>
<div style="text-align:justify;">
''Abhyanga'' (massage), ''pradeha'' (unction) and ''parisheka'' (medicated bath) should be given to the patient, either hot or cold, according to the appropriateness of the two types of ''jwara'' of the patient.
''Abhyanga'' (massage), ''pradeha'' (unction) and ''parisheka'' (medicated bath) should be given to the patient, either hot or cold, according to the appropriateness of the two types of ''jwara'' of the patient.
Medicated ''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]
</div>
=== ''Chandanadya taila'' ===
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अथ चन्दनाद्यं तैलमुपदेक्ष्यामः-
अथ चन्दनाद्यं तैलमुपदेक्ष्यामः-
मध्वारनालक्षीरदधिघृतसलिलसेकावगाहाश्च सद्यो दाहज्वरमपनयन्ति शीतस्पर्शत्वात्||२५९||
मध्वारनालक्षीरदधिघृतसलिलसेकावगाहाश्च सद्यो दाहज्वरमपनयन्ति शीतस्पर्शत्वात्||२५९||
<div class="mw-collapsible-content">
atha candanādyaṁ tailamupadēkṣyāmaḥ-
atha candanādyaṁ tailamupadēkṣyāmaḥ-
madhvAranAlakShIradadhighRutasalilasekAvagAhAshca sadyo dAhajvaramapanayanti shItasparshatvAt||259||
madhvAranAlakShIradadhighRutasalilasekAvagAhAshca sadyo dAhajvaramapanayanti shItasparshatvAt||259||
</div></div>
<div style="text-align:justify;">
Now, ''Chandanadya taila'' preparation will be described – ''chandana'' (red variety of ''chandana''), ''bhadrashri'' (white variety of ''chandana''), ''kalanusarya, kaiyaka, padma, padmaka, ushira, sariva, madhuka, nagapushpa, udichya, vanya, padma, utpala, nalina'' (a white variety of ''padma''), ''kumuda''; ''saugandhika, pundarika, shata patra, bis, mrinala, shaluka, shaivala, kasheruka, ananta, kusha, kasa, ikshu, darbha, shara, nala'' – root of ''shali, jambu, vetasa, vanira'' (a variety of ''vetasa'' which do not have fragrant root), ''gundra, kakubha, asana, ashvakarna'' (a variety of ''shala''), ''syandana'' (''nemi vriksha''), ''vatapotha'' (''palasha''), ''shala, tala, dava, tinisha'' (''vanjula''), ''khadira, kadara'' (''vitkhadira''), ''kadamba,'' fruit of ''kashmarya, sarja, plaksha, vata'' (the variety without any adventitious root), ''kapitana'' (popularly known as ''gandhamunda''), ''udumbara, ashvattha, nyagodhra, dhataki, durva, itkata, shringataka, manjishtha, jyotishmati'' (''kanganika''), seeds of ''pushkara, karunyachandana, badari, kovidara, kadali, samvartaka, ariṡṭa'' (a variety of ''neem'' growing in the hills), ''shataparva'' (''bibhitaka''), ''shita kumbhika'' (''kashtha patala''), ''shatavari, shriparni, shravani, mahashravani'' (''alambusha'' – having big fruits), ''rohini, seeta paki'' (''ganda durva''), ''odana paki'' (''neela bhendi''), ''kala'' (''kakoli''), ''bala, payasya, vidari, jeevaka, rishabhaka, meda, mahameda, madurasa, rishyaprokta'' (''riddhi''), ''trina shunya'' (''ketaki''), ''mocharasa, atarushaka, bakula, kutaja, patola, shalmali, narikela, kharjura, mridvika, priyala, priyangu, dhanvana, atmagupta, madhuka,'' and such other drugs which are cold in potency. Also, the drugs which have the same cooling effect can also be added to prepare this decoction, using double the quantity of water. The ''kalka'' (paste) of all the above mentioned drugs must also be taken. Oil mixed with the above stated decoction and paste should be boiled on mild fire till half the quantity is left.
Now, ''Chandanadya taila'' preparation will be described – ''chandana'' (red variety of ''chandana''), ''bhadrashri'' (white variety of ''chandana''), ''kalanusarya, kaiyaka, padma, padmaka, ushira, sariva, madhuka, nagapushpa, udichya, vanya, padma, utpala, nalina'' (a white variety of ''padma''), ''kumuda''; ''saugandhika, pundarika, shata patra, bis, mrinala, shaluka, shaivala, kasheruka, ananta, kusha, kasa, ikshu, darbha, shara, nala'' – root of ''shali, jambu, vetasa, vanira'' (a variety of ''vetasa'' which do not have fragrant root), ''gundra, kakubha, asana, ashvakarna'' (a variety of ''shala''), ''syandana'' (''nemi vriksha''), ''vatapotha'' (''palasha''), ''shala, tala, dava, tinisha'' (''vanjula''), ''khadira, kadara'' (''vitkhadira''), ''kadamba,'' fruit of ''kashmarya, sarja, plaksha, vata'' (the variety without any adventitious root), ''kapitana'' (popularly known as ''gandhamunda''), ''udumbara, ashvattha, nyagodhra, dhataki, durva, itkata, shringataka, manjishtha, jyotishmati'' (''kanganika''), seeds of ''pushkara, karunyachandana, badari, kovidara, kadali, samvartaka, ariṡṭa'' (a variety of ''neem'' growing in the hills), ''shataparva'' (''bibhitaka''), ''shita kumbhika'' (''kashtha patala''), ''shatavari, shriparni, shravani, mahashravani'' (''alambusha'' – having big fruits), ''rohini, seeta paki'' (''ganda durva''), ''odana paki'' (''neela bhendi''), ''kala'' (''kakoli''), ''bala, payasya, vidari, jeevaka, rishabhaka, meda, mahameda, madurasa, rishyaprokta'' (''riddhi''), ''trina shunya'' (''ketaki''), ''mocharasa, atarushaka, bakula, kutaja, patola, shalmali, narikela, kharjura, mridvika, priyala, priyangu, dhanvana, atmagupta, madhuka,'' and such other drugs which are cold in potency. Also, the drugs which have the same cooling effect can also be added to prepare this decoction, using double the quantity of water. The ''kalka'' (paste) of all the above mentioned drugs must also be taken. Oil mixed with the above stated decoction and paste should be boiled on mild fire till half the quantity is left.
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]
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=== Guidelines for a patient with burning sensation ===
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भवन्ति चात्र-
भवन्ति चात्र-
वायवश्चन्द्रपादाश्च शीता दाहज्वरापहाः||२६६||
वायवश्चन्द्रपादाश्च शीता दाहज्वरापहाः||२६६||
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bhavanti cātra-
bhavanti cātra-
vAyavashcandrapAdAshca shItA dAhajvarApahAH||266||
vAyavashcandrapAdAshca shItA dAhajvarApahAH||266||
</div></div>
<div style="text-align:justify;">
A patient of ''jwara'' suffering from burning sensation should reside in a house cooled by the leaves of ''puṡkara, padma, utpala, kadalī'' or ''kṡauma''. The house can also be cooled by cold water of sandalwood or the patient can also reside in a ''dhāra gṛha'' (a house cooled by running water either flowing from above or falling from the roof) or a house cooled by ice cool water. This gives comfort to the patient. His body should be touched with the pleasant touch of gold or conch shell or coral or jewels and pearls which are cooled by the sandalwood water. He should be made to wear the garlands made of ''nīlotpala'' or ''padma'' and fanned with the cold air from different types of fans which are cooled with sandalwood water.
A patient of ''jwara'' suffering from burning sensation should reside in a house cooled by the leaves of ''puṡkara, padma, utpala, kadalī'' or ''kṡauma''. The house can also be cooled by cold water of sandalwood or the patient can also reside in a ''dhāra gṛha'' (a house cooled by running water either flowing from above or falling from the roof) or a house cooled by ice cool water. This gives comfort to the patient. His body should be touched with the pleasant touch of gold or conch shell or coral or jewels and pearls which are cooled by the sandalwood water. He should be made to wear the garlands made of ''nīlotpala'' or ''padma'' and fanned with the cold air from different types of fans which are cooled with sandalwood water.
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]
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=== ''Agurvadya tailam'' ===
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अथोष्णाभिप्रायिणां ज्वरितानामभ्यङ्गादीनुपक्रमानुपदेक्ष्यामः-अगुरुकुष्ठतगरपत्रनलदशैलेयध्यामकहरेणुकास्थौणेयकक्षेमकैलावराङ्गदलपुरतमालपत्रभूतीकरोहिषसरलशल्लकी-देवदार्वग्निमन्थबिल्वस्योनाककाश्मर्यपाटलापुनर्नवावृश्चीरकण्टकारीबृहतीशालपर्णीपृश्निपर्णीमाषपर्णीमुद्गपर्णीगोक्षुरकैरण्ड-शोभाञ्जनकवरुणार्कचिरबिल्वतिल्वकशटीपुष्करमूलगण्डीरोरुबूकपत्तूराक्षीवाश्मान्तकशिग्रुमातुलुङ्गपीलुकमूलकपर्णी-तिलपर्णीपीलुपर्णीमेषशृङ्गीहिंस्रादन्तशठैरावतकभल्लातकास्फोतकाण्डीरात्मजैकेषीकाकरञ्जधान्यकाजमोद-पृथ्वीकासुमुखसुरसकुठेरककालमालकपर्णासक्षवकफणिज्झकभूस्तृणशृङ्गवेरपिप्पलीसर्षपाश्वगन्धारास्नारुहारोहावचाबलातिबला-गुडूचीशतपुष्पाशीतवल्लीनाकुलीगन्धनाकुलीश्वेताज्योतिष्मतीचित्रकाध्यण्डाम्लचाङ्गेरी-तिलबदरकुलत्थमाषाणामेवंविधानामन्येषां चोष्णवीर्याणां यथालाभमौषधानां कषायं कारयेत्, तेन कषायेण तेषामेव चकल्केन सुरासौवीरकतुषोदकमैरेयमेदकदधिमण्डारनालकट्वरप्रतिविनीतेन तैलपात्रं विपाचयेत्|
अथोष्णाभिप्रायिणां ज्वरितानामभ्यङ्गादीनुपक्रमानुपदेक्ष्यामः-अगुरुकुष्ठतगरपत्रनलदशैलेयध्यामकहरेणुकास्थौणेयकक्षेमकैलावराङ्गदलपुरतमालपत्रभूतीकरोहिषसरलशल्लकी-देवदार्वग्निमन्थबिल्वस्योनाककाश्मर्यपाटलापुनर्नवावृश्चीरकण्टकारीबृहतीशालपर्णीपृश्निपर्णीमाषपर्णीमुद्गपर्णीगोक्षुरकैरण्ड-शोभाञ्जनकवरुणार्कचिरबिल्वतिल्वकशटीपुष्करमूलगण्डीरोरुबूकपत्तूराक्षीवाश्मान्तकशिग्रुमातुलुङ्गपीलुकमूलकपर्णी-तिलपर्णीपीलुपर्णीमेषशृङ्गीहिंस्रादन्तशठैरावतकभल्लातकास्फोतकाण्डीरात्मजैकेषीकाकरञ्जधान्यकाजमोद-पृथ्वीकासुमुखसुरसकुठेरककालमालकपर्णासक्षवकफणिज्झकभूस्तृणशृङ्गवेरपिप्पलीसर्षपाश्वगन्धारास्नारुहारोहावचाबलातिबला-गुडूचीशतपुष्पाशीतवल्लीनाकुलीगन्धनाकुलीश्वेताज्योतिष्मतीचित्रकाध्यण्डाम्लचाङ्गेरी-तिलबदरकुलत्थमाषाणामेवंविधानामन्येषां चोष्णवीर्याणां यथालाभमौषधानां कषायं कारयेत्, तेन कषायेण तेषामेव चकल्केन सुरासौवीरकतुषोदकमैरेयमेदकदधिमण्डारनालकट्वरप्रतिविनीतेन तैलपात्रं विपाचयेत्|
इत्यगुर्वाद्यं तैलम्
इत्यगुर्वाद्यं तैलम्
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athōṣṇābhiprāyiṇāṁ jvaritānāmabhyaṅgādīnupakramānupadēkṣyāmaḥ-agurukuṣṭhatagarapatranaladaśailēyadhyāmakaharēṇukāsthauṇēyakakṣēmakailāvarāṅgadalapuratamālapatrabhūtīkarōhiṣasaralaśallakī-dēvadārvagnimanthabilvasyōnākakāśmaryapāṭalāpunarnavāvr̥ścīrakaṇṭakārībr̥hatīśālaparṇīpr̥śniparṇīmāṣaparṇīmudgaparṇīgōkṣurakairaṇḍa-śōbhāñjanakavaruṇārkacirabilvatilvakaśaṭīpuṣkaramūlagaṇḍīrōrubūkapattūrākṣīvāśmāntakaśigrumātuluṅgapīlukamūlakaparṇī-tilaparṇīpīluparṇīmēṣaśr̥ṅgīhiṁsrādantaśaṭhairāvatakabhallātakāsphōtakāṇḍīrātmajaikēṣīkākarañjadhānyakājamōda-pr̥thvīkāsumukhasurasakuṭhērakakālamālakaparṇāsakṣavakaphaṇijjhakabhūstr̥ṇaśr̥ṅgavērapippalīsarṣapāśvagandhārāsnāruhārōhāvacābalātibalā-guḍūcīśatapuṣpāśītavallīnākulīgandhanākulīśvētājyōtiṣmatīcitrakādhyaṇḍāmlacāṅgērī- tilabadarakulatthamāṣāṇāmēvaṁvidhānāmanyēṣāṁ cōṣṇavīryāṇāṁ yathālābhamauṣadhānāṁ kaṣāyaṁ kārayēt, tēna kaṣāyēṇa tēṣāmēva ca kalkēnasurāsauvīrakatuṣōdakamairēyamēdakadadhimaṇḍāranālakaṭvaraprativinītēna tailapātraṁ vipācayēt|
athōṣṇābhiprāyiṇāṁ jvaritānāmabhyaṅgādīnupakramānupadēkṣyāmaḥ-agurukuṣṭhatagarapatranaladaśailēyadhyāmakaharēṇukāsthauṇēyakakṣēmakailāvarāṅgadalapuratamālapatrabhūtīkarōhiṣasaralaśallakī-dēvadārvagnimanthabilvasyōnākakāśmaryapāṭalāpunarnavāvr̥ścīrakaṇṭakārībr̥hatīśālaparṇīpr̥śniparṇīmāṣaparṇīmudgaparṇīgōkṣurakairaṇḍa-śōbhāñjanakavaruṇārkacirabilvatilvakaśaṭīpuṣkaramūlagaṇḍīrōrubūkapattūrākṣīvāśmāntakaśigrumātuluṅgapīlukamūlakaparṇī-tilaparṇīpīluparṇīmēṣaśr̥ṅgīhiṁsrādantaśaṭhairāvatakabhallātakāsphōtakāṇḍīrātmajaikēṣīkākarañjadhānyakājamōda-pr̥thvīkāsumukhasurasakuṭhērakakālamālakaparṇāsakṣavakaphaṇijjhakabhūstr̥ṇaśr̥ṅgavērapippalīsarṣapāśvagandhārāsnāruhārōhāvacābalātibalā-guḍūcīśatapuṣpāśītavallīnākulīgandhanākulīśvētājyōtiṣmatīcitrakādhyaṇḍāmlacāṅgērī- tilabadarakulatthamāṣāṇāmēvaṁvidhānāmanyēṣāṁ cōṣṇavīryāṇāṁ yathālābhamauṣadhānāṁ kaṣāyaṁ kārayēt, tēna kaṣāyēṇa tēṣāmēva ca kalkēnasurāsauvīrakatuṣōdakamairēyamēdakadadhimaṇḍāranālakaṭvaraprativinītēna tailapātraṁ vipācayēt|
ityagurvAdyaM tailam
ityagurvAdyaM tailam
</div></div>
<div style="text-align:justify;">
Now, we will explain the therapies for patients of ''jwara'' for whom hot treatment is desirable –
Now, we will explain the therapies for patients of ''jwara'' for whom hot treatment is desirable –
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]
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=== Indications of fomentation for alleviating cold ===
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भवन्ति चात्र-
भवन्ति चात्र-
शीतज्वरं जयन्त्याशु संसर्गबलयोजनात्||२७१||
शीतज्वरं जयन्त्याशु संसर्गबलयोजनात्||२७१||
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bhavanti cātra-
bhavanti cātra-
shItajvaraM jayantyAshu saMsargabalayojanAt||271||
shItajvaraM jayantyAshu saMsargabalayojanAt||271||
</div></div>
<div style="text-align:justify;">
Thirteen varities of ''sweda'' procedures have been described in the [[Swedadhyaya]] of [[Sutra Sthana]]. A physician who is well versed with the proper duration of ''sweda'' as suitable to the season and person should administer them for the treatment of ''shīta jwara''.
Thirteen varities of ''sweda'' procedures have been described in the [[Swedadhyaya]] of [[Sutra Sthana]]. A physician who is well versed with the proper duration of ''sweda'' as suitable to the season and person should administer them for the treatment of ''shīta jwara''.
''Sheeta jwara'' is also cured by the embrace of passionate ladies who are beautiful, have plump body and are young, due to their youthful heat.
''Sheeta jwara'' is also cured by the embrace of passionate ladies who are beautiful, have plump body and are young, due to their youthful heat.
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 ''[[dosha]]s'') and the ''bala'' of each ''[[dosha]]''. [268-271]
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===Contra-indications of ''[[langhana]]'' ===
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वातजे श्रमजे चैव पुराणे क्षतजे ज्वरे|
वातजे श्रमजे चैव पुराणे क्षतजे ज्वरे|
लङ्घनं न हितं विद्याच्छमनैस्तानुपाचरेत्||२७२||
लङ्घनं न हितं विद्याच्छमनैस्तानुपाचरेत्||२७२||
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vātajē śramajē caiva purāṇē kṣatajē jvarē|
vātajē śramajē caiva purāṇē kṣatajē jvarē|
la~gghanaM na hitaM vidyAcchamanaistAnupAcaret||272||
la~gghanaM na hitaM vidyAcchamanaistAnupAcaret||272||
</div></div>
''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]
<div style="text-align:justify;">
''[[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]
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=== Guidelines for improving ''agni'' (digestive strength) ===
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विक्षिप्यामाशयोष्माणं यस्माद्गत्वा रसं नृणाम्|
विक्षिप्यामाशयोष्माणं यस्माद्गत्वा रसं नृणाम्|
आदशाहमुपक्रम्य कषायाद्यैरुपाचरेत्|२८३|
आदशाहमुपक्रम्य कषायाद्यैरुपाचरेत्|२८३|
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vikṣipyāmāśayōṣmāṇaṁ yasmādgatvā rasaṁ nr̥ṇām|
vikṣipyāmāśayōṣmāṇaṁ yasmādgatvā rasaṁ nr̥ṇām|
AdashAhamupakramya kaShAyAdyairupAcaret|283|
AdashAhamupakramya kaShAyAdyairupAcaret|283|
</div></div>
<div style="text-align:justify;">
The aggravated ''[[dosha]]s'' afflict the ''[[rasa dhatu]]'' and displace the ''agnī'' from the ''āmāshaya'', for causing ''jwara''. Thus, such patients have less of ''agni'' (digestive strength). Even if a rice pot is kept on burning fire with enough fuel, the rice will not get cooked if the fire is blown out by a strong wind. Similarly, in a patient of ''jwara'', the ''ūṡmā'' (digestive fire) is blown out of the ''paktī sthāna'' (place of digestion) and in this condition the consumed food is not digested properly. If the food is light, then also it gets digested with difficulty. Therefore, the line of treatment in ''jwara'' of ''[[langhana]]'' is useful for the preservation of the power of digestion.
The aggravated ''doshas'' afflict the ''rasa dhatu'' and displace the ''agnī'' from the ''āmāshaya'', for causing ''jwara''. Thus, such patients have less of ''agni'' (digestive strength). Even if a rice pot is kept on burning fire with enough fuel, the rice will not get cooked if the fire is blown out by a strong wind. Similarly, in a patient of ''jwara'', the ''ūṡmā'' (digestive fire) is blown out of the ''paktī sthāna'' (place of digestion) and in this condition the consumed food is not digested properly. If the food is light, then also it gets digested with difficulty. Therefore, the line of treatment in ''jwara'' of ''langhana'' is useful for the preservation of the power of digestion.
The ''[[mala]]s'' of the seven ''[[dhatu]]s'' get metabolized in seven days. Therefore, generally on the eighth day the ''jwara'' becomes ''nirama'' (free from the accumulated metabolic waste product).
If a person takes heavy food in the stage when the ''[[dosha]]s'' are aggravated and the power of digestion is suppressed, he succumbs to death immediately, or becomes miserable for a long time. Therefore, a wise physician should not immediately give either heavy or unctuous food in the beginning stage of ''jwara'', even if it is caused by the aggravation of ''[[vata]]''.
If a person takes heavy food in the stage when the ''doshas'' are aggravated and the power of digestion is suppressed, he succumbs to death immediately, or becomes miserable for a long time. Therefore, a wise physician should not immediately give either heavy or unctuous food in the beginning stage of ''jwara'', even if it is caused by the aggravation of ''vāta''.
If the ''jwara'' is caused by ''[[vata]]'' and is not associated with the other two ''[[dosha]]s'' 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]
</div>
=== Guidelines for management in ''sannipata'' conditions ===
<div class="mw-collapsible mw-collapsed">
सामा ये ये च कफजाः कफपित्तज्वराश्च ये||२८३||
सामा ये ये च कफजाः कफपित्तज्वराश्च ये||२८३||
कफस्थानानुपूर्व्या वा सन्निपातज्वरं जयेत्|२८७|
कफस्थानानुपूर्व्या वा सन्निपातज्वरं जयेत्|२८७|
<div class="mw-collapsible-content">
sāmā yē yē ca kaphajāḥ kaphapittajvarāśca yē||283||
sāmā yē yē ca kaphajāḥ kaphapittajvarāśca yē||283||
kaphasthAnAnupUrvyA vA sannipAtajvaraM jayet|287|
kaphasthAnAnupUrvyA vA sannipAtajvaraM jayet|287|
</div></div>
''Langhana'' and similar other therapies described in [[Langhanabrimhaniya Adhyaya]] of [[Sutra Sthana]] should be invariably administered in the following conditions:
<div style="text-align:justify;">
''[[Langhana]]'' and similar other therapies described in [[Langhanabrimhaniya Adhyaya]] of [[Sutra Sthana]] should be invariably administered in the following conditions:
*When the ''jwara'' is in the ''sama'' stage
*When the ''jwara'' is in the ''sama'' stage
*When ''jwara'' is produced by the aggravated ''kapha dosha''
*When ''jwara'' is produced by the aggravated ''[[kapha dosha]]''
*When both the ''kapha'' and the ''pitta dosha'' are aggravated together
*When both the ''[[kapha]]'' and the ''[[pitta dosha]]'' are aggravated together
''Vamana, virechana'' and ''bastī'' therapies should be administered to cure the ''jwara'' caused by the aggravated ''vāta, pitta'' and ''kapha dosha'' respectively.
''[[Vamana]], [[virechana]]'' and ''[[basti]]'' therapies should be administered to cure the ''jwara'' caused by the aggravated ''[[vata]], [[pitta]]'' and ''[[kapha dosha]]'' respectively.
In the case of ''saṁsṛṡṭra'' and ''sannīpātaja'' (in case of combination of two or all the three ''doshas'') type of ''jwara'', the ''tara'', ''tama'' and ''sama'' (lesser, greater or equal) status of the vitiated ''doshas'' should be ascertained and the treatment planned according to the line of treatment and drugs prescribed for that ''dosha''.
In the case of ''saṁsṛṡṭra'' and ''sannīpātaja'' (in case of combination of two or all the three ''[[dosha]]s'') type of ''jwara'', the ''tara'', ''tama'' and ''sama'' (lesser, greater or equal) status of the vitiated ''[[dosha]]s'' should be ascertained and the treatment planned according to the line of treatment and drugs prescribed for that ''[[dosha]]''.
''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 ''[[dosha]]s'' in order, beginning with the site of ''[[kapha]]''.[283-287]
</div>
=== Management of ''karnamulika shotha'' (inflammatoion near the root of the ears) ===
<div class="mw-collapsible mw-collapsed">
सन्निपातज्वरस्यान्ते कर्णमूले सुदारूणः||२८७||
सन्निपातज्वरस्यान्ते कर्णमूले सुदारूणः||२८७||
प्रदेहैः कफपित्तघ्नैर्नावनैः कवलग्रहैः|२८९|
प्रदेहैः कफपित्तघ्नैर्नावनैः कवलग्रहैः|२८९|
<div class="mw-collapsible-content">
sannipātajvarasyāntē karṇamūlē sudārūṇaḥ||287||
sannipātajvarasyāntē karṇamūlē sudārūṇaḥ||287||
pradehaiH kaphapittaghnairnAvanaiH kavalagrahaiH|289|
pradehaiH kaphapittaghnairnAvanaiH kavalagrahaiH|289|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
=== Indications of blood letting ===
<div class="mw-collapsible mw-collapsed">
शीतोष्णस्निग्धरूक्षाद्यैर्ज्वरो यस्य न शाम्यति||२८९||
शीतोष्णस्निग्धरूक्षाद्यैर्ज्वरो यस्य न शाम्यति||२८९||
शाखानुसारी रक्तस्य सोऽवसेकात् प्रशाम्यति|२९०|
शाखानुसारी रक्तस्य सोऽवसेकात् प्रशाम्यति|२९०|
<div class="mw-collapsible-content">
śītōṣṇasnigdharūkṣādyairjvarō yasya na śāmyati||289||
śītōṣṇasnigdharūkṣādyairjvarō yasya na śāmyati||289||
shAkhAnusArI raktasya so~avasekAt prashAmyati|290|
shAkhAnusArI raktasya so~avasekAt prashAmyati|290|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Indication of consumption of ghee ===
<div class="mw-collapsible mw-collapsed">
विसर्पेणाभिघातेन यश्च विस्फोटकैर्ज्वरः||२९०||
विसर्पेणाभिघातेन यश्च विस्फोटकैर्ज्वरः||२९०||
तत्रादौ सर्पिषः पानं कफपित्तोत्तरो न चेत्|२९१|
तत्रादौ सर्पिषः पानं कफपित्तोत्तरो न चेत्|२९१|
<div class="mw-collapsible-content">
visarpēṇābhighātēna yaśca visphōṭakairjvaraḥ||290||
visarpēṇābhighātēna yaśca visphōṭakairjvaraḥ||290||
tatrAdau sarpiShaH pAnaM kaphapittottaro na cet|291|
tatrAdau sarpiShaH pAnaM kaphapittottaro na cet|291|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
=== Management of ''jeerna jwara'' (chronic stage) ===
<div class="mw-collapsible mw-collapsed">
दौर्बल्याद्देहधातूनां ज्वरो जीर्णोऽनुवर्तते||२९१||
दौर्बल्याद्देहधातूनां ज्वरो जीर्णोऽनुवर्तते||२९१||
बल्येः सम्बृंहणैस्तस्मादाहारैस्तमुपाचरेत्|२९२|
बल्येः सम्बृंहणैस्तस्मादाहारैस्तमुपाचरेत्|२९२|
<div class="mw-collapsible-content">
daurbalyāddēhadhātūnāṁ jvarō jīrṇō'nuvartatē||291||
daurbalyāddēhadhātūnāṁ jvarō jīrṇō'nuvartatē||291||
balyeH sambRuMhaNaistasmAdAhAraistamupAcaret|292|
balyeH sambRuMhaNaistasmAdAhAraistamupAcaret|292|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Management of ''[[dosha]]'' dominance in ''vishamajwara'' ===
<div class="mw-collapsible mw-collapsed">
कर्म साधारणं जह्यात्तृतीयकचतुर्थकौ ||२९२||
कर्म साधारणं जह्यात्तृतीयकचतुर्थकौ ||२९२||
कषायोष्णं च विषमे ज्वरे शस्तं कफोत्तरे|२९६|
कषायोष्णं च विषमे ज्वरे शस्तं कफोत्तरे|२९६|
<div class="mw-collapsible-content">
karma sādhāraṇaṁ jahyāttr̥tīyakacaturthakau ||292||
karma sādhāraṇaṁ jahyāttr̥tīyakacaturthakau ||292||
kaShAyoShNaM ca viShame jvare shastaM kaphottare|296|
kaShAyoShNaM ca viShame jvare shastaM kaphottare|296|
</div></div>
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]
<div style="text-align:justify;">
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]
</div>
=== Guidelines and various formulations in ''vishama jwara'' ===
<div class="mw-collapsible mw-collapsed">
योगाः पराः प्रवक्ष्यन्ते विषमज्वरनाशनाः||२९६||
योगाः पराः प्रवक्ष्यन्ते विषमज्वरनाशनाः||२९६||
धारणादगदानां च सेवनान्न भवेज्ज्वरः|३१०|
धारणादगदानां च सेवनान्न भवेज्ज्वरः|३१०|
<div class="mw-collapsible-content">
yōgāḥ parāḥ pravakṣyantē viṣamajvaranāśanāḥ||296||
yōgāḥ parāḥ pravakṣyantē viṣamajvaranāśanāḥ||296||
dhAraNAdagadAnAM ca sevanAnna bhavejjvaraH|310|
dhAraNAdagadAnAM ca sevanAnna bhavejjvaraH|310|
</div></div>
<div style="text-align:justify;">
Formulations which are effective in curing ''jwara'' are being described. A wise physician should administer them, keeping in view their suitability for the type of ''dosha'' involved. These recipes are as follows –
Formulations which are effective in curing ''jwara'' are being described. A wise physician should administer them, keeping in view their suitability for the type of ''dosha'' involved. These recipes are as follows –
*''Sura'' along with its ''manda'' (alcohol along with its supernatant part) as drink
*''Sura'' along with its ''manda'' (alcohol along with its supernatant part) as drink
*The meat of chicken, patridge and peacock are used as food
*The meat of chicken, patridge and peacock are used as food
*Intake of medicated ghee called as ''shatapala; abhaya; triphala'' decoction; ''guduchi'' juice; preparation of ''nīlinī, ajagandhā, trivrita'' and ''kaṭurohiṇī'' during the onset of fever. These things should be administered to the patient appropriately, after the patient is given ''snehana'' and ''swedana'' therapies (oleation and sudation).
*Intake of medicated ghee called as ''shatapala; abhaya; triphala'' decoction; ''guduchi'' juice; preparation of ''nīlinī, ajagandhā, trivrita'' and ''kaṭurohiṇī'' during the onset of fever. These things should be administered to the patient appropriately, after the patient is given ''[[snehana]]'' and ''[[swedana]]'' therapies (oleation and sudation).
*Emesis after the administration of ghee in large quantity
*Emesis after the administration of ghee in large quantity
*Emesis after taking large quantity of food and drinks
*Emesis after taking large quantity of food and drinks
*Wearing of ''maṇis'' (precious stones and jewels), ''auṡadha'' (drugs), ''mangalya'' (auspicious talisman) and ''viṡa'' (poisonous substances)
*Wearing of ''maṇis'' (precious stones and jewels), ''auṡadha'' (drugs), ''mangalya'' (auspicious talisman) and ''viṡa'' (poisonous substances)
*Intake of ''agada'' (antidote like drugs).[296-309]
*Intake of ''agada'' (antidote like drugs).[296-309]
</div>
=== Spiritual therapy ===
<div class="mw-collapsible mw-collapsed">
सोमं सानुचरं देवं समातृगणमीश्वरम्||३१०||
सोमं सानुचरं देवं समातृगणमीश्वरम्||३१०||
ज्वराद्विमुच्यते शीघ्रं साधूनां दर्शनेन च|
ज्वराद्विमुच्यते शीघ्रं साधूनां दर्शनेन च|
<div class="mw-collapsible-content">
sōmaṁ sānucaraṁ dēvaṁ samātr̥gaṇamīśvaram||310||
sōmaṁ sānucaraṁ dēvaṁ samātr̥gaṇamīśvaram||310||
jvarAdvimucyate shIghraM sAdhUnAM darshanena ca|
jvarAdvimucyate shIghraM sAdhUnAM darshanena ca|
</div></div>
<div style="text-align:justify;">
Prayers should be offered to lord Ishvara along with Umā, their attendents and matṛs. This immediately cures ''viṡama jwara''.
Prayers should be offered to lord Ishvara along with Umā, their attendents and matṛs. This immediately cures ''viṡama jwara''.
Devotion to father and mother, prayer to ''gurūs'', observance of celibacy, practice of ''tapa'' (penance), truthfulness and ''niyama'' (religious rites), ''japa'' (incantations), ''homa'' (like ''yajña'' – offering oblation to fire), hearing the recitation of the ''vedās'' and the ''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]
</div>
=== Management of ''jwara'' located in various ''[[dhatu]]'' ===
<div class="mw-collapsible mw-collapsed">
ज्वरे रसस्थे वमनमुपवासं च कारयेत्||३१५||
ज्वरे रसस्थे वमनमुपवासं च कारयेत्||३१५||
अस्थिमज्जगते देया निरूहाः सानुवासनाः|३१७|
अस्थिमज्जगते देया निरूहाः सानुवासनाः|३१७|
<div class="mw-collapsible-content">
jvarādvimucyatē śīghraṁ sādhūnāṁ darśanēna ca|
jvarādvimucyatē śīghraṁ sādhūnāṁ darśanēna ca|
asthimajjagate deyA nirUhAH sAnuvAsanAH|317|
asthimajjagate deyA nirUhAH sAnuvAsanAH|317|
</div></div>
When the ''doshas'' causing ''jwara'' are located in –
<div style="text-align:justify;">
*the ''rasa dhātu'', then ''vamana'' and ''upavāsa'' (emesis and fasting) should be done.
When the ''[[dosha]]s'' causing ''jwara'' are located in –
*the ''rakta dhātu'', then ''seka'' and ''pradeha'' (pouring of hot medicated liquids and ointment application) should be done.
*the ''[[rasa dhatu]]'', then ''[[vamana]]'' and ''upavāsa'' (emesis and fasting) should be done.
*in the ''mānsa'' and the ''medas virecana'' and ''upavāsa'' should be done.
*the ''[[rakta dhatu]]'', then ''seka'' and ''pradeha'' (pouring of hot medicated liquids and ointment application) should be done.
*in the ''asthī'' and ''majjā dhātūs, nirūha'' and ''anuvāsana bastīs'' should be given. [315-317]
*in the ''[[mamsa dhatu]]'' and the ''[[meda dhatu]] [[virecana]]'' and ''upavāsa'' should be done.
*in the ''[[asthi dhatu]]'' and ''[[majja dhatu]]s, nirūha'' and ''anuvāsana [[basti]]s'' should be given. [315-317]
</div>
=== Management of ''abhicharaja'' and ''abhishangaja jwara'' ===
<div class="mw-collapsible mw-collapsed">
शापाभिचाराद्भूतानामभिषङ्गाच्च यो ज्वरः||३१७||
शापाभिचाराद्भूतानामभिषङ्गाच्च यो ज्वरः||३१७||
दैवव्यपाश्रयं तत्र सर्वमौषधमिष्यते|
दैवव्यपाश्रयं तत्र सर्वमौषधमिष्यते|
<div class="mw-collapsible-content">
śāpābhicārādbhūtānāmabhiṣaṅgācca yō jvaraḥ||317||
śāpābhicārādbhūtānāmabhiṣaṅgācca yō jvaraḥ||317||
daivavyapAshrayaM tatra sarvamauShadhamiShyate|
daivavyapAshrayaM tatra sarvamauShadhamiShyate|
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Management of ''abhighataja jwara'' ===
<div class="mw-collapsible mw-collapsed">
अभिघातज्वरो नश्येत् पानाभ्यङ्गेन सर्पिषः||३१८||
अभिघातज्वरो नश्येत् पानाभ्यङ्गेन सर्पिषः||३१८||
रक्तावसेकैर्मद्यैश्च सात्म्यैर्मांसरसौदनैः|
रक्तावसेकैर्मद्यैश्च सात्म्यैर्मांसरसौदनैः|
सानाहो मद्यसात्म्यानां मदिरारसभोजनैः||३१९||
सानाहो मद्यसात्म्यानां मदिरारसभोजनैः||३१९||
क्षतानां व्रणितानां च क्षतव्रणचिकित्सया|
क्षतानां व्रणितानां च क्षतव्रणचिकित्सया|
<div class="mw-collapsible-content">
abhighātajvarō naśyēt pānābhyaṅgēna sarpiṣaḥ||318||
abhighātajvarō naśyēt pānābhyaṅgēna sarpiṣaḥ||318||
raktāvasēkairmadyaiśca sātmyairmāṁsarasaudanaiḥ|
raktāvasēkairmadyaiśca sātmyairmāṁsarasaudanaiḥ|
sānāhō madyasātmyānāṁ madirārasabhōjanaiḥ||319||
sānāhō madyasātmyānāṁ madirārasabhōjanaiḥ||319||
kṣatānāṁ vraṇitānāṁ ca kṣatavraṇacikitsayā|
kṣatānāṁ vraṇitānāṁ ca kṣatavraṇacikitsayā|
abhighAtajvaro nashyet pAnAbhya~ggena sarpiShaH||318||
abhighAtajvaro nashyet pAnAbhya~ggena sarpiShaH||318||
raktAvasekairmadyaishca sAtmyairmAMsarasaudanaiH|
raktAvasekairmadyaishca sAtmyairmAMsarasaudanaiH|
sAnAho madyasAtmyAnAM madirArasabhojanaiH||319||
sAnAho madyasAtmyAnAM madirArasabhojanaiH||319||
kShatAnAM vraNitAnAM ca kShatavraNacikitsayA|
kShatAnAM vraNitAnAM ca kShatavraNacikitsayA|
</div></div>
<div style="text-align:justify;">
''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]
</div>
=== Management of ''agantuja jwara'' due to mental factors ===
<div class="mw-collapsible mw-collapsed">
आश्वासेनेष्टलाभेन वायोः प्रशमनेन च||३२०||
आश्वासेनेष्टलाभेन वायोः प्रशमनेन च||३२०||
हर्षणैश्च शमं यान्ति कामशोकभयज्वराः|
हर्षणैश्च शमं यान्ति कामशोकभयज्वराः|
काम्यैरर्थैर्मनोज्ञैश्च पित्तघ्नैश्चाप्युपक्रमैः||३२१||
काम्यैरर्थैर्मनोज्ञैश्च पित्तघ्नैश्चाप्युपक्रमैः||३२१||
सद्वाक्यैश्च शमं याति ज्वरः क्रोधसमुत्थितः|
सद्वाक्यैश्च शमं याति ज्वरः क्रोधसमुत्थितः|
कामात् क्रोधज्वरो नाशं क्रोधात् कामसमुद्भवः||३२२||
कामात् क्रोधज्वरो नाशं क्रोधात् कामसमुद्भवः||३२२||
याति ताभ्यामुभाभ्यां च भयशोकसमुत्थितः|
याति ताभ्यामुभाभ्यां च भयशोकसमुत्थितः|
ज्वरस्य वेगं कालं च चिन्तयञ्ज्वर्यते तु यः||३२३||
ज्वरस्य वेगं कालं च चिन्तयञ्ज्वर्यते तु यः||३२३||
तस्येष्टैस्तु विचित्रैश्च विषयैर्नाशयेत् स्मृतिम्|३२४|
तस्येष्टैस्तु विचित्रैश्च विषयैर्नाशयेत् स्मृतिम्|३२४|
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āśvāsēnēṣṭalābhēna vāyōḥ praśamanēna ca||320||
āśvāsēnēṣṭalābhēna vāyōḥ praśamanēna ca||320||
harṣaṇaiśca śamaṁ yānti kāmaśōkabhayajvarāḥ|
harṣaṇaiśca śamaṁ yānti kāmaśōkabhayajvarāḥ|
kāmyairarthairmanōjñaiśca pittaghnaiścāpyupakramaiḥ||321||
kāmyairarthairmanōjñaiśca pittaghnaiścāpyupakramaiḥ||321||
sadvākyaiśca śamaṁ yāti jvaraḥ krōdhasamutthitaḥ|
sadvākyaiśca śamaṁ yāti jvaraḥ krōdhasamutthitaḥ|
kāmāt krōdhajvarō nāśaṁ krōdhāt kāmasamudbhavaḥ||322||
kāmāt krōdhajvarō nāśaṁ krōdhāt kāmasamudbhavaḥ||322||
yāti tābhyāmubhābhyāṁ ca bhayaśōkasamutthitaḥ|
yāti tābhyāmubhābhyāṁ ca bhayaśōkasamutthitaḥ|
jvarasya vēgaṁ kālaṁ ca cintayañjvaryatē tu yaḥ||323||
jvarasya vēgaṁ kālaṁ ca cintayañjvaryatē tu yaḥ||323||
harShaNaishca shamaM yAnti kAmashokabhayajvarAH|
harShaNaishca shamaM yAnti kAmashokabhayajvarAH|
kAmyairarthairmanoj~jaishca pittaghnaishcApyupakramaiH||321||
kAmyairarthairmanoj~jaishca pittaghnaishcApyupakramaiH||321||
sadvAkyaishca shamaM yAti jvaraH krodhasamutthitaH|
sadvAkyaishca shamaM yAti jvaraH krodhasamutthitaH|
kAmAt krodhajvaro nAshaM krodhAt kAmasamudbhavaH||322||
kAmAt krodhajvaro nAshaM krodhAt kAmasamudbhavaH||322||
yAti tAbhyAmubhAbhyAM ca bhayashokasamutthitaH|
yAti tAbhyAmubhAbhyAM ca bhayashokasamutthitaH|
jvarasya vegaM kAlaM ca cintaya~jjvaryate tu yaH||323||
jvarasya vegaM kAlaM ca cintaya~jjvaryate tu yaH||323||
tasyeShTaistu vicitraishca viShayairnAshayet smRutim|324|
tasyeShTaistu vicitraishca viShayairnAshayet smRutim|324|
</div></div>
<div style="text-align:justify;">
The ''jwara'' caused by ''kāma'' (passion), ''shoka'' (grief) and ''bhaya'' (fear) gets cured by the ''āshvāshana'' (assurance), ''ishṭa labha'' (providing the desired object), alleviation of ''vāyu'' and ''harshana'' (bringing excitement).
The ''jwara'' caused by ''kāma'' (passion), ''shoka'' (grief) and ''bhaya'' (fear) gets cured by the ''āshvāshana'' (assurance), ''ishṭa labha'' (providing the desired object), alleviation of ''vāyu'' and ''harshana'' (bringing excitement).
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]
</div>
=== Signs of remission of ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
ज्वरप्रमोक्षे पुरुषः कूजन् वमति चेष्टते|
श्वसन्विवर्णः स्विन्नाङ्गो वेपते लीयते मुहुः||३२४||
श्वसन्विवर्णः स्विन्नाङ्गो वेपते लीयते मुहुः||३२४||
प्रलपत्युष्णसर्वाङ्गः शीताङ्गश्च भवत्यपि|
प्रलपत्युष्णसर्वाङ्गः शीताङ्गश्च भवत्यपि|
विसञ्ज्ञो ज्वरवेगार्तः सक्रोध इव वीक्ष्यते ||३२५||
विसञ्ज्ञो ज्वरवेगार्तः सक्रोध इव वीक्ष्यते ||३२५||
सदोषशब्दं च शकृद्द्रवं स्रवति वेगवत्|
सदोषशब्दं च शकृद्द्रवं स्रवति वेगवत्|
लिङ्गान्येतानि जानीयाज्ज्वरमोक्षे विचक्षणः||३२६||
लिङ्गान्येतानि जानीयाज्ज्वरमोक्षे विचक्षणः||३२६||
बहुदोषस्य बलवान् प्रायेणाभिनवो ज्वरः|
बहुदोषस्य बलवान् प्रायेणाभिनवो ज्वरः|
सत्क्रियादोषपक्त्या चेद्विमुञ्चति सुदारुणम्||३२७||
सत्क्रियादोषपक्त्या चेद्विमुञ्चति सुदारुणम्||३२७||
कृत्वा दोषवशाद्वेगं क्रमादुपरमन्ति ये|
कृत्वा दोषवशाद्वेगं क्रमादुपरमन्ति ये|
तेषामदारुणो मोक्षो ज्वराणां चिरकारिणाम्||३२८||
तेषामदारुणो मोक्षो ज्वराणां चिरकारिणाम्||३२८||
<div class="mw-collapsible-content">
jvarapramōkṣē puruṣaḥ kūjan vamati cēṣṭatē|
jvarapramōkṣē puruṣaḥ kūjan vamati cēṣṭatē|
śvasanvivarṇaḥ svinnāṅgō vēpatē līyatē muhuḥ||324||
śvasanvivarṇaḥ svinnāṅgō vēpatē līyatē muhuḥ||324||
pralapatyuṣṇasarvāṅgaḥ śītāṅgaśca bhavatyapi|
pralapatyuṣṇasarvāṅgaḥ śītāṅgaśca bhavatyapi|
visañjñō jvaravēgārtaḥ sakrōdha iva vīkṣyatē ||325||
visañjñō jvaravēgārtaḥ sakrōdha iva vīkṣyatē ||325||
sadōṣaśabdaṁ ca śakr̥ddravaṁ sravati vēgavat|
sadōṣaśabdaṁ ca śakr̥ddravaṁ sravati vēgavat|
liṅgānyētāni jānīyājjvaramōkṣē vicakṣaṇaḥ||326||
liṅgānyētāni jānīyājjvaramōkṣē vicakṣaṇaḥ||326||
bahudōṣasya balavān prāyēṇābhinavō jvaraḥ|
bahudōṣasya balavān prāyēṇābhinavō jvaraḥ|
satkriyādōṣapaktyā cēdvimuñcati sudāruṇam||327||
satkriyādōṣapaktyā cēdvimuñcati sudāruṇam||327||
kr̥tvā dōṣavaśādvēgaṁ kramāduparamanti yē|
kr̥tvā dōṣavaśādvēgaṁ kramāduparamanti yē|
tēṣāmadāruṇō mōkṣō jvarāṇāṁ cirakāriṇām||328||
tēṣāmadāruṇō mōkṣō jvarāṇāṁ cirakāriṇām||328||
jvarapramokShe puruShaH kUjan vamati ceShTate|
jvarapramokShe puruShaH kUjan vamati ceShTate|
shvasanvivarNaH svinnA~ggo vepate lIyate muhuH||324||
shvasanvivarNaH svinnA~ggo vepate lIyate muhuH||324||
pralapatyuShNasarvA~ggaH shItA~ggashca bhavatyapi|
pralapatyuShNasarvA~ggaH shItA~ggashca bhavatyapi|
visa~jj~jo jvaravegArtaH sakrodha iva vIkShyate ||325||
visa~jj~jo jvaravegArtaH sakrodha iva vIkShyate ||325||
sadoShashabdaM ca shakRuddravaM sravati vegavat|
sadoShashabdaM ca shakRuddravaM sravati vegavat|
li~ggAnyetAni jAnIyAjjvaramokShe vicakShaNaH||326||
li~ggAnyetAni jAnIyAjjvaramokShe vicakShaNaH||326||
bahudoShasya balavAn prAyeNAbhinavo jvaraH|
bahudoShasya balavAn prAyeNAbhinavo jvaraH|
satkriyAdoShapaktyA cedvimu~jcati sudAruNam||327||
satkriyAdoShapaktyA cedvimu~jcati sudAruNam||327||
kRutvA doShavashAdvegaM kramAduparamanti ye|
kRutvA doShavashAdvegaM kramAduparamanti ye|
teShAmadAruNo mokSho jvarANAM cirakAriNAm||328||
teShAmadAruNo mokSho jvarANAM cirakAriNAm||328||
</div></div>
<div style="text-align:justify;">
The clinical features manifested at the time of remission of (''sannipata jwara'') are – the patient produces ''kujana'' (rumbling) sound, vomiting, abnormal movements of the limbs (''cheshta''), heavy breathing or difficulty in breathing, discoloration, ''svinna anga'' (sweating), trembling (''vepate''), frequent fainting (''lihyate muhuḥ''), delirium, the body becoming very hot and cold at times, unconsciousness, more rise of temperature, angry appearance and forceful passage of liquid stools mixed with ''[[dosha]]s'' with sound.
If a severe condition of ''jwara'' with excessively aggravated ''[[dosha]]s'' and recent onset, is treated with appropriate therapy, then ''[[dosha]] paka'' occurs. Because of this, the sudden remission of ''jwara'' occurs with difficulty (''daruna moksha'').
In chronic stage of ''jwara'', the episodes are remitted depending upon strength of ''[[dosha]]''. The remission occurs slowly without difficulty. [324-328]
</div>
=== Signs of completely cured ''jwara'' patient ===
<div class="mw-collapsible mw-collapsed">
विगतक्लमसन्तापमव्यथं विमलेन्द्रियम्|
युक्तं प्रकृतिसत्त्वेन विद्यात् पुरुषमज्वरम्||३२९||
युक्तं प्रकृतिसत्त्वेन विद्यात् पुरुषमज्वरम्||३२९||
<div class="mw-collapsible-content">
vigataklamasantāpamavyathaṁ vimalēndriyam|
vigataklamasantāpamavyathaṁ vimalēndriyam|
yuktaṁ prakr̥tisattvēna vidyāt puruṣamajvaram||329||
yuktaṁ prakr̥tisattvēna vidyāt puruṣamajvaram||329||
vigataklamasantApamavyathaM vimalendriyam|
vigataklamasantApamavyathaM vimalendriyam|
yuktaM prakRutisattvena vidyAt puruShamajvaram||329||
yuktaM prakRutisattvena vidyAt puruShamajvaram||329||
</div></div>
<div style="text-align:justify;">
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]
</div>
=== Precautions after being cured from ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
सज्वरो ज्वरमुक्तश्च विदाहीनि गुरूणि च|
असात्म्यान्यन्नपानानि विरुद्धानि च वर्जयेत्||३३०||
असात्म्यान्यन्नपानानि विरुद्धानि च वर्जयेत्||३३०||
व्यवायमतिचेष्टाश्च स्नानमत्यशनानि च|
व्यवायमतिचेष्टाश्च स्नानमत्यशनानि च|
तथा ज्वरः शमं याति प्रशान्तो जायते न च||३३१||
तथा ज्वरः शमं याति प्रशान्तो जायते न च||३३१||
व्यायामं च व्यवायं च स्नानं चङ्क्रमणानि च|
व्यायामं च व्यवायं च स्नानं चङ्क्रमणानि च|
ज्वरमुक्तो न सेवेत यावन्न बलवान् भवेत्||३३२||
ज्वरमुक्तो न सेवेत यावन्न बलवान् भवेत्||३३२||
<div class="mw-collapsible-content">
sajvarō jvaramuktaśca vidāhīni gurūṇi ca|
sajvarō jvaramuktaśca vidāhīni gurūṇi ca|
asātmyānyannapānāni viruddhāni ca varjayēt||330||
asātmyānyannapānāni viruddhāni ca varjayēt||330||
vyavāyamaticēṣṭāśca snānamatyaśanāni ca|
vyavāyamaticēṣṭāśca snānamatyaśanāni ca|
tathā jvaraḥ śamaṁ yāti praśāntō jāyatē na ca||331||
tathā jvaraḥ śamaṁ yāti praśāntō jāyatē na ca||331||
vyāyāmaṁ ca vyavāyaṁ ca snānaṁ caṅkramaṇāni ca|
vyāyāmaṁ ca vyavāyaṁ ca snānaṁ caṅkramaṇāni ca|
jvaramuktō na sēvēta yāvanna balavān bhavēt||332||
jvaramuktō na sēvēta yāvanna balavān bhavēt||332||
sajvaro jvaramuktashca vidAhIni gurUNi ca|
sajvaro jvaramuktashca vidAhIni gurUNi ca|
asAtmyAnyannapAnAni viruddhAni ca varjayet||330||
asAtmyAnyannapAnAni viruddhAni ca varjayet||330||
vyavAyamaticeShTAshca snAnamatyashanAni ca|
vyavAyamaticeShTAshca snAnamatyashanAni ca|
tathA jvaraH shamaM yAti prashAnto jAyate na ca||331||
tathA jvaraH shamaM yAti prashAnto jAyate na ca||331||
vyAyAmaM ca vyavAyaM ca snAnaM ca~gkramaNAni ca|
vyAyAmaM ca vyavAyaM ca snAnaM ca~gkramaNAni ca|
jvaramukto na seveta yAvanna balavAn bhavet||332||
jvaramukto na seveta yAvanna balavAn bhavet||332||
</div></div>
<div style="text-align:justify;">
A person suffering from ''jwara'' and the one who has become free from it should not indulge in and avoid the following - the intake of food and drinks which are ''vidahi'' (causing burning sensation), ''guru'' (heavy), ''asatmya'' (unwholesome) and ''viruddha'' (mutually contradictory); sexual intercourse, excessive exhaustion, bath and excessive walking. By observing these rules the fever gets alleviated and does not occur again.
A person suffering from ''jwara'' and the one who has become free from it should not indulge in and avoid the following - the intake of food and drinks which are ''vidahi'' (causing burning sensation), ''guru'' (heavy), ''asatmya'' (unwholesome) and ''viruddha'' (mutually contradictory); sexual intercourse, excessive exhaustion, bath and excessive walking. By observing these rules the fever gets alleviated and does not occur again.
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]
</div>
=== ''Punaravarti jwara'' (recurrent ''jwara'') ===
<div class="mw-collapsible mw-collapsed">
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||
<div class="mw-collapsible-content">
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||
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||
</div></div>
<div style="text-align:justify;">
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 ''[[dosha]]s'' 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, ''[[dosha]]s'' undergo ''paripāka'' (metabolic transformation) in the ''[[dhatu]]s'' 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 ''[[dosha]]s'' completely, even by resorting to little unwholesome regime after the cure of the disease.
Therefore, the ''[[dosha]]s'' should be eliminated from the body either by elimination or alleviation therapies depending upon the stage and strength of the ''[[dosha]]s'', 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]
</div>
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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तस्यां तस्यामवस्थायां ज्वरितानां विचक्षणः|
तस्यां तस्यामवस्थायां ज्वरितानां विचक्षणः|
ज्वराक्रियाक्रमापेक्षी कुर्यात्तत्तच्चिकित्सितम्||३४४||
ज्वराक्रियाक्रमापेक्षी कुर्यात्तत्तच्चिकित्सितम्||३४४||
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tasyāṁ tasyāmavasthāyāṁ jvaritānāṁ vicakṣaṇaḥ|
tasyāṁ tasyāmavasthāyāṁ jvaritānāṁ vicakṣaṇaḥ|
tasyAM tasyAmavasthAyAM jvaritAnAM vicakShaNaH|
tasyAM tasyAmavasthAyAM jvaritAnAM vicakShaNaH|
jvarAkriyAkramApekShI kuryAttattaccikitsitam||344||
jvarAkriyAkramApekShI kuryAttattaccikitsitam||344||
</div></div>
<div style="text-align:justify;">
The wise physician should treat the patient in different stages of ''jwara'', according to the line of treatment of ''jwara''. [344]
The wise physician should treat the patient in different stages of ''jwara'', according to the line of treatment of ''jwara''. [344]
</div>
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रोगराट् सर्वभूतानामन्तकृद्दारुणो ज्वरः|
रोगराट् सर्वभूतानामन्तकृद्दारुणो ज्वरः|
तस्माद्विशेषतस्तस्य यतेत प्रशमे भिषक्||३४५||
तस्माद्विशेषतस्तस्य यतेत प्रशमे भिषक्||३४५||
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rōgarāṭ sarvabhūtānāmantakr̥ddāruṇō jvaraḥ|
rōgarāṭ sarvabhūtānāmantakr̥ddāruṇō jvaraḥ|
rogarAT sarvabhUtAnAmantakRuddAruNo jvaraH|
rogarAT sarvabhUtAnAmantakRuddAruNo jvaraH|
tasmAdvisheShatastasya yateta prashame bhiShak||345||
tasmAdvisheShatastasya yateta prashame bhiShak||345||
</div></div>
<div style="text-align:justify;">
''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]
</div>
=== Summary ===
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तत्र श्लोकः-
तत्र श्लोकः-
यथाक्रमं यथाप्रश्नमुक्तं ज्वरचिकित्सितम्|
यथाक्रमं यथाप्रश्नमुक्तं ज्वरचिकित्सितम्|
आत्रेयेणाग्निवेशाय भूतानां हितकाम्यया||३४६||
आत्रेयेणाग्निवेशाय भूतानां हितकाम्यया||३४६||
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tatra ślōkaḥ-
tatra ślōkaḥ-
yathAkramaM yathAprashnamuktaM jvaracikitsitam|
yathAkramaM yathAprashnamuktaM jvaracikitsitam|
AtreyeNAgniveshAya bhUtAnAM hitakAmyayA||346||
AtreyeNAgniveshAya bhUtAnAM hitakAmyayA||346||
</div></div>
<div style="text-align:justify;">
With a desire for the welfare of the living creatures, Atreya has furnished the replies to the queries of Agniveśa regarding the treatment of ''jwara''. [347]
With a desire for the welfare of the living creatures, Atreya has furnished the replies to the queries of Agniveśa regarding the treatment of ''jwara''. [347]
=== ''Tattva Vimarsha'' ===
== Tattva Vimarsha (Fundamental Principles) ==
*All diseases including ''jwara'' occur due to disequilibrium of ''dosha''. If the ''dosha'' are in equilibrium state, health is maintained and disease cannot occur.
*All diseases including ''jwara'' occur due to disequilibrium of ''[[dosha]]''. If the ''[[dosha]]'' are in equilibrium state, health is maintained and disease cannot occur.
*The origin of all diseases is because of the tendency for greed or attachment (''parigraha'').
*The origin of all diseases is because of the tendency for greed or attachment (''parigraha'').
*In order to know a disease, the diagnosis of ''sharira'' (physical) and ''manasa'' (mental); ''saumya'' (predominated by cold) and ''agneya'' (predominated by heat); ''antarvega'' (internal) and ''bahirvega'' (external); ''prakrita'' (according to seasons) and ''vaikrita'' (unseasonal); ''sadhya''(curable) and ''asadhya'' (incurable) should be made and treated accordingly.
*In order to know a disease, the diagnosis of ''sharira'' (physical) and ''manasa'' (mental); ''saumya'' (predominated by cold) and ''agneya'' (predominated by heat); ''antarvega'' (internal) and ''bahirvega'' (external); ''prakrita'' (according to seasons) and ''vaikrita'' (unseasonal); ''sadhya''(curable) and ''asadhya'' (incurable) should be made and treated accordingly.
*The psychic involvement in a disease shall be assessed on the basis of ''vaichitya'' (mental instability), ''arati'' (disliking for everything) and ''glani'' (feeling of weakness in the body).
*The psychic involvement in a disease shall be assessed on the basis of ''vaichitya'' (mental instability), ''arati'' (disliking for everything) and ''glani'' (feeling of weakness in the body).
*''Dosha'' dominance can be assessed by the desire to take cold or hot things. In ''vata-pitta'' dominant diseases, there is desire for cold things and in ''vata-kapha'' dominant diseases, there is desire for hot things.
*''[[Dosha]]'' dominance can be assessed by the desire to take cold or hot things. In ''[[vata]]-[[pitta]]'' dominant diseases, there is desire for cold things and in ''[[vata]]-[[kapha]]'' dominant diseases, there is desire for hot things.
*Seasonal variations in temperature, environment can adversely affect the ''dosha'' balance leading to diseases originated from naturally vitiated ''dosha''.
*Seasonal variations in temperature, environment can adversely affect the ''[[dosha]]'' balance leading to diseases originated from naturally vitiated ''[[dosha]]''.
*As a seed remains dormant in the soil and germinates at a favorable time, similarly the ''doshas'' remain in dormant condition in the ''dhatu'' and get aggravated at a favorable time. These ''dosha'' gain strength at an appropriate time and when the power of the inhibiting (disease preventing) factors subsides, then disease occurs.
*As a seed remains dormant in the soil and germinates at a favorable time, similarly the ''[[dosha]]s'' remain in dormant condition in the ''dhatu'' and get aggravated at a favorable time. These ''[[dosha]]'' gain strength at an appropriate time and when the power of the inhibiting (disease preventing) factors subsides, then disease occurs.
*In the ''abhighataja jwara'', caused by any injury, vitiated ''vata'' affects predominantly ''rakta'' (blood) to resulting in ''jwara'' with discomfort, swelling, discoloration and pain. This resembles with inflammation.
*In the ''abhighataja jwara'', caused by any injury, vitiated ''[[vata]]'' affects predominantly ''[[rakta]]'' (blood) to resulting in ''jwara'' with discomfort, swelling, discoloration and pain. This resembles with inflammation.
*The exogenous ''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).
*The exogenous ''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).
*The processes of vitiated ''dosha'' spread all over body after combining with the ''rasa'' (first ''dhatu'' of nutrition), its effect of displacement of ''agni'' (hampering metabolism), obstruction of transport channels specifically sweat pores leading to increase in internal heat are important milestones in pathogenesis of ''jwara''.
*The processes of vitiated ''[[dosha]]'' spread all over body after combining with the ''[[rasa]]'' (first ''[[dhatu]]'' of nutrition), its effect of displacement of ''agni'' (hampering metabolism), obstruction of transport channels specifically sweat pores leading to increase in internal heat are important milestones in pathogenesis of ''jwara''.
*''Langhana'' (fasting) reduces the aggravated ''dosha'', stimulates the ''agni'', and leads to lightness and restoration of appetite with alleviation of ''jwara'' .
*''[[Langhana]]'' (fasting) reduces the aggravated ''[[dosha]]'', stimulates the ''agni'', and leads to lightness and restoration of appetite with alleviation of ''jwara'' .
*''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.
*''[[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.
*Any treatment shall always be performed after proper assessment of nature and state of ''dosha''. Otherwise it leads to complications and adverse effects.
*Any treatment shall always be performed after proper assessment of nature and state of ''[[dosha]]''. Otherwise it leads to complications and adverse effects.
*The purification treatments are done only in a state of ''utklishta dosha'' (on the verge of being expelled out). If the ''dosha'' are excessively vitiated, but not in ''utklishta'', then pre-purification treatments like ''deepana, pachana, snehana'' are performed to bring the ''dosha'' to ''utlishta'' state.
*The purification treatments are done only in a state of ''utklishta [[dosha]]'' (on the verge of being expelled out). If the ''[[dosha]]'' are excessively vitiated, but not in ''utklishta'', then pre-purification treatments like ''[[deepana]], [[pachana]], [[snehana]]'' are performed to bring the ''[[dosha]]'' to ''utlishta'' state.
*''Langhana'' (fasting), ''swedana'' (fomentation to remove obstruction in sweat pores), ''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 initial stage of ''jwara''.
*''[[Langhana]]'' (fasting), ''[[swedana]]'' (fomentation to remove obstruction in sweat pores), ''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 initial stage of ''jwara''.
*When ''vayu'' is predominantly aggravated in ''jwara'', then patient should be treated by the administration of ''ghee, niruha'' and ''anuvasana bastis'' (medicated enemas), unctuous and hot diet and drinks.
*When ''vayu'' is predominantly aggravated in ''jwara'', then patient should be treated by the administration of ''ghee, niruha'' and ''anuvasana [[basti]]s'' (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.
*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, the patient should be administered emetic therapy, ''pachana'' (therapy which promotes the digestion and metabolism), non-unctuous diet and drinks, fasting and hot decoctions are useful.
*In state of ''[[kapha]]'' predominance, the patient should be administered emetic therapy, ''[[pachana]]'' (therapy which promotes the digestion and metabolism), non-unctuous diet and drinks, fasting and hot decoctions are useful.
*When the ''doshas'' causing ''jwara'' are located in the ''rasa dhatu'', then ''vamana'' and ''upavasa'' (emesis and fasting) should be done; in case of location in the ''rakta dhatu, seka'' and ''pradeha'' (pouring of hot medicated liquids and ointment application) should be done; in case of ''mamsa'' and the ''medas virechana'' and ''upavasa'' should be done; in the ''asthi'' and ''majja dhatus, niruha'' and ''anuvasana bastis'' should be given.
*When the ''[[dosha]]s'' causing ''jwara'' are located in the ''[[rasa dhatu]]'', then ''[[vamana]]'' and ''[[upavasa]]'' (emesis and fasting) should be done; in case of location in the ''[[rakta dhatu]], seka'' and ''pradeha'' (pouring of hot medicated liquids and ointment application) should be done; in case of ''[[mamsa dhatu]]'' and the ''[[meda dhatu]] [[virechana]]'' and ''upavasa'' should be done; in the ''[[asthi dhatu]]'' and ''[[majja dhatu]]s, niruha'' and ''anuvasana [[basti]]s'' should be given.
*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.
*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.
*''Jwara'' caused by abhighata (external injury) gets cured by the intake and massage of ghee, blood-letting, intake of rice with wholesome meat soup.
*''Jwara'' caused by abhighata (external injury) gets cured by the intake and massage of ghee, blood-letting, intake of rice with wholesome meat soup.
*Mental factors like kama (passion), shoka (grief) and bhaya (fear) gets cured by the ashvasana (assurance), ishṭa labha (providing the desired object), alleviation of vayu and harshana (bringing excitement or pleasure).
*Mental factors like kama (passion), shoka (grief) and bhaya (fear) gets cured by the ashvasana (assurance), ishṭa labha (providing the desired object), alleviation of vayu and harshana (bringing excitement or pleasure).
*Krodha (anger) subsides by providing kamya artha (desired object), manojna artha (pleasing object), therapies for the alleviation of pitta and sadvakya (correct advice).
*Krodha (anger) subsides by providing kamya artha (desired object), manojna artha (pleasing object), therapies for the alleviation of [[pitta]] and sadvakya (correct advice).
*The jwara caused by krodha subsides by kama and that caused by kama gets cured by krodha. Jwara caused by bhaya (fear) and shoka (grief or sorrow) subsides by both kama and krodha.
*The jwara caused by krodha subsides by kama and that caused by kama gets cured by krodha. Jwara caused by bhaya (fear) and shoka (grief or sorrow) subsides by both kama and krodha.
*If a patient gets jwara just by thinking about it, then his mind should be diverted to desirable, different and surprising incidents (vishaya).
*If a patient gets jwara just by thinking about it, then his mind should be diverted to desirable, different and surprising incidents (vishaya).
*For prevention of re-occurrence of jwara and during its treatment, one should avoid the following: intake of food and drinks which are vidahi (causing burning sensation), guru (heavy), asatmya (unwholesome) and viruddha (mutually contradictory); sexual intercourse, excessive exhaustion, bath, excessive walking exercise, should be avoided by the person who has become free from jwara till he regains strength.
*For prevention of re-occurrence of jwara and during its treatment, one should avoid the following: intake of food and drinks which are vidahi (causing burning sensation), guru (heavy), asatmya (unwholesome) and viruddha (mutually contradictory); sexual intercourse, excessive exhaustion, bath, excessive walking exercise, should be avoided by the person who has become free from jwara till he regains strength.
*The remission of jwara depends upon strength of dosha. In acute stage, the remission occurs with difficulty because of severity of dosha. In chronic stage, the remission occurs without difficulty due to mild strength of dosha.
*The remission of jwara depends upon strength of [[dosha]]. In acute stage, the remission occurs with difficulty because of severity of [[dosha]]. In chronic stage, the remission occurs without difficulty due to mild strength of [[dosha]].
*The signs of regaining health after remission of a disease are disappearance of klama (mental fatigue) and santapa (raised temperature/feeling of heat), absence of pain, clarity of senses and gaining natural mental faculties.
*The signs of regaining health after remission of a disease are disappearance of klama (mental fatigue) and santapa (raised temperature/feeling of heat), absence of pain, clarity of senses and gaining natural mental faculties.
*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, who has become free from jwara, resorts to prohibited factors (as described before) before gaining strength, then the jwara reappears.
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== Vidhi Vimarsha (Applied Inferences) ==
The clinical applications of jwara and different types of fevers are described in details in a separate article on [[Jwara]].
=== Glossary ===
=== Related Chapters ===
*Prakriti (prakRuti; प्रकृति) - the nature of the disease
*[[Jwara Nidana]] [[Jwara]]
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