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no edit summary
{{CiteButton}}
{{#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
|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.
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>
== Sanskrit text, Transliteration and English Translation ==
<div class="mw-collapsible mw-collapsed">
अथातो ज्वरचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
<div class="mw-collapsible-content">
athātō jwaracikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||
athAto jwaracikitsitaM vyAkhyAsyAmaH||1||
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 ===
<div class="mw-collapsible mw-collapsed">
विज्वरं ज्वरसन्देहं पर्यपृच्छत् पुनर्वसुम्|
विविक्ते शान्तमासीनमग्निवेशः कृताञ्जलिः||३||
देहेन्द्रियमनस्तापी सर्वरोगाग्रजो बली|
ज्वरः प्रधानो रोगाणामुक्तो भगवता पुरा||४||
तस्य प्राणिसपत्नस्य ध्रुवस्य प्रलयोदये|
प्रकृतिं च प्रवृत्तिं च प्रभावं कारणानि च||५||
पूर्वरूपमधिष्ठानं बलकालात्मलक्षणम्|
व्यासतो विधिभेदाच्च पृथग्भिन्नस्य चाकृतिम्||६||
लिङ्गमामस्य जीर्णस्य सौषधं च क्रियाक्रमम्|
विमुञ्चतः प्रशान्तस्य चिह्नं यच्च पृथक् पृथक्||७||
ज्वरावसृष्टो रक्ष्यश्च यावत्कालं यतो यतः|
प्रशान्तः कारणैर्यैश्च पुनरावर्तते ज्वरः||८||
याश्चापि पुनरावृत्तं क्रियाः प्रशमयन्ति तम्|
जगद्धितार्थं तत् सर्वं भगवन्! वक्तुमर्हसि||९||
तदग्निवेशस्य वचो निशम्य गुरुरब्रवीत्|
ज्वराधिकारे यद्वाच्यं तत् सौम्य! निखिलं शृणु||१०||
<div class="mw-collapsible-content">
vijwaraṁ jwarasandēhaṁ paryapr̥cchat punarvasum|
viviktē śāntamāsīnamagnivēśaḥ kr̥tāñjaliḥ||3||
dēhēndriyamanastāpī sarvarōgāgrajō balī|
jwaraḥ pradhānō rōgāṇāmuktō bhagavatā purā||4||
tasya prāṇisapatnasya dhruvasya pralayōdayē|
prakr̥tiṁ ca pravr̥ttiṁ ca prabhāvaṁ kāraṇāni ca||5||
pūrvarūpamadhiṣṭhānaṁ balakālātmalakṣaṇam|
vyāsatō vidhibhēdācca [2] pr̥thagbhinnasya cākr̥tim||6||
liṅgamāmasya jīrṇasya sauṣadhaṁ ca kriyākramam|
vimuñcataḥ praśāntasya cihnaṁ yacca pr̥thak pr̥thak||7||
jvarāvasr̥ṣṭō rakṣyaśca yāvatkālaṁ yatō yataḥ|
praśāntaḥ kāraṇairyaiśca punarāvartatē jwaraḥ||8||
yāścāpi punarāvr̥ttaṁ kriyāḥ praśamayanti tam|
jagaddhitārthaṁ tat sarvaṁ bhagavan! vaktumarhasi||9||
tadagnivēśasya vacō niśamya gururabravīt|
jvarādhikārē yadvācyaṁ tat saumya! nikhilaṁ śr̥ṇu||10||
vijwaraM jwarasandehaM paryapRucchat punarvasum|
vivikte shAntamAsInamagniveshaH kRutA~jjaliH||3||
dehendriyamanastApI sarvarogAgrajo balI|
jwaraH pradhAno rogANAmukto bhagavatA purA||4||
tasya prANisapatnasya dhruvasya pralayodaye|
prakRutiM ca pravRuttiM ca prabhAvaM kAraNAni ca||5||
pUrvarUpamadhiShThAnaM balakAlAtmalakShaNam|
vyAsato vidhibhedAcca pRuthagbhinnasya cAkRutim||6||
li~ggamAmasya jIrNasya sauShadhaM ca kriyAkramam|
vimu~jcataH prashAntasya cihnaM yacca pRuthak pRuthak||7||
jwaravasRuShTo rakShyashca yAvatkAlaM yato yataH|
prashAntaH kAraNairyaishca punarAvartate jwaraH||8||
yAshcApi punarAvRuttaM kriyAH prashamayanti tam|
jagaddhitArthaM tat sarvaM bhagavan! vaktumarhasi||9||
tadagniveshasya vaco nishamya gururabravIt|
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).
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
*Pravritti or origin of the disease
*''Prabhava'', the sequels of the disease
*''Karana'' or the causative factors
*''Purvarupa'' or the premonitory signs and symptoms
*''Adhisthana'' or place of manifestation
*''Bala kala'' or its severity and the time of manifestation
*''Atma lakshana'' or cardinal features which are invariably associated with this disease
*Details of classification (''vidhi bheda'')
*Signs and symptoms of each type of the disease
*Sign and symptoms of ''ama jwara'' i.e. primary stage of the disease
*Sign and symptoms of ''jirna jwara''a i.e. chronic stage
*Drugs for the treatment of the disease
*Various therapeutic procedures
*Signs and symptoms that are manifested when the fever is getting cured, or when it is alleviated – both separately
*The duration for which the patient who has become free from a disease has to avoid certain regimens and the reasons for that
*The reasons for the reattack of the fever after it has subsided
*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]
</div>
=== Synonyms of ''jwara'' ===
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ज्वरो विकारो रोगश्च व्याधिरातङ्क एव च|
एकोऽर्थो नामपर्यायैर्विविधैरभिधीयते||११||
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jvarō vikārō rōgaśca vyādhirātaṅka ēva ca|
ēkō'rthō nāmaparyāyairvividhairabhidhīyatē||11||
jvaro vikAro rogashca vyAdhirAta~gka eva ca|
eko~artho nAmaparyAyairvividhairabhidhIyate||11||
</div></div>
''Jwara, vikara, roga, vyadhi'' and ''atanka'' – these terms are synonymous and used to indicate this condition. [11]
=== ''[[Prakriti]]'' or nature of ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
तस्य प्रकृतिरुद्दिष्टा दोषाः शारीरमानसाः|
देहिनं न हि निर्दोषं ज्वरः समुपसेवते||१२||
क्षयस्तमो ज्वरः पाप्मा मृत्युश्चोक्ता यमात्मकाः|
पञ्चत्वप्रत्ययान्नॄणां क्लिश्यतां स्वेन कर्मणा||१३||
इत्यस्य प्रकृतिः प्रोक्ता, ...|१४|
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tasya prakr̥tiruddiṣṭā dōṣāḥ śārīramānasāḥ|
dēhinaṁ na hi nirdōṣaṁ jwaraḥ samupasēvatē||12||
kṣayastamō jwaraḥ pāpmā mr̥tyuścōktā yamātmakāḥ|
pañcatvapratyayānnr̥̄ṇāṁ kliśyatāṁ svēna karmaṇā||13||
ityasya prakr̥tiḥ prōktā, ...|14|
tasya prakRutiruddiShTA doShAH shArIramAnasAH|
dehinaM na hi nirdoShaM jwaraH samupasevate||12||
kShayastamo jwaraH pApmA mRutyushcoktA yamAtmakAH|
pa~jcatvapratyayAnnRUNAM klishyatAM svena karmaNA||13||
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>
=== ''Pravritti'' (origin of the disease) ===
<div class="mw-collapsible mw-collapsed">
... प्रवृत्तिस्तु परिग्रहात्|
निदाने पूर्वमुद्दिष्टा रुद्रकोपाच्च दारुणात्||१४||
द्वितीये हि युगे शर्वमक्रोधव्रतमास्थितम्|
दिव्यं सहस्रं वर्षाणामसुरा अभिदुद्रुवुः||१५||
तपोविघ्नाशनाः कर्तुं तपोविघ्नं महात्मनः|
पश्यन् समर्थश्चोपेक्षां चक्रे दक्षः प्रजापतिः||१६||
पुनर्माहेश्वरं भागं ध्रुवं दक्षः प्रजापतिः|
यज्ञे न कल्पयामास प्रोच्यमानः सुरैरपि||१७||
ऋचः पशुपतेर्याश्च शैव्य आहतयश्च याः|
यज्ञसिद्धिप्रदास्ताभिर्हीनं चैव स इष्टवान्||१८||
अथोत्तीर्णव्रतो देवो बुद्ध्वा दक्षव्यतिक्रमम्|
रुद्रो रौद्रं पुरस्कृत्य भावमात्मविदात्मनः||१९||
सृष्ट्वा ललाटे चक्षुर्वै दग्ध्वा तानसुरान् प्रभुः|
बालं क्रोधाग्निसन्तप्तमसृजत् सत्रनाशनम्||२०||
ततो यज्ञः स विध्वस्तो व्यथिताश्च दिवौकसः|
दाहव्यथापरीताश्च भ्रान्ता भूतगणा दिशः||२१||
अथेश्वरं देवगणः सह सप्तर्षिभिर्विभुम्|
तमृग्भिरस्तुवन् यावच्छैवे भावे शिवः स्थितः||२२||
शिवं शिवाय भूतानां स्थितं ज्ञात्वा कृताञ्जलिः|
भिया भस्मप्रहरणस्त्रिशिरा नवलोचनः||२३||
ज्वालामालाकुलो रौद्रो ह्रस्वजङ्घोदरः क्रमात्|
क्रोधाग्निरुक्तवान् देवमहं किं करवाणि ते||२४||
तमुवाचेश्वरः क्रोधं ज्वरो लोके भविष्यसि|
जन्मादौ निधने च त्वमपचारान्तरेषु च||२५||
<div class="mw-collapsible-content">
... pravr̥ttistu parigrahāt|
nidānē pūrvamuddiṣṭā rudrakōpācca dāruṇāt||14||
dvitīyē hi yugē śarvamakrōdhavratamāsthitam|
divyaṁ sahasraṁ varṣāṇāmasurā abhidudruvuḥ||15||
tapōvighnāśanāḥ kartuṁ tapōvighnaṁ mahātmanaḥ|
paśyan samarthaścōpēkṣāṁ cakrē dakṣaḥ prajāpatiḥ||16||
punarmāhēśvaraṁ bhāgaṁ dhruvaṁ dakṣaḥ prajāpatiḥ|
yajñē na kalpayāmāsa prōcyamānaḥ surairapi||17||
r̥caḥ paśupatēryāśca śaivya āhatayaśca yāḥ|
yajñasiddhipradāstābhirhīnaṁ caiva sa iṣṭavān||18||
athōttīrṇavratō dēvō buddhvā dakṣavyatikramam|
rudrō raudraṁ puraskr̥tya bhāvamātmavidātmanaḥ||19||
sr̥ṣṭvā lalāṭē cakṣurvai dagdhvā tānasurān prabhuḥ|
bālaṁ krōdhāgnisantaptamasr̥jat satranāśanam||20||
tatō yajñaḥ sa vidhvastō vyathitāśca divaukasaḥ|
dāhavyathāparītāśca bhrāntā bhūtagaṇā diśaḥ||21||
athēśvaraṁ dēvagaṇaḥ saha saptarṣibhirvibhum|
tamr̥gbhirastuvan yāvacchaivē bhāvē śivaḥ sthitaḥ||22||
śivaṁ śivāya bhūtānāṁ sthitaṁ jñātvā kr̥tāñjaliḥ|
bhiyā bhasmapraharaṇastriśirā navalōcanaḥ||23||
jvālāmālākulō raudrō hrasvajaṅghōdaraḥ kramāt|
krōdhāgniruktavān dēvamahaṁ kiṁ karavāṇi tē||24||
tamuvācēśvaraḥ krōdhaṁ jvarō lōkē bhaviṣyasi|
janmādau nidhanē ca tvamapacārāntarēṣu ca||25||
... pravRuttistu parigrahAt|
nidAne pUrvamuddiShTA rudrakopAcca dAruNAt||14||
dvitIye hi yuge sharvamakrodhavratamAsthitam|
divyaM sahasraM varShANAmasurA abhidudruvuH||15||
tapovighnAshanAH kartuM tapovighnaM mahAtmanaH|
pashyan samarthashcopekShAM cakre dakShaH prajApatiH||16||
punarmAheshvaraM bhAgaM dhruvaM dakShaH prajApatiH|
yaj~je na kalpayAmAsa procyamAnaH surairapi||17||
RucaH pashupateryAshca shaivya Ahatayashca yAH|
yaj~jasiddhipradAstAbhirhInaM caiva sa iShTavAn||18||
athottIrNavrato devo buddhvA dakShavyatikramam|
rudro raudraM puraskRutya bhAvamAtmavidAtmanaH||19||
sRuShTvA lalATe cakShurvai dagdhvA tAnasurAn prabhuH|
bAlaM krodhAgnisantaptamasRujat satranAshanam||20||
tato yaj~jaH sa vidhvasto vyathitAshca divaukasaH|
dAhavyathAparItAshca bhrAntA bhUtagaNA dishaH||21||
atheshvaraM devagaNaH saha saptarShibhirvibhum|
tamRugbhirastuvan yAvacchaive bhAve shivaH sthitaH||22||
shivaM shivAya bhUtAnAM sthitaM j~jAtvA kRutA~jjaliH|
bhiyA bhasmapraharaNastrishirA navalocanaH||23||
jvAlAmAlAkulo raudro hrasvaja~gghodaraH kramAt|
krodhAgniruktavAn devamahaM kiM karavANi te||24||
tamuvAceshvaraH krodhaM jvaro loke bhaviShyasi|
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).
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]
</div>
=== ''Prabhava'', the sequels of the disease ===
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सन्तापः सारुचिस्तृष्णा साङ्गमर्दो हृदि व्यथा|
ज्वरप्रभावो, जन्मादौ निधने च महत्तमः||२६||
प्रकृतिश्च प्रवृत्तिश्च प्रभावश्च प्रदर्शितः|२७|
<div class="mw-collapsible-content">
santāpaḥ sārucistr̥ṣṇā sāṅgamardō hr̥di vyathā|
jwaraprabhāvō, janmādau nidhanē ca mahattamaḥ||26||
prakr̥tiśca pravr̥ttiśca prabhāvaśca pradarśitaḥ|27|
santApaH sArucistRuShNA sA~ggamardo hRudi vyathA|
jwaraprabhAvo, janmAdau nidhane ca mahattamaH||26||
prakRutishca pravRuttishca prabhAvashca pradarshitaH|27|
</div></div>
<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||
<div class="mw-collapsible-content">
nidānē kāraṇānyaṣṭau pūrvōktāni vibhāgaśaḥ||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]
</div>
=== Premonitory symptoms of ''jwara'' ===
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आलस्यं नयने सास्रे जृम्भणं गौरवं क्रमः|
ज्वलनातपवाय्वम्बुभक्तिद्वेषावनिश्चितौ||२८||
अविपाकास्यवैरस्ये हानिश्च बलवर्णयोः|
शीलवैकृतमल्पं च ज्वरलक्षणमग्रजम्||२९||
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ālasyaṁ nayanē sāsrē jr̥mbhaṇaṁ gauravaṁ kramaḥ|
jvalanātapavāyvambubhaktidvēṣāvaniścitau||28||
avipākāsyavairasyē hāniśca balavarṇayōḥ|
śīlavaikr̥tamalpaṁ ca jwaralakṣaṇamagrajam||29||
AlasyaM nayane sAsre jRumbhaNaM gauravaM kramaH|
jvalanAtapavAyvambubhaktidveShAvanishcitau||28||
avipAkAsyavairasye hAnishca balavarNayoH|
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]
</div>
=== Sites of ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
केवलं समनस्कं च ज्वराधिष्ठानमुच्यते|
शरीरं, बलकालस्तु निदाने सम्प्रदर्शितः||३०||
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kēvalaṁ samanaskaṁ ca jvarādhiṣṭhānamucyatē|
śarīraṁ, balakālastu nidānē sampradarśitaḥ||30||
kevalaM samanaskaM ca jwaradhiShThAnamucyate|
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]
</div>
=== Cardinal feature ===
<div class="mw-collapsible mw-collapsed">
ज्वरप्रत्यात्मिकं लिङ्गं सन्तापो देहमानसः|
ज्वरेणाविशता भूतं न हि किञ्चिन्न तप्यते||३१||
<div class="mw-collapsible-content">
jwarapratyātmikaṁ liṅgaṁ santāpō dēhamānasaḥ|
jvarēṇāviśatā bhūtaṁ na hi kiñcinna tapyatē||31||
jwarapratyAtmikaM li~ggaM santApo dehamAnasaH|
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]
</div>
=== Classification ===
<div class="mw-collapsible mw-collapsed">
द्विविधो विधिभेदेन ज्वरः शारीरमानसः|
पुनश्च द्विविधो दृष्टः सौम्यश्चाग्नेय एव वा||३२||
अन्तर्वेगो बहिर्वेगो द्विविधः पुनरुच्यते|
प्राकृतो वैकृतश्चैव साध्यश्चासाध्य एव च||३३||
पुनः पञ्चविधो दृष्टो दोषकालबलाबलात्|
सन्ततः सततोऽन्येद्युस्तृतीयकचतुर्थकौ||३४||
पुनराश्रयभेदेन धातूनां सप्तधा मतः|
भिन्नः कारणभेदेन पुनरष्टविधो ज्वरः||३५||
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dvividhō vidhibhēdēna jwaraḥ śārīramānasaḥ|
punaśca dvividhō dr̥ṣṭaḥ saumyaścāgnēya ēva vā||32||
antarvēgō bahirvēgō dvividhaḥ punarucyatē|
prākr̥tō vaikr̥taścaiva sādhyaścāsādhya ēva ca||33||
punaḥ pañcavidhō dr̥ṣṭō dōṣakālabalābalāt|
santataḥ satatō'nyēdyustr̥tīyakacaturthakau||34||
punarāśrayabhēdēna dhātūnāṁ saptadhā mataḥ|
bhinnaḥ kāraṇabhēdēna punaraṣṭavidhō jwaraḥ||35||
dvividho vidhibhedena jwaraH shArIramAnasaH|
punashca dvividho dRuShTaH saumyashcAgneya eva vA||32||
antarvego bahirvego dvividhaH punarucyate|
prAkRuto vaikRutashcaiva sAdhyashcAsAdhya eva ca||33||
punaH pa~jcavidho dRuShTo doShakAlabalAbalAt|
santataH satato~anyedyustRutIyakacaturthakau||34||
punarAshrayabhedena dhAtUnAM saptadhA mataH|
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 –
*''Sharira'' (physical) and ''[[manas]]a'' (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)
''Jwara'' is again classified into five categories depending upon the strength and weakness of dosha and the time. These are intermittent in nature:
#''Santata''
#''Satata''
#''Anyedushka''
#''Tritiyaka''
#''Chaturthaka''.
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]
</div>
=== Clinical features of somatic and psychic ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
शारीरो जायते पूर्वं देहे, मनसि मानसः|
वैचित्त्यमरतिर्ग्लानिर्मनसस्तापलक्षणम्||३६||
इन्द्रियाणां च वैकृत्यं ज्ञेयं सन्तापलक्षणम्|३७|
<div class="mw-collapsible-content">
śārīrō jāyatē pūrvaṁ dēhē, manasi mānasaḥ|
vaicittyamaratirglānirmanasastāpalakṣaṇam||36||
indriyāṇāṁ ca vaikr̥tyaṁ jñēyaṁ santāpalakṣaṇam|37|
shArIro jAyate pUrvaM dehe, manasi mAnasaH|
vaicittyamaratirglAnirmanasastApalakShaNam||36||
indriyANAM ca vaikRutyaM j~jeyaM santApalakShaNam|37|
</div></div>
<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||
इच्छत्युभयमेतत्तु ज्वरो व्यामिश्रलक्षणः|३८|
<div class="mw-collapsible-content">
vātapittātmakaḥ śītamuṣṇaṁ vātakaphātmakaḥ||37||
icchatyubhayamētattu jvarō vyāmiśralakṣaṇaḥ|38|
vAtapittAtmakaH shItamuShNaM vAtakaphAtmakaH||37||
icchatyubhayametattu jvaro vyAmishralakShaNaH|38|
</div></div>
<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||
दाहकृत्तेजसा युक्तः, शीतकृत् सोमसंश्रयात्|३९|
<div class="mw-collapsible-content">
yōgavāhaḥ paraṁ vāyuḥ saṁyōgādubhayārthakr̥t||38||
dāhakr̥ttējasā yuktaḥ, śītakr̥t sōmasaṁśrayāt|39|
yogavAhaH paraM vAyuH saMyogAdubhayArthakRut||38||
dAhakRuttejasA yuktaH, shItakRut somasaMshrayAt|39|
</div></div>
<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||
सन्ध्यस्थिशूलमस्वेदो दोषवर्चोविनिग्रहः|
अन्तर्वेगस्य लिङ्गानि ज्वरस्यैतानि लक्षयेत्||४०||
सन्तापोऽभ्यधिको बाह्यस्तृष्णादीनां च मार्दवम्|
बहिर्वेगस्य लिङ्गानि सुखसाध्यत्वमेव च||४१||
<div class="mw-collapsible-content">
antardāhō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||39||
sandhyasthiśūlamasvēdō dōṣavarcōvinigrahaḥ|
antarvēgasya liṅgāni jwarasyaitāni lakṣayēt||40||
santāpō'bhyadhikō bāhyastr̥ṣṇādīnāṁ ca mārdavam|
bahirvēgasya liṅgāni sukhasādhyatvamēva ca||41||
antardAho~adhikastRuShNA pralApaH shvasanaM bhramaH||39||
sandhyasthishUlamasvedo doShavarcovinigrahaH|
antarvegasya li~ggAni jwarasyaitAni lakShayet||40||
santApo~abhyadhiko bAhyastRuShNAdInAM ca mArdavam|
bahirvegasya li~ggAni sukhasAdhyatvameva ca||41||
</div></div>
<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]
</div>
=== ''Prakrita jwara''(seasonal ''jwara'') ===
<div class="mw-collapsible mw-collapsed">
प्राकृतः सुखसाध्यस्तु वसन्तशरदुद्भवः|
उष्णमुष्णेन संवृद्धं पित्तं शरदि कुप्यति||४२||
चितः शीते कफश्चैवं वसन्ते समुदीर्यते|
वर्षास्वम्लविपाकाभिरद्भिरोषधिभिस्तथा||४३||
सञ्चितं पित्तमुद्रिक्तं शरद्यादित्यतेजसा|
ज्वरं सञ्जनयत्याशु तस्य चानुबलः कफः||४४||
प्रकृत्यैव विसर्गस्य तत्र नानशनाद्भयम्|
अद्भिरोषधिभिश्चैव मधुराभिश्चितः कफः||४५||
हेमन्ते, सूर्यसन्तप्तः स वसन्ते प्रकुप्यति|
वसन्ते श्लेष्मणा तस्माज्ज्वरः समुपजायते||४६||
आदानमध्ये तस्यापि वातपित्तं भवेदनु|
आदावन्ते च मध्ये च बुद्ध्वा दोषबलाबलम्||४७||
शरद्वसन्तयोर्विद्वाञ्ज्वरस्य प्रतिकारयेत्|
कालप्रकृतिमुद्दिश्य निर्दिष्टः प्राकृतो ज्वरः||४८||
प्रायेणानिलजो दुःखः कालेष्वन्येषु वैकृतः|
हेतवो विविधास्तस्य निदाने सम्प्रदर्शिताः||४९||
<div class="mw-collapsible-content">
prākr̥taḥ sukhasādhyastu vasantaśaradudbhavaḥ|
uṣṇamuṣṇēna saṁvr̥ddhaṁ pittaṁ śaradi kupyati||42||
citaḥ śītē kaphaścaivaṁ vasantē samudīryatē|
varṣāsvamlavipākābhiradbhirōṣadhibhistathā||43||
sañcitaṁ pittamudriktaṁ śaradyādityatējasā|
jwaraṁ sañjanayatyāśu tasya cānubalaḥ kaphaḥ||44||
prakr̥tyaiva visargasya tatra nānaśanādbhayam|
adbhirōṣadhibhiścaiva madhurābhiścitaḥ kaphaḥ||45||
hēmantē, sūryasantaptaḥ sa vasantē prakupyati|
vasantē ślēṣmaṇā tasmājjwaraḥ samupajāyatē||46||
ādānamadhyē tasyāpi vātapittaṁ bhavēdanu|
ādāvantē ca madhyē ca buddhvā dōṣabalābalam||47||
śaradvasantayōrvidvāñjwarasya pratikārayēt|
kālaprakr̥timuddiśya nirdiṣṭaḥ prākr̥tō jwaraḥ||48||
prāyēṇānilajō duḥkhaḥ kālēṣvanyēṣu vaikr̥taḥ|
hētavō vividhāstasya nidānē sampradarśitāḥ||49||
prAkRutaH sukhasAdhyastu vasantasharadudbhavaH|
uShNamuShNena saMvRuddhaM pittaM sharadi kupyati||42||
citaH shIte kaphashcaivaM vasante samudIryate|
varShAsvamlavipAkAbhiradbhiroShadhibhistathA||43||
sa~jcitaM pittamudriktaM sharadyAdityatejasA|
jwaraM sa~jjanayatyAshu tasya cAnubalaH kaphaH||44||
prakRutyaiva visargasya tatra nAnashanAdbhayam|
adbhiroShadhibhishcaiva madhurAbhishcitaH kaphaH||45||
hemante, sUryasantaptaH sa vasante prakupyati|
vasante shleShmaNA tasmAjjwaraH samupajAyate||46||
AdAnamadhye tasyApi vAtapittaM bhavedanu|
AdAvante ca madhye ca buddhvA doShabalAbalam||47||
sharadvasantayorvidvA~jjwarasya pratikArayet|
kAlaprakRutimuddishya nirdiShTaH prAkRuto jwaraH||48||
prAyeNAnilajo duHkhaH kAleShvanyeShu vaikRutaH|
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.
''[[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.
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.
==== ''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:
*''vatika jwara'' irrespective of its season of occurrence
*''paitika jwara'' occurring in seasons other than autumn and
*''kaphaja jwara'' occurring in seasons other than spring.
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|
हेतुभिर्बहुभिर्जातो बलिभिर्बहुलक्षणः||५०||
ज्वरः प्राणान्तकृद्यश्च शीघ्रमिन्द्रियनाशनः|
सप्ताहाद्वा दशाहाद्वा द्वादशाहात्तथैव च||५१||
सप्रलापभ्रमश्वासस्तीक्ष्णो हन्याज्ज्वरो नरम्|
ज्वरः क्षीणस्य शूनस्य गम्भीरो दैर्घरात्रिकः||५२||
असाध्यो बलवान् यश्च केशसीमन्तकृज्ज्वरः|५३|
<div class="mw-collapsible-content">
balavatsvalpadōṣēṣu jwaraḥ sādhyō'nupadravaḥ|
hētubhirbahubhirjātō balibhirbahulakṣaṇaḥ||50||
jwaraḥ prāṇāntakr̥dyaśca śīghramindriyanāśanaḥ|
saptāhādvā daśāhādvā dvādaśāhāttathaiva ca||51||
sapralāpabhramaśvāsastīkṣṇō hanyājjvarō naram|
jwaraḥ kṣīṇasya śūnasya gambhīrō dairgharātrikaḥ||52||
asādhyō balavān yaśca kēśasīmantakr̥jjwaraḥ|53|
balavatsvalpadoSheShu jwaraH sAdhyo~anupadravaH|
hetubhirbahubhirjAto balibhirbahulakShaNaH||50||
jwaraH prANAntakRudyashca shIghramindriyanAshanaH|
saptAhAdvA dashAhAdvA dvAdashAhAttathaiva ca||51||
sapralApabhramashvAsastIkShNo hanyAjjvaro naram|
jwaraH kShINasya shUnasya gambhIro dairgharAtrikaH||52||
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 –
*Which is caused by either greater amount of / strong etiological factors
*Which manifests with many clinical features
*Which destroys the sense organs immediately.
'''Bad prognosis:'''
''Tikshna jwara'' (severe, associated with delirium, giddiness and breathlessness causes death of the patient either on the seventh, tenth or twelfth day.
''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||
सर्वदेहानुगाः स्तब्धा ज्वरं कुर्वन्ति सन्ततम्|
दशाहं द्वादशाहं वा सप्ताहं वा सुदुःसहः||५४||
स शीघ्रं शीघ्रकारित्वात् प्रशमं याति हन्ति वा|
कालदूष्यप्रकृतिभिर्दोषस्तुल्यो हि सन्ततम्||५५||
निष्प्रत्यनीकः कुरुते तस्माज्ज्ञेयः सुदुःसहः|
यथा धातूंस्तथा मूत्रं पुरीषं चानिलादयः||५६||
युगपच्चानुपद्यन्ते नियमात् सन्तते ज्वरे|
स शुद्ध्या वाऽप्यशुद्ध्या वा रसादीनामशेषतः||५७||
सप्ताहादिषु कालेषु प्रशमं याति हन्ति वा|
यदा तु नातिशुध्यन्ति न वा शुध्यन्ति सर्वशः||५८||
द्वादशैते समुद्दिष्टाः सन्ततस्याश्रयास्तदा|
विसर्गं द्वादशे कृत्वा दिवसेऽव्यक्तलक्षणम्||५९||
दुर्लभोपशमः कालं दीर्घमप्यनुवर्तते|
इति बुद्ध्वा ज्वरं वैद्य उपक्रामेत्तु सन्ततम् ||६०||
क्रियाक्रमविधौ युक्तः प्रायः प्रागपतर्पणैः|६१|
<div class="mw-collapsible-content">
srōtōbhirvisr̥tā dōṣā guravō rasavāhibhiḥ||53||
sarvadēhānugāḥ stabdhā jwaraṁ kurvanti santatam|
daśāhaṁ dvādaśāhaṁ vā saptāhaṁ vā suduḥsahaḥ||54||
sa śīghraṁ śīghrakāritvāt praśamaṁ yāti hanti vā|
kāladūṣyaprakr̥tibhirdōṣastulyō hi santatam||55||
niṣpratyanīkaḥ kurutē tasmājjñēyaḥ suduḥsahaḥ|
yathā dhātūṁstathā mūtraṁ purīṣaṁ cānilādayaḥ||56||
yugapaccānupadyantē niyamāt santatē jvarē|
sa śuddhyā vā'pyaśuddhyā vā rasādīnāmaśēṣataḥ||57||
saptāhādiṣu kālēṣu praśamaṁ yāti hanti vā|
yadā tu nātiśudhyanti na vā śudhyanti sarvaśaḥ||58||
dvādaśaitē samuddiṣṭāḥ santatasyāśrayāstadā|
visargaṁ dvādaśē kr̥tvā divasē'vyaktalakṣaṇam||59||
durlabhōpaśamaḥ kālaṁ dīrghamapyanuvartatē|
iti buddhvā jwaraṁ vaidya upakrāmēttu santatam ||60||
kriyākramavidhau yuktaḥ prāyaḥ prāgapatarpaṇaiḥ|61|
srotobhirvisRutA doShA guravo rasavAhibhiH||53||
sarvadehAnugAH stabdhA jwaraM kurvanti santatam|
dashAhaM dvAdashAhaM vA saptAhaM vA suduHsahaH||54||
sa shIghraM shIghrakAritvAt prashamaM yAti hanti vA|
kAladUShyaprakRutibhirdoShastulyo hi santatam||55||
niShpratyanIkaH kurute tasmAjj~jeyaH suduHsahaH|
yathA dhAtUMstathA mUtraM purIShaM cAnilAdayaH||56||
yugapaccAnupadyante niyamAt santate jvare|
sa shuddhyA vA~apyashuddhyA vA rasAdInAmasheShataH||57||
saptAhAdiShu kAleShu prashamaM yAti hanti vA|
yadA tu nAtishudhyanti na vA shudhyanti sarvashaH||58||
dvAdashaite samuddiShTAH santatasyAshrayAstadA|
visargaM dvAdashe kRutvA divase~avyaktalakShaNam||59||
durlabhopashamaH kAlaM dIrghamapyanuvartate|
iti buddhvA jwaraM vaidya upakrAmettu santatam ||60||
kriyAkramavidhau yuktaH prAyaH prAgapatarpaNaiH|61|
</div></div>
<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.
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]
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==== ''Satata jwara'' ====
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रक्तधात्वाश्रयः प्रायो दोषः सततकं ज्वरम्||६१||
सप्रत्यनीकः कुरुते कालवृद्धिक्षयात्मकम्|
अहोरात्रे सततको द्वौ कालावनुवर्तते||६२||
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raktadhātvāśrayaḥ prāyō dōṣaḥ satatakaṁ jwaram||61||
sapratyanīkaḥ kurutē kālavr̥ddhikṣayātmakam|
ahōrātrē satatakō dvau kālāvanuvartatē||62||
raktadhAtvAshrayaH prAyo doShaH satatakaM jwaram||61||
sapratyanIkaH kurute kAlavRuddhikShayAtmakam|
ahorAtre satatako dvau kAlAvanuvartate||62||
</div></div>
<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|
अन्येद्युष्कं ज्वरं दोषो रुद्ध्वा मेदोवहाः सिराः||६३||
सप्रत्यनीको जनयत्येककालमहर्निशि|
<div class="mw-collapsible-content">
kālaprakr̥tidūṣyāṇāṁ prāpyaivānyatamādbalam|
anyēdyuṣkaṁ jwaraṁ dōṣō ruddhvā mēdōvahāḥ sirāḥ||63||
sapratyanīkō janayatyēkakālamaharniśi|
kAlaprakRutidUShyANAM prApyaivAnyatamAdbalam|
anyedyuShkaM jwaraM doSho ruddhvA medovahAH sirAH||63||
sapratyanIko janayatyekakAlamaharnishi|
</div></div>
<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]
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==== ''Tritiyaka'' and ''chaturthaka jwara'' ====
<div class="mw-collapsible mw-collapsed">
दोषोऽस्थिमज्जगः कुर्यात्तृतीयकचतुर्थकौ||६४||
गतिर्द्व्येकान्तराऽन्येद्युर्दोषस्योक्ताऽन्यथा परैः|
अन्येद्युष्कं ज्वरं कुर्यादपि संश्रित्य शोणितम्||६५||
मांसस्रोतांस्यनुगतो जनयेत्तु तृतीयकम्|
संश्रितो मेदसो मार्गं दोषश्चापि चतुर्थकम् ||६६||
अन्येद्युष्कः प्रतिदिनं दिनं हित्वा तृतीयकः|
दिनद्वयं यो विश्रम्य प्रत्येति स चतुर्थकः||६७||
<div class="mw-collapsible-content">
dōṣō'sthimajjagaḥ kuryāttr̥tīyakacaturthakau||64||
gatirdvyēkāntarā'nyēdyurdōṣasyōktā'nyathā paraiḥ|
anyēdyuṣkaṁ jwaraṁ kuryādapi saṁśritya śōṇitam||65||
māṁsasrōtāṁsyanugatō janayēttu tr̥tīyakam|
saṁśritō mēdasō mārgaṁ dōṣaścāpi caturthakam ||66||
anyēdyuṣkaḥ pratidinaṁ dinaṁ hitvā tr̥tīyakaḥ|
dinadvayaṁ yō viśramya pratyēti sa caturthakaḥ||67||
doSho~asthimajjagaH kuryAttRutIyakacaturthakau||64||
gatirdvyekAntarA~anyedyurdoShasyoktA~anyathA paraiH|
anyedyuShkaM jwaraM kuryAdapi saMshritya shoNitam||65||
mAMsasrotAMsyanugato janayettu tRutIyakam|
saMshrito medaso mArgaM doShashcApi caturthakam ||66||
anyedyuShkaH pratidinaM dinaM hitvA tRutIyakaH|
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''.
''Anyedushka jwara'' occurs every day, while ''tritiyaka jwara'' occurs after a gap of one day and ''chaurthaka'' occurs after two days gap. [64-67]
</div>
=== Cause of alterations in ''jwara'' episodes ===
<div class="mw-collapsible mw-collapsed">
अधिशेते यथा भूमिं बीजं काले च रोहति|
अधिशेते तथा धातुं दोषः काले च कुप्यति||६८||
स वृद्धिं बलकालं च प्राप्य दोषस्तृतीयकम्|
चतुर्थकं च कुरुते प्रत्यनीकबलक्षयात्||६९||
कृत्वा वेगं गतबलाः स्वे स्वे स्थाने व्यवस्थिताः|
पुनर्विवृद्धाः स्वे काले ज्वरयन्ति नरं मलाः||७०||
कफपित्तात्त्रिकग्राही पृष्ठाद्वातकफात्मकः|
वातपित्ताच्छिरोग्राही त्रिविधः स्यात्तृतीयकः||७१||
चतुर्थको दर्शयति प्रभावं द्विविधं ज्वरः|
जङ्घाभ्यां श्लैष्मिकः पूर्वं शिरस्तोऽनिलसम्भवः||७२||
<div class="mw-collapsible-content">
adhiśētē yathā bhūmiṁ bījaṁ kālē ca rōhati|
adhiśētē tathā dhātuṁ dōṣaḥ kālē ca kupyati||68||
sa vr̥ddhiṁ balakālaṁ ca prāpya dōṣastr̥tīyakam|
caturthakaṁ ca kurutē pratyanīkabalakṣayāt||69||
kr̥tvā vēgaṁ gatabalāḥ svē svē sthānē vyavasthitāḥ|
punarvivr̥ddhāḥ svē kālē jwarayanti naraṁ malāḥ||70||
kaphapittāttrikagrāhī pr̥ṣṭhādvātakaphātmakaḥ|
vātapittācchirōgrāhī trividhaḥ syāttr̥tīyakaḥ||71||
caturthakō darśayati prabhāvaṁ dvividhaṁ jwaraḥ|
jaṅghābhyāṁ ślaiṣmikaḥ pūrvaṁ śirastō'nilasambhavaḥ||72||
adhishete yathA bhUmiM bIjaM kAle ca rohati|
adhishete tathA dhAtuM doShaH kAle ca kupyati||68||
sa vRuddhiM balakAlaM ca prApya doShastRutIyakam|
caturthakaM ca kurute pratyanIkabalakShayAt||69||
kRutvA vegaM gatabalAH sve sve sthAne vyavasthitAH|
punarvivRuddhAH sve kAle jwarayanti naraM malAH||70||
kaphapittAttrikagrAhI pRuShThAdvAtakaphAtmakaH|
vAtapittAcchirogrAhI trividhaH syAttRutIyakaH||71||
caturthako darshayati prabhAvaM dvividhaM jwaraH|
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 ''tritiyaka jwara'' manifests in three types –
*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
*The head region is affected in the case of aggravation of ''[[vata]]'' and ''[[pitta dosha]]''.
Similarly ''chaturthaka jwara'' is also of two types –
*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]
</div>
<div class="mw-collapsible mw-collapsed">
विषमज्वर एवान्यश्चतुर्थकविपर्ययः|
त्रिविधो धातुरेकैको द्विधातुस्थः करोति यम्||७३||
<div class="mw-collapsible-content">
viṣamajwara ēvānyaścaturthakaviparyayaḥ|
trividhō dhāturēkaikō dvidhātusthaḥ karōti yam||73||
viShamajwara evAnyashcaturthakaviparyayaH|
trividho dhAturekaiko dvidhAtusthaH karoti yam||73||
</div></div>
<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|
सन्निपाते तु यो भूयान् स दोषः परिकीर्तितः||७४||
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prāyaśaḥ sannipātēna dr̥ṣṭaḥ pañcavidhō jwaraḥ|
sannipātē tu yō bhūyān sa dōṣaḥ parikīrtitaḥ||74||
prAyashaH sannipAtena dRuShTaH pa~jcavidho jwaraH|
sannipAte tu yo bhUyAn sa doShaH parikIrtitaH||74||
</div></div>
<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|
कालमर्थवशाच्चैव ज्वरस्तं तं प्रपद्यते||७५||
गुरुत्वं दैन्यमुद्वेगः सदनं छर्द्यरोचकौ|
रसस्थिते बहिस्तापः साङ्गमर्दो विजृम्भणम्||७६||
रक्तोष्णाः पिडकास्तृष्णा सरक्तं ष्ठीवनं मुहुः|
दाहरागभ्रममदप्रलापा रक्तसंस्थिते||७७||
अन्तर्दाहः सतृण्मोहः सग्लानिः सृष्टविट्कता|
दौर्गन्ध्यं गात्रविक्षेपो ज्वरे मांसस्थिते भवेत्||७८||
स्वेदस्तीव्रा पिपासा च प्रलापो वम्यभीक्ष्णशः|
स्वगन्धस्यासहत्वं च मेदःस्थे ग्लान्यरोचकौ||७९||
विरेकवमने चोभे सास्थिभेदं प्रकूजनम्|
विक्षेपणं च गात्राणां श्वासश्चास्थिगते ज्वरे||८०||
हिक्का श्वासस्तथा कासस्तमसश्चातिदर्शनम्|
मर्मच्छेदो बहिः शैत्यं दाहोऽन्तश्चैव मज्जगे||८१||
शुक्रस्थानगतः शुक्रमोक्षं कृत्वा विनाश्य च|
प्राणं वाय्वग्निसोमैश्च सार्धं गच्छत्यसौ विभुः||८२||
रसरक्ताश्रितः साध्यो मेदोमांसगतश्च यः|
अस्थिमज्जगतः कृच्छ्रः शुक्रस्थो नैव सिद्ध्यति||८३||
<div class="mw-collapsible-content">
r̥tvahōrātradōṣāṇāṁ manasaśca balābalāt|
kālamarthavaśāccaiva jwarastaṁ taṁ prapadyatē||75||
gurutvaṁ dainyamudvēgaḥ sadanaṁ chardyarōcakau|
rasasthitē bahistāpaḥ sāṅgamardō vijr̥mbhaṇam||76||
raktōṣṇāḥ piḍakāstr̥ṣṇā saraktaṁ ṣṭhīvanaṁ muhuḥ|
dāharāgabhramamadapralāpā raktasaṁsthitē||77||
antardāhaḥ satr̥ṇmōhaḥ saglāniḥ sr̥ṣṭaviṭkatā|
daurgandhyaṁ gātravikṣēpō jvarē māṁsasthitē bhavēt||78||
svēdastīvrā pipāsā ca pralāpō vamyabhīkṣṇaśaḥ|
svagandhasyāsahatvaṁ ca mēdaḥsthē glānyarōcakau||79||
virēkavamanē cōbhē sāsthibhēdaṁ prakūjanam|
vikṣēpaṇaṁ ca gātrāṇāṁ śvāsaścāsthigatē jvarē||80||
hikkā śvāsastathā kāsastamasaścātidarśanam|
marmacchēdō bahiḥ śaityaṁ dāhō'ntaścaiva majjagē||81||
śukrasthānagataḥ śukramōkṣaṁ kr̥tvā vināśya ca|
prāṇaṁ vāyvagnisōmaiśca sārdhaṁ gacchatyasau vibhuḥ||82||
rasaraktāśritaḥ sādhyō mēdōmāṁsagataśca yaḥ|
asthimajjagataḥ kr̥cchraḥ śukrasthō naiva siddhyati||83||
RutvahorAtradoShANAM manasashca balAbalAt|
kAlamarthavashAccaiva jwarastaM taM prapadyate||75||
gurutvaM dainyamudvegaH sadanaM chardyarocakau|
rasasthite bahistApaH sA~ggamardo vijRumbhaNam||76||
raktoShNAH piDakAstRuShNA saraktaM ShThIvanaM muhuH|
dAharAgabhramamadapralApA raktasaMsthite||77||
antardAhaH satRuNmohaH saglAniH sRuShTaviTkatA|
daurgandhyaM gAtravikShepo jvare mAMsasthite bhavet||78||
svedastIvrA pipAsA ca pralApo vamyabhIkShNashaH|
svagandhasyAsahatvaM ca medaHsthe glAnyarocakau||79||
virekavamane cobhe sAsthibhedaM prakUjanam|
vikShepaNaM ca gAtrANAM shvAsashcAsthigate jvare||80||
hikkA shvAsastathA kAsastamasashcAtidarshanam|
marmacchedo bahiH shaityaM dAho~antashcaiva majjage||81||
shukrasthAnagataH shukramokShaM kRutvA vinAshya ca|
prANaM vAyvagnisomaishca sArdhaM gacchatyasau vibhuH||82||
rasaraktAshritaH sAdhyo medomAMsagatashca yaH|
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:
''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):
#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 ''[[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 ''[[dosha]]s'' causing ''jwara'' are lodged in the ''[[mamsa dhatu]]''.
#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) 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.
#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 ''[[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|
समासेनोपदिष्टस्य व्यासतः शृणु लक्षणम्||८४||
शिरोरुक् पर्वणां भेदो दाहो रोम्णां प्रहर्षणम्|
कण्ठास्यशोषो वमथुस्तृष्णा मूर्च्छा भ्रमोऽरुचिः||८५||
स्वप्ननाशोऽतिवाग्जृम्भा वातपित्तज्वराकृतिः|
शीतको गौरवं तन्द्रा स्तैमित्यं पर्वणां च रुक्||८६||
शिरोग्रहः प्रतिश्यायः कासः स्वेदाप्रवर्तनम्|
सन्तापो मध्यवेगश्च वातश्लेष्मज्वराकृतिः||८७||
मुहुर्दाहो मुहुः शीतं स्वेदस्तम्भो मुहुर्मुहुः|
मोहः कासोऽरुचिस्तृष्णा श्लेष्मपित्तप्रवर्तनम्||८८||
लिप्ततिक्तास्यता तन्द्रा श्लेष्मपित्तज्वराकृतिः|
इत्येते द्वन्द्वजाः प्रोक्ताः ...|८९|
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hētubhirlakṣaṇaiścōktaḥ pūrvamaṣṭavidhō jwaraḥ|
samāsēnōpadiṣṭasya vyāsataḥ śr̥ṇu lakṣaṇam||84||
śirōruk [1] parvaṇāṁ bhēdō dāhō rōmṇāṁ praharṣaṇam|
kaṇṭhāsyaśōṣō vamathustr̥ṣṇā mūrcchā bhramō'ruciḥ||85||
svapnanāśō'tivāgjr̥mbhā vātapittajvarākr̥tiḥ|
śītakō gauravaṁ tandrā staimityaṁ parvaṇāṁ ca ruk||86||
śirōgrahaḥ pratiśyāyaḥ kāsaḥ svēdāpravartanam|
santāpō madhyavēgaśca vātaślēṣmajvarākr̥tiḥ||87||
muhurdāhō muhuḥ śītaṁ svēdastambhō [2] muhurmuhuḥ|
mōhaḥ kāsō'rucistr̥ṣṇā ślēṣmapittapravartanam||88||
liptatiktāsyatā tandrā ślēṣmapittajvarākr̥tiḥ|
ityētē dvandvajāḥ prōktāḥ ...|89|
hetubhirlakShaNaishcoktaH pUrvamaShTavidho jwaraH|
samAsenopadiShTasya vyAsataH shRuNu lakShaNam||84||
shiroruk parvaNAM bhedo dAho romNAM praharShaNam|
kaNThAsyashoSho vamathustRuShNA mUrcchA bhramo~aruciH||85||
svapnanAsho~ativAgjRumbhA vAtapittajwarakRutiH|
shItako gauravaM tandrA staimityaM parvaNAM ca ruk||86||
shirograhaH pratishyAyaH kAsaH svedApravartanam|
santApo madhyavegashca vAtashleShmajwarakRutiH||87||
muhurdAho muhuH shItaM svedastambho muhurmuhuH|
mohaH kAso~arucistRuShNA shleShmapittapravartanam||88||
liptatiktAsyatA tandrA shleShmapittajwarakRutiH|
ityete dvandvajAH proktAH ...|89|
</div></div>
<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:
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]]'':
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]]'':
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]
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=== ''Sannipataja jwara'' ===
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... सन्निपातज उच्यते||८९||
सन्निपातज्वरस्योर्ध्वं त्रयोदशविधस्य हि|
प्राक्सूत्रितस्य वक्ष्यामि लक्षणं वै पृथक् पृथक्||९०||
भ्रमः पिपासा दाहश्च गौरवं शिरसोऽतिरुक्|
वातपित्तोल्बणे विद्याल्लिङ्गं मन्दकफे ज्वरे||९१||
शैत्यं कासोऽरुचिस्तन्द्रापिपासादाहरुग्व्यथाः|
वातश्लेष्मोल्बणे व्याधौ लिङ्गं पित्तावरे विदुः||९२||
छर्दिः शैत्यं मुहुर्दाहस्तृष्णा मोहोऽस्थिवेदना|
मन्दवाते व्यवस्यन्ति लिङ्गं पित्तकफोल्बणे||९३||
सन्ध्यस्थिशिरसः शूलं प्रलापो गौरवं भ्रमः|
वातोल्बणे स्याद् द्व्यनुगे तृष्णा कण्ठास्यशुष्कता||९४||
रक्तविण्मूत्रता दाहः स्वेदस्तृड् बलसङ्क्षयः|
मूर्च्छा चेति त्रिदोषे स्याल्लिङ्गं पित्ते गरीयसि||९५||
आलस्यारुचिहृल्लासदाहवम्यरतिभ्रमैः|
कफोल्बणं सन्निपातं तन्द्राकासेन चादिशेत्||९६||
प्रतिश्या छर्दिरालस्यं तन्द्राऽरुच्यग्निमार्दवम्|
हीनवाते पित्तमध्ये लिङ्गं श्लेष्माधिके मतम्||९७||
हारिद्रमूत्रनेत्रत्वं दाहस्तृष्णा भ्रमोऽरुचिः|
हीनवाते मध्यकफे लिङ्गं पित्ताधिके मतम्||९८||
शिरोरुग्वेपथुः श्वासः प्रलापश्छर्द्यरोचकौ|
हीनपित्ते मध्यकफे लिङ्गं स्यान्मारुताधिके||९९||
शीतको गौरवं तन्द्रा प्रलापोऽस्थिशिरोऽतिरुक्|
हीनपित्ते वातमध्ये लिङ्गं श्लेष्माधिके विदुः||१००||
श्वासः कासः प्रतिश्यायो मुखशोषोऽतिपार्श्वरुक्|
कफहीने पित्तमध्ये लिङ्गं वाताधिके मतम्||१०१||
वर्चोभेदोऽग्निदौर्बल्यं [३] तृष्णा दाहोऽरुचिर्भ्रमः|
कफहीने वातमध्ये लिङ्गं पित्ताधिके विदुः||१०२||
सन्निपातज्वरस्योर्ध्वमतो वक्ष्यामि लक्षणम्|
क्षणे दाहः क्षणे शीतमस्थिसन्धिशिरोरुजा||१०३||
सास्रावे कलुषे रक्ते निर्भुग्ने चापि दर्शने [४] |
सस्वनौ सरुजौ कर्णौ कण्ठः शूकैरिवावृतः||१०४||
तन्द्रा मोहः प्रलापश्च कासः श्वासोऽरुचिर्भ्रमः|
परिदग्धा खरस्पर्शा जिह्वा स्रस्ताङ्गता परम्||१०५||
ष्ठीवनं रक्तपित्तस्य कफेनोन्मिश्रितस्य च|
शिरसो लोठनं तृष्णा निद्रानाशो हृदि व्यथा||१०६||
स्वेदमूत्रपुरीषाणां चिराद्दर्शनमल्पशः|
कृशत्वं नातिगात्राणां प्रततं कण्ठकूजनम्||१०७||
कोठानां श्यावरक्तानां मण्डलानां च दर्शनम्|
मूकत्वं स्रोतसां पाको गुरुत्वमुदरस्य च||१०८||
चिरात् पाकश्च दोषाणां सन्निपातज्वराकृतिः|१०९|
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... sannipātaja ucyatē||89||
sannipātajwarasyōrdhvaṁ trayōdaśavidhasya hi|
prāksūtritasya vakṣyāmi lakṣaṇaṁ vai pr̥thak pr̥thak||90||
bhramaḥ pipāsā dāhaśca gauravaṁ śirasō'tiruk|
vātapittōlbaṇē vidyālliṅgaṁ mandakaphē jvarē||91||
śaityaṁ kāsō'rucistandrāpipāsādāharugvyathāḥ|
vātaślēṣmōlbaṇē vyādhau liṅgaṁ pittāvarē viduḥ||92||
chardiḥ śaityaṁ muhurdāhastr̥ṣṇā mōhō'sthivēdanā|
mandavātē vyavasyanti liṅgaṁ pittakaphōlbaṇē||93||
sandhyasthiśirasaḥ śūlaṁ pralāpō gauravaṁ bhramaḥ|
vātōlbaṇē syād dvyanugē tr̥ṣṇā kaṇṭhāsyaśuṣkatā||94||
raktaviṇmūtratā dāhaḥ svēdastr̥ḍ balasaṅkṣayaḥ|
mūrcchā cēti tridōṣē syālliṅgaṁ pittē garīyasi||95||
ālasyārucihr̥llāsadāhavamyaratibhramaiḥ|
kaphōlbaṇaṁ sannipātaṁ tandrākāsēna cādiśēt||96||
pratiśyā chardirālasyaṁ tandrā'rucyagnimārdavam|
hīnavātē pittamadhyē liṅgaṁ ślēṣmādhikē matam||97||
hāridramūtranētratvaṁ dāhastr̥ṣṇā bhramō'ruciḥ|
hīnavātē madhyakaphē liṅgaṁ pittādhikē matam||98||
śirōrugvēpathuḥ śvāsaḥ pralāpaśchardyarōcakau|
hīnapittē madhyakaphē liṅgaṁ syānmārutādhikē||99||
śītakō gauravaṁ tandrā pralāpō'sthiśirō'tiruk|
hīnapittē vātamadhyē liṅgaṁ ślēṣmādhikē viduḥ||100||
śvāsaḥ kāsaḥ pratiśyāyō mukhaśōṣō'tipārśvaruk|
kaphahīnē pittamadhyē liṅgaṁ vātādhikē matam||101||
varcōbhēdō'gnidaurbalyaṁ tr̥ṣṇā dāhō'rucirbhramaḥ|
kaphahīnē vātamadhyē liṅgaṁ pittādhikē viduḥ||102||
sannipātajwarasyōrdhvamatō vakṣyāmi lakṣaṇam|
kṣaṇē dāhaḥ kṣaṇē śītamasthisandhiśirōrujā||103||
sāsrāvē kaluṣē raktē nirbhugnē cāpi darśanē |
sasvanau sarujau karṇau kaṇṭhaḥ śūkairivāvr̥taḥ||104||
tandrā mōhaḥ pralāpaśca kāsaḥ śvāsō'rucirbhramaḥ|
paridagdhā kharasparśā jihvā srastāṅgatā param||105||
ṣṭhīvanaṁ raktapittasya kaphēnōnmiśritasya ca|
śirasō lōṭhanaṁ tr̥ṣṇā nidrānāśō hr̥di vyathā||106||
svēdamūtrapurīṣāṇāṁ cirāddarśanamalpaśaḥ|
kr̥śatvaṁ nātigātrāṇāṁ pratataṁ kaṇṭhakūjanam||107||
kōṭhānāṁ śyāvaraktānāṁ maṇḍalānāṁ ca darśanam|
mūkatvaṁ srōtasāṁ pākō gurutvamudarasya ca||108||
cirāt pākaśca dōṣāṇāṁ sannipātajvarākr̥tiḥ|109|
... sannipAtaja ucyate||89||
sannipAtajwarasyordhvaM trayodashavidhasya hi|
prAksUtritasya vakShyAmi lakShaNaM vai pRuthak pRuthak||90||
bhramaH pipAsA dAhashca gauravaM shiraso~atiruk|
vAtapittolbaNe vidyAlli~ggaM mandakaphe jvare||91||
shaityaM kAso~arucistandrApipAsAdAharugvyathAH|
vAtashleShmolbaNe vyAdhau li~ggaM pittAvare viduH||92||
chardiH shaityaM muhurdAhastRuShNA moho~asthivedanA|
mandavAte vyavasyanti li~ggaM pittakapholbaNe||93||
sandhyasthishirasaH shUlaM pralApo gauravaM bhramaH|
vAtolbaNe syAd dvyanuge tRuShNA kaNThAsyashuShkatA||94||
raktaviNmUtratA dAhaH svedastRuD balasa~gkShayaH|
mUrcchA ceti tridoShe syAlli~ggaM pitte garIyasi||95||
AlasyArucihRullAsadAhavamyaratibhramaiH|
kapholbaNaM sannipAtaM tandrAkAsena cAdishet||96||
pratishyA chardirAlasyaM tandrA~arucyagnimArdavam|
hInavAte pittamadhye li~ggaM shleShmAdhike matam||97||
hAridramUtranetratvaM dAhastRuShNA bhramo~aruciH|
hInavAte madhyakaphe li~ggaM pittAdhike matam||98||
shirorugvepathuH shvAsaH pralApashchardyarocakau|
hInapitte madhyakaphe li~ggaM syAnmArutAdhike||99||
shItako gauravaM tandrA pralApo~asthishiro~atiruk|
hInapitte vAtamadhye li~ggaM shleShmAdhike viduH||100||
shvAsaH kAsaH pratishyAyo mukhashoSho~atipArshvaruk|
kaphahIne pittamadhye li~ggaM vAtAdhike matam||101||
varcobhedo~agnidaurbalyaM tRuShNA dAho~arucirbhramaH|
kaphahIne vAtamadhye li~ggaM pittAdhike viduH||102||
sannipAtajwarasyordhvamato vakShyAmi lakShaNam|
kShaNe dAhaH kShaNe shItamasthisandhishirorujA||103||
sAsrAve kaluShe rakte nirbhugne cApi darshane |
sasvanau sarujau karNau kaNThaH shUkairivAvRutaH||104||
tandrA mohaH pralApashca kAsaH shvAso~arucirbhramaH|
paridagdhA kharasparshA jihvA srastA~ggatA param||105||
ShThIvanaM raktapittasya kaphenonmishritasya ca|
shiraso loThanaM tRuShNA nidrAnAsho hRudi vyathA||106||
svedamUtrapurIShANAM cirAddarshanamalpashaH|
kRushatvaM nAtigAtrANAM pratataM kaNThakUjanam||107||
koThAnAM shyAvaraktAnAM maNDalAnAM ca darshanam|
mUkatvaM srotasAM pAko gurutvamudarasya ca||108||
cirAt pAkashca doShANAM sannipAtajwarakRutiH|109|
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<div style="text-align:justify;">
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:
*''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 ''[[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 ''[[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 ''[[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 ''[[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 ''[[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 ''[[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 ''[[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 ''[[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
**Pain in the bones, joints and head
**Eyes are with excessive lacrimation, dull, reddish with eyeballs protruded out.
**Ringing sound and pain in the ears
**Pricking pain in throat like thorn of grain
**Drowsiness, delusion, delirium, cough, breathlessness, anorexia and giddiness
**Burning sensation of tongue, and turns rough to touch
**Excessive fatigue
**Spitting of blood and bile mixed with phlegm (sputum)
**Swaying movements of head, thirst, sleeplessness and pain in the cardiac region
**Sweat, urine and stool reduced in amount with delayed evacuation.
**Body is not excessively emaciated (due to accumulated ''[[dosha]]'')
**Constant ''kujana'' (cooing sound)
**Urticaria and bluish – black or reddish circular patches appear on the skin
**Patient speaks less or unable to speak
**Inflammation of ''srotasa''
**Heaviness in the abdomen
**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'' ===
<div class="mw-collapsible mw-collapsed">
दोषे विबद्धे नष्टेऽग्नौ सर्वसम्पूर्णलक्षणः||१०९||
सन्निपातज्वरोऽसाध्यः कृच्छ्रसाध्यस्त्वतोऽन्यथा|
निदाने त्रिविधा प्रोक्ता या पृथग्जज्वराकृतिः||११०||
संसर्गसन्निपातानां तया चोक्तं स्वलक्षणम्|१११|
<div class="mw-collapsible-content">
dōṣē vibaddhē naṣṭē'gnau sarvasampūrṇalakṣaṇaḥ||109||
sannipātajvarō'sādhyaḥ kr̥cchrasādhyastvatō'nyathā|
nidānē trividhā prōktā yā pr̥thagjajvarākr̥tiḥ||110||
saṁsargasannipātānāṁ tayā cōktaṁ svalakṣaṇam|111|
doShe vibaddhe naShTe~agnau sarvasampUrNalakShaNaH||109||
sannipAtajvaro~asAdhyaH kRucchrasAdhyastvato~anyathA|
nidAne trividhA proktA yA pRuthagjajvarAkRutiH||110||
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>
=== Classification of ''agantuja jwara'' ===
<div class="mw-collapsible mw-collapsed">
आगन्तुरष्टमो यस्तु स निर्दिष्टश्चतुर्विधः||१११||
अभिघाताभिषङ्गाभ्यामभिचाराभिशापतः|
<div class="mw-collapsible-content">
āganturaṣṭamō yastu sa nirdiṣṭaścaturvidhaḥ||111||
abhighātābhiṣaṅgābhyāmabhicārābhiśāpataḥ|
AganturaShTamo yastu sa nirdiShTashcaturvidhaH||111||
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]
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=== ''Abhighataja jwara'' (due to injury or trauma) ===
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शस्त्रलोष्टकशाकाष्ठमुष्ट्यरत्नितलद्विजैः||११२||
तद्विधैश्च हते गात्रे ज्वरः स्यादभिघातजः|
तत्राभिघातजे वायुः प्रायो रक्तं प्रदूषयन्||११३||
सव्यथाशोफवैवर्ण्यं करोति सरुजं ज्वरम्|११४|
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śastralōṣṭakaśākāṣṭhamuṣṭyaratnitaladvijaiḥ||112||
tadvidhaiśca hatē gātrē jvaraḥ syādabhighātajaḥ|
tatrābhighātajē vāyuḥ prāyō raktaṁ pradūṣayan||113||
savyathāśōphavaivarṇyaṁ karōti sarujaṁ jvaram|114|
shastraloShTakashAkAShThamuShTyaratnitaladvijaiH||112||
tadvidhaishca hate gAtre jvaraH syAdabhighAtajaH|
tatrAbhighAtaje vAyuH prAyo raktaM pradUShayan||113||
savyathAshophavaivarNyaM karoti sarujaM jvaram|114|
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<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]
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=== ''Abhishangaja, abhishapaja'' and ''abhicharaja jwara'' ===
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कामशोकभयक्रोधैरभिषक्तस्य यो ज्वरः||११४||
सोऽभिषङ्गाज्वरो ज्ञेयो यश्च भूताभिषङ्गजः|
कामशोकभयाद्वायुः, क्रोधात् पित्तं, त्रयो मलाः||११५||
भूताभिषङ्गात् कुप्यन्ति भूतसामान्यलक्षणाः|
भूताधिकारे व्याख्यातं तदष्टविधलक्षणम्||११६||
विषवृक्षानिलस्पर्शात्तथाऽन्यैर्विषसम्भवैः|
अभिषक्तस्य चाप्याहुर्ज्वरमेकेऽभिषङ्गजम्||११७||
चिकित्सया विषघ्न्यैव स शमं लभते नरः|
अभिचाराभिशापाभ्यां सिद्धानां यः प्रवर्तते||११८||
सन्निपातज्वरो घोरः स विज्ञेयः सुदुःसहः|
सन्निपातज्वरस्योक्तं लिङ्गं यत्तस्य तत् स्मृतम्||११९||
चित्तोन्द्रियशरीराणामर्तयोऽन्याश्च नैकशः|
प्रयोगं त्वभिचारस्य दृष्ट्वा शापस्य चैव हि||१२०||
स्वयं श्रुत्वाऽनुमानेन लक्ष्यते प्रशमेन वा|
वैविध्यादभिचारस्य शापस्य च तदात्मके||१२१||
यथाकर्मप्रयोगेण लक्षणं स्यात् पृथग्विधम्|
ध्याननिःश्वासबहुलं लिङ्गं कामज्वरे स्मृतम्||१२२||
शोकजे बाष्पबहुलं त्रासप्रायं भयज्वरे|
क्रोधजे बहुसंरम्भं भूतावेशे त्वमानुषम्||१२३||
मूर्च्छामोहमदग्लानिभूयिष्ठं विषसम्भवे|
केषाञ्चिदेषां लिङ्गानां सन्तापो जायते पुरः||१२४||
पश्चात्तुल्यं तु केषाञ्चिदेषु कामज्वरादिषु|
कामादिजानामुद्दिष्टं ज्वराणां यद्विशेषणम्||१२५||
कामादिजानां रोगाणामन्येषामपि तत् स्मृतम्|
मनस्यभिहते पूर्वं कामाद्यैर्न तथा बलम्||१२६||
ज्वरः प्राप्नोति वाताद्यैर्देहो यावन्न दूष्यति|
देहे चाभिह(द्रु)ते पूर्वं वाताद्यैर्न तथा बलम्||१२७||
ज्वरः प्राप्नोति कामाद्यैर्मनो यावन्न दूष्यति|
ते पूर्वं केवलाः पश्चान्निजैर्व्यामिश्रलक्षणाः||१२८||
हेत्वौषधविशिष्टाश्च भवन्त्यागन्तवो ज्वराः|१२९|
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kāmaśōkabhayakrōdhairabhiṣaktasya yō jvaraḥ||114||
sō'bhiṣaṅgājvarō jñēyō yaśca bhūtābhiṣaṅgajaḥ|
kāmaśōkabhayādvāyuḥ, krōdhāt pittaṁ, trayō malāḥ||115||
bhūtābhiṣaṅgāt kupyanti bhūtasāmānyalakṣaṇāḥ|
bhūtādhikārē vyākhyātaṁ tadaṣṭavidhalakṣaṇam||116||
viṣavr̥kṣānilasparśāttathā'nyairviṣasambhavaiḥ|
abhiṣaktasya cāpyāhurjvaramēkē'bhiṣaṅgajam||117||
cikitsayā viṣaghnyaiva sa śamaṁ labhatē naraḥ|
abhicārābhiśāpābhyāṁ siddhānāṁ yaḥ pravartatē||118||
sannipātajvarō ghōraḥ sa vijñēyaḥ suduḥsahaḥ|
sannipātajvarasyōktaṁ liṅgaṁ yattasya tat smr̥tam||119||
cittōndriyaśarīrāṇāmartayō'nyāśca naikaśaḥ|
prayōgaṁ tvabhicārasya dr̥ṣṭvā śāpasya caiva hi||120||
svayaṁ śrutvā'numānēna lakṣyatē praśamēna vā|
vaividhyādabhicārasya śāpasya ca tadātmakē||121||
yathākarmaprayōgēṇa lakṣaṇaṁ syāt pr̥thagvidham|
dhyānaniḥśvāsabahulaṁ liṅgaṁ kāmajvarē smr̥tam||122||
śōkajē bāṣpabahulaṁ trāsaprāyaṁ bhayajvarē|
krōdhajē bahusaṁrambhaṁ bhūtāvēśē tvamānuṣam||123||
mūrcchāmōhamadaglānibhūyiṣṭhaṁ viṣasambhavē|
kēṣāñcidēṣāṁ liṅgānāṁ santāpō jāyatē puraḥ||124||
paścāttulyaṁ tu kēṣāñcidēṣu kāmajvarādiṣu|
kāmādijānāmuddiṣṭaṁ jvarāṇāṁ yadviśēṣaṇam||125||
kāmādijānāṁ rōgāṇāmanyēṣāmapi tat smr̥tam|
manasyabhihatē pūrvaṁ kāmādyairna tathā balam||126||
jvaraḥ prāpnōti vātādyairdēhō yāvanna dūṣyati|
dēhē cābhiha(dru)tē pūrvaṁ vātādyairna tathā balam||127||
jvaraḥ prāpnōti kāmādyairmanō yāvanna dūṣyati|128|
kAmashokabhayakrodhairabhiShaktasya yo jvaraH||114||
so~abhiSha~ggAjvaro j~jeyo yashca bhUtAbhiSha~ggajaH|
kAmashokabhayAdvAyuH, krodhAt pittaM, trayo malAH||115||
bhUtAbhiSha~ggAt kupyanti bhUtasAmAnyalakShaNAH|
bhUtAdhikAre vyAkhyAtaM tadaShTavidhalakShaNam||116||
viShavRukShAnilasparshAttathA~anyairviShasambhavaiH|
abhiShaktasya cApyAhurjvarameke~abhiSha~ggajam||117||
cikitsayA viShaghnyaiva sa shamaM labhate naraH|
abhicArAbhishApAbhyAM siddhAnAM yaH pravartate||118||
sannipAtajvaro ghoraH sa vij~jeyaH suduHsahaH|
sannipAtajvarasyoktaM li~ggaM yattasya tat smRutam||119||
cittondriyasharIrANAmartayo~anyAshca naikashaH|
prayogaM tvabhicArasya dRuShTvA shApasya caiva hi||120||
svayaM shrutvA~anumAnena lakShyate prashamena vA|
vaividhyAdabhicArasya shApasya ca tadAtmake||121||
yathAkarmaprayogeNa lakShaNaM syAt pRuthagvidham|
dhyAnaniHshvAsabahulaM li~ggaM kAmajvare smRutam||122||
shokaje bAShpabahulaM trAsaprAyaM bhayajvare|
krodhaje bahusaMrambhaM bhUtAveshe tvamAnuSham||123||
mUrcchAmohamadaglAnibhUyiShThaM viShasambhave|
keShA~jcideShAM li~ggAnAM santApo jAyate puraH||124||
pashcAttulyaM tu keShA~jcideShu kAmajvarAdiShu|
kAmAdijAnAmuddiShTaM jvarANAM yadvisheShaNam||125||
kAmAdijAnAM rogANAmanyeShAmapi tat smRutam|
manasyabhihate pUrvaM kAmAdyairna tathA balam||126||
jvaraH prApnoti vAtAdyairdeho yAvanna dUShyati|
dehe cAbhiha(dru)te pUrvaM vAtAdyairna tathA balam||127||
jvaraH prApnoti kAmAdyairmano yAvanna dUShyati|
tē pūrvaṁ kēvalāḥ paścānnijairvyāmiśralakṣaṇāḥ||128||
hētvauṣadhaviśiṣṭāśca bhavantyāgantavō jvarāḥ|129|
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'''''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.
'''''Abhicharaja jwara''''': The activities such as abhichara (evil ''tantrik'' rituals) and ''abhishapa'' of ''siddhas'' (curse by saints who have attained spiritual perfection) results in the manifestation of ''sannipataja jwara'', which are respectively called ''abhicharaja'' and ''abhishapaja jwara'' respectively. These types of ''jwara'' are intolerable and the clinical features of ''sannipata jwara'' manifest in them accompanied by other clinical features of the mind, sense organs and body due to the cause afflicting.
''Abhishapaja jwara, abhicharaja'' and ''abhishapdaja jwara'' can be ascertained from the following clinical features –
*Either by the direct observation of the performance of the ''tantric'' rituals and ''shapa'' (curse)
*By hearing from others about it
*By inference (''anumana'') about it from some feature and
*By the alleviation of ''jwara'' after counteracting their effects.
Depending upon the varieties of ''abhichara'' and ''abhishapa'', tantric and disease occurred by curse are there, clinical features also vary. A through understanding is essential for the diagnosis of such varieties of diseases.
''Jwara'' of psychological origin are further described as:-
*''Kamaja jwara'' - ''Dhyana'' (constantly thinking of same object), frequent sighs of lament are the clinical features of ''jwara'' caused by ''kama'' (passion)
*''Shokaja jwara'' - Excessive crying is the clinical presentation of ''jwara'' caused by grief.
*''Bhayaja jwara'' - Patient generally feels himself threatened in the ''jwara'' caused by fear.
*''Krodhaj jwara'' - Patient is agitated excessively in the ''jwara'' caused by anger.
Para psychic manifestations are also presented in the ''jwara'' due to affliction by the ''bhootas'' (evil spirits).
''Jwara'' caused by ''visha'' (intoxications) is associated with the features of fainting, unconsciousness, intoxication and fatigue.
In some ''jwara'', fever appears first and then the signs and symptoms of ''kama'' etc. as described above are manifested, and it may happen the other way also.
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 ''[[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]
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=== General patho-physiology of ''jwara'' ===
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संसृष्टाः सन्निपतिताः पृथग्वा कुपिता मलाः||१२९||
रसाख्यं धातुमन्वेत्य पक्तिं स्थानान्निरस्य च|
स्वेन तेनोष्मण चैव कृत्वा देहोष्मणो बलम्||१३०||
स्रोतांसि रुद्ध्वा सम्प्राप्ताः केवलं देहमुल्बणाः|
सन्तापमधिकं देहे जनयन्ति नरस्तदा||१३१||
भवत्यत्युष्णसर्वाङ्गो ज्वरितस्तेन चोच्यते|१३२|
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saṁsr̥ṣṭāḥ sannipatitāḥ pr̥thagvā kupitā malāḥ||129||
rasākhyaṁ dhātumanvētya paktiṁ sthānānnirasya ca|
svēna tēnōṣmaṇa caiva kr̥tvā dēhōṣmaṇō balam||130||
srōtāṁsi ruddhvā samprāptāḥ kēvalaṁ dēhamulbaṇāḥ|
santāpamadhikaṁ dēhē janayanti narastadā||131||
bhavatyatyuṣṇasarvāṅgō jvaritastēna cōcyatē|132|
te pUrvaM kevalAH pashcAnnijairvyAmishralakShaNAH||128||
hetvauShadhavishiShTAshca bhavantyAgantavo jvarAH|
saMsRuShTAH sannipatitAH pRuthagvA kupitA malAH||129||
rasAkhyaM dhAtumanvetya paktiM sthAnAnnirasya ca|
svena tenoShmaNa caiva kRutvA dehoShmaNo balam||130||
srotAMsi ruddhvA samprAptAH kevalaM dehamulbaNAH|
santApamadhikaM dehe janayanti narastadA||131||
bhavatyatyuShNasarvA~ggo jvaritastena cocyate|132|
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These aggravated ''[[dosha]]'' either alone or in the combination of two or three, spread along with the ''[[rasa dhatu]]'' (the first ''[[dhatu]]'' responsible for nourishment of the body) and displace the ''jatharagni'' from its own place. Supplemented by the ''[[dosha]]''’s own heat and the heat of the ''jatharagni'', the heat of the body gets accentuated and they are further aggravated by the blockage of the circulatory channels. It then pervades the entire body to produce excessive heat. Therefore, the temperature increases all over the body and this condition is called ''jwara''.[129-132]
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=== Cause of lack of sweating ===
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स्रोतसां सन्निरुद्धत्वात् स्वेदं ना नाधिगच्छति||१३२||
स्वस्थानात् प्रच्युते चाग्नौ प्रायशस्तरुणेज्वरे|१३३|
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srōtasāṁ sanniruddhatvāt svēdaṁ nā nādhigacchati||132||
svasthānāt pracyutē cāgnau prāyaśastaruṇējvarē|133|
srotasAM sanniruddhatvAt svedaM nA nAdhigacchati||132||
svasthAnAt pracyute cAgnau prAyashastaruNejvare|133|
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A person suffering from ''taruna jwara'' (the initial stage of ''jwara'') does not sweat because of the obstruction of the channels of circulation and the displacement of ''agni''. [132-133]
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=== Clinical features of ''Ama Jwara'' (first stage of ''jwara'') ===
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अरुचिश्चाविपाकश्च गुरुत्वमुदरस्य च||१३३||
हृदयस्याविशुद्धिश्च तन्द्रा चालस्यमेव च|
ज्वरोऽविसर्गी बलवान् दोषाणामप्रवर्तनम्||१३४||
लालाप्रसेको हृल्लासः क्षुन्नाशो विरसं मुखम्|
स्तब्धसुप्तगुरुवं च गात्राणां बहुमूत्रता||१३५||
न विड् जीर्णा न च ग्लानिर्ज्वरस्यामस्य लक्षणम्|
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aruciścāvipākaśca gurutvamudarasya ca||133||
hr̥dayasyāviśuddhiśca tandrā cālasyamēva ca|
jvarō'visargī balavān dōṣāṇāmapravartanam||134||
lālāprasēkō hr̥llāsaḥ kṣunnāśō virasaṁ mukham|
stabdhasuptaguruvaṁ ca gātrāṇāṁ bahumūtratā||135||
na viḍ jīrṇā na ca glānirjvarasyāmasya lakṣaṇam|
arucishcAvipAkashca gurutvamudarasya ca||133||
hRudayasyAvishuddhishca tandrA cAlasyameva ca|
jvaro~avisargI balavAn doShANAmapravartanam||134||
lAlApraseko hRullAsaH kShunnAsho virasaM mukham|
stabdhasuptaguruvaM ca gAtrANAM bahumUtratA||135||
na viD jIrNA na ca glAnirjvarasyAmasya lakShaNam|
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The ''ama jwara'' (first stage of ''jwara'') presents with the following clinical features –
*Anorexia, indigestion, heaviness in the stomach
*Feeling of heaviness and accumulation of impurities in cardiac region, drowsiness and laziness
*Continuous, fever with acute onset.
*Non-elimination of the [[dosha]] along with [[mala]] or waste products
*Excess salivation, nausea, loss of appetite, and tastelessness in the mouth
*Rigidity, numbness and heaviness of the body
*Excessive urination
*Improper formation of stool
*Absence of muscle emaciation [133-136]
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=== Clinical features of ''pachyamana jwara'' (second stage of ''jwara'') ===
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ज्वरवेगोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||१३६||
मलप्रवृत्तिरुत्क्लेशः पच्यमानस्य लक्षणम्|१३७|
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jvaravēgō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||136||
malapravr̥ttirutklēśaḥ pacyamānasya lakṣaṇam|137|
jvaravego~adhikastRuShNA pralApaH shvasanaM bhramaH||136||
malapravRuttirutkleshaH pacyamAnasya lakShaNam|137|
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The features of ''pachyamana jwara'' (second stage of fever) are as follows – high grade fever and excess thirst, delirium, dyspnea, giddiness and excess evacuation of wastes [136]
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=== Clinical features of ''nirama jwara'' (third stage of ''jwara'') ===
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क्षुत् क्षामता लघुत्वं च गात्राणां ज्वरमार्दवम्||१३७||
दोषप्रवृत्तिरष्टाहो निरामज्वरलक्षणम्|१३८|
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kṣut kṣāmatā laghutvaṁ ca gātrāṇāṁ jvaramārdavam||137||
dōṣapravr̥ttiraṣṭāhō nirāmajvaralakṣaṇam|138|
kShut kShAmatA laghutvaM ca gAtrANAM jvaramArdavam||137||
doShapravRuttiraShTAho nirAmajvaralakShaNam|138|
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Restoration of hunger, debility, lightness in the body, reduced fever, elimination of the ''[[dosha]]'' along with the waste products from the body – are all the clinical features of ''nirama jwara'' (condition when the patient’s body becomes free from the ''ama''). These features generally appear on the 8th day. [137-138]
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=== Precaution at initial stage of ''jwara'' ===
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नवज्वरे दिवास्वप्नस्नानाभ्यङ्गान्नमैथुनम्||१३८||
क्रोधप्रवातव्यायामान् कषायांश्च विवर्जयेत्|१३९|
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navajvarē divāsvapnasnānābhyaṅgānnamaithunam||138||
krōdhapravātavyāyāmān kaṣāyāṁśca vivarjayēt|139|
navajvare divAsvapnasnAnAbhya~ggAnnamaithunam||138||
krodhapravAtavyAyAmAn kaShAyAMshca vivarjayet|139|
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<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]
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=== Contra-indications of ''langhana'' (fasting) ===
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ज्वरे लङ्घनमेवादावुपदिष्टमृते ज्वरात्||१३९||
क्षयानिलभयक्रोधकामशोकश्रमोद्भवात् |१४०|
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jvarē laṅghanamēvādāvupadiṣṭamr̥tē jvarāt||139||
kṣayānilabhayakrōdhakāmaśōkaśramōdbhavāt |140|
jvare la~gghanamevAdAvupadiShTamRute jvarAt||139||
kShayAnilabhayakrodhakAmashokashramodbhavAt |140|
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<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]
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=== Benefits of ''[[langhana]]'' (fasting) in ''jwara'' ===
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लङ्घनेन क्षयं नीते दोषे सन्धुक्षितेऽनले||१४०||
विज्वरत्वं लघुत्वं च क्षुच्चैवास्योपजायते |
प्राणाविरोधिना चैनं लङ्घनेनोपपादयेत्||१४१||
बलाधिष्ठानमारोग्यं यदर्थोऽयं क्रियाक्रमः|१४२|
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laṅghanēna kṣayaṁ nītē dōṣē sandhukṣitē'nalē||140||
vijvaratvaṁ laghutvaṁ ca kṣuccaivāsyōpajāyatē |
prāṇāvirōdhinā cainaṁ laṅghanēnōpapādayēt||141||
balādhiṣṭhānamārōgyaṁ yadarthō'yaṁ kriyākramaḥ|142|
la~gghanena kShayaM nIte doShe sandhukShite~anale||140||
vijvaratvaM laghutvaM ca kShuccaivAsyopajAyate |
prANAvirodhinA cainaM la~gghanenopapAdayet||141||
balAdjhiShThAnamArogyaM yadartho~ayaM kriyAkramaH|142|
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<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]]'' 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]
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=== Management principle of ''jwara'' ===
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लङ्घनं स्वेदनं कालो यवाग्वस्तिक्तको रसः||१४२||
पाचनान्यविपक्वानां दोषाणां तरुणे ज्वरे|१४३|
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laṅghanaṁ svēdanaṁ kālō yavāgvastiktakō rasaḥ||142||
pācanānyavipakvānāṁ dōṣāṇāṁ taruṇē jvarē|143|
la~gghanaM svedanaM kAlo yavAgvastiktako rasaH||142||
pAcanAnyavipakvAnAM doShANAM taruNe jvare|143|
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''[[Langhana]]'' (fasting), ''[[swedana]]'' (fomentation), ''kala'' (waiting period of eight days), ''yavagu'' (medicated gruels) and ''tikta rasa'' drugs (drugs having bitter taste) and all digestive enhancers of ''avipakva [[dosha]]'' (untransformed) are prescribed in the ''taruna jwara'' (the initial stage of ''jwara'').[142]
=== Various drinks for management of thirst ===
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तृष्यते सलिलं चोष्णं दद्याद्वातकफज्वरे ||१४३||
मद्योत्थे पैत्तिके चाथ शीतलं तिक्तकैः शृतम्|
दीपनं पाचनं चैव ज्वरघ्नमुभयं हि तत्||१४४||
स्रोतसां शोधनं बल्यं रुचिस्वेदकरं शिवम्|१४५|
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tr̥ṣyatē salilaṁ cōṣṇaṁ dadyādvātakaphajvarē ||143||
madyōtthē paittikē cātha śītalaṁ tiktakaiḥ śr̥tam|
dīpanaṁ pācanaṁ caiva jvaraghnamubhayaṁ hi tat||144||
srōtasāṁ śōdhanaṁ balyaṁ rucisvēdakaraṁ śivam|145|
tRuShyate salilaM coShNaM dadyAdvAtakaphajvare ||143||
madyotthe paittike cAtha shItalaM tiktakaiH shRutam|
dIpanaM pAcanaM caiva jvaraghnamubhayaM hi tat||144||
srotasAM shodhanaM balyaM rucisvedakaraM shivam|145|
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<div style="text-align:justify;">
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]]'';
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]
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=== ''Shadanga paniya'' ===
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मुस्तपर्पटकोशीरचन्दनोदीच्यनागरैः||१४५||
शृतशीतं जलं दद्यात् पिपासाज्वरशान्तये|१४६|
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mustaparpaṭakōśīracandanōdīcyanāgaraiḥ||145||
śr̥taśītaṁ jalaṁ dadyāt pipāsājvaraśāntayē|146|
mustaparpaTakoshIracandanodIcyanAgaraiH||145||
shRutashItaM jalaM dadyAt pipAsAjvarashAntaye|146|
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<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]
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=== Indication of ''[[vamana]]'' (therapeutic emesis) ===
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कफप्रधानानुत्क्लिष्टान् दोषानामाशयस्थितान्||१४६||
बुद्ध्वा ज्वरकरान् काले वम्यानां वमनैर्हरेत्|१४७|
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kaphapradhānānutkliṣṭān dōṣānāmāśayasthitān||146||
buddhvā jvarakarān kālē vamyānāṁ vamanairharēt|147|
kaphapradhAnAnutkliShTAn doShAnAmAshayasthitAn||146||
buddhvA jvarakarAn kAle vamyAnAM vamanairharet|147|
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<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]
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=== Hazards of improper ''[[vamana]]'' (therapeutic emesis) ===
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अनुपस्थितदोषाणां वमनं तरुणेज्वरे||१४७||
हृद्रोगं श्वासमानाहं मोहं च जनयेद्भृशम्|
सर्वदेहानुगाः सामा धातुस्था असुनिर्हराः ||१४८||
दोषाः फलानामामानां स्वरसा इव सात्ययाः|१४९|
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anupasthitadōṣāṇāṁ vamanaṁ taruṇējvarē||147||
hr̥drōgaṁ śvāsamānāhaṁ mōhaṁ ca janayēdbhr̥śam|
sarvadēhānugāḥ sāmā dhātusthā asunirharāḥ ||148||
dōṣāḥ phalānāmāmānāṁ svarasā iva sātyayāḥ|149|
anupasthitadoShANAM vamanaM taruNejvare||147||
hRudrogaM shvAsamAnAhaM mohaM ca janayedbhRusham|
sarvadehAnugAH sAmA dhAtusthA asunirharAH ||148||
doShAH phalAnAmAmAnAM svarasA iva sAtyayAH|149|
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<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]
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=== Post ''[[vamana]]'' protocol ===
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वमितं लङ्घितं काले यवागूभिरुपाचरेत्||१४९||
यथास्वौषधसिद्धाभिर्मण्डपूर्वाभिरादितः|
यावज्ज्वरमृदूभावात् षडहं वा विचक्षणः||१५०||
तस्याग्निर्दीप्यते ताभिः समिद्भिरिव पावकः|
ताश्च भेषजसंयोगाल्लघुत्वाच्चाग्निदीपनाः||१५१||
वातमूत्रपुरीषाणां दोषाणां चानुलोमनाः|
स्वेदनाय द्रवोष्णत्वाद्द्रवत्वात्तृट्प्रशान्तये||१५२||
आहारभावात् प्राणाय सरत्वाल्लाघवाय च|
ज्वरघ्न्यो ज्वरसात्म्यत्वात्तस्मात् पेयाभिरादितः||१५३||
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vamitaṁ laṅghitaṁ kālē yavāgūbhirupācarēt||149||
yathāsvauṣadhasiddhābhirmaṇḍapūrvābhirāditaḥ|
yāvajjvaramr̥dūbhāvāt ṣaḍahaṁ vā vicakṣaṇaḥ||150||
tasyāgnirdīpyatē tābhiḥ samidbhiriva pāvakaḥ|
tāśca bhēṣajasaṁyōgāllaghutvāccāgnidīpanāḥ||151||
vātamūtrapurīṣāṇāṁ dōṣāṇāṁ cānulōmanāḥ|
svēdanāya dravōṣṇatvāddravatvāttr̥ṭpraśāntayē||152||
āhārabhāvāt prāṇāya saratvāllāghavāya ca|
jvaraghnyō jvarasātmyatvāttasmāt pēyābhirāditaḥ||153||
vamitaM la~gghitaM kAle yavAgUbhirupAcaret||149||
yathAsvauShadhasiddhAbhirmaNDapUrvAbhirAditaH|
yAvajjvaramRudUbhAvAt ShaDahaM vA vicakShaNaH||150||
tasyAgnirdIpyate tAbhiH samidbhiriva pAvakaH|
tAshca bheShajasaMyogAllaghutvAccAgnidIpanAH||151||
vAtamUtrapurIShANAM doShANAM cAnulomanAH|
svedanAya dravoShNatvAddravatvAttRuTprashAntaye||152||
AhArabhAvAt prANAya saratvAllAghavAya ca|
jvaraghnyo jvarasAtmyatvAttasmAt peyAbhirAditaH||153||
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<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.
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 ''[[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]
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=== Contra-indications of ''yavagu'' ===
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ज्वरानुपचरेद्धीमानृते मद्यसमुत्थितात्|
मदात्यये मद्यनित्ये ग्रीष्मे पित्तकफाधिके||१५४||
ऊर्ध्वगे रक्तपित्ते च यवागूर्न हिता ज्वरे|१५५|
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jvarānupacarēddhīmānr̥tē madyasamutthitāt|
madātyayē madyanityē grīṣmē pittakaphādhikē||154||
ūrdhvagē raktapittē ca yavāgūrna hitā jvarē|155|
jvarAnupacareddhImAnRute madyasamutthitAt|
madAtyaye madyanitye grIShme pittakaphAdhike||154||
Urdhvage raktapitte ca yavAgUrna hitA jvare|155|
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<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]
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तत्र तर्पणमेवाग्रे प्रयोज्यं लाजसक्तुभिः||१५५||
ज्वरापहैः फलरसैर्युक्तं समधुशर्करम्|१५६|
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tatra tarpaṇamēvāgrē prayōjyaṁ lājasaktubhiḥ||155||
jvarāpahaiḥ phalarasairyuktaṁ samadhuśarkaram|156|
tatra tarpaNamevAgre prayojyaM lAjasaktubhiH||155||
jvarApahaiH phalarasairyuktaM samadhusharkaram|156|
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<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]
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=== Guidelines for diet, mouth cleansing and tooth brush ===
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ततः सात्म्यबलापेक्षी भोजयेज्जीर्णतर्पणम्||१५६||
तनुना मुद्गयूषेण जाङ्गलानां रसेन वा|
अन्नकालेषु चाप्यस्मै विधेयं दन्तधावनम्||१५७||
योऽस्य वक्त्ररसस्तस्माद्विपरीतं प्रियं च यत्|
तदस्य मुखवैशद्यं प्रकाङ्क्षां चान्नपानयोः||१५८||
धत्ते रसविशेषाणामभिज्ञत्वं करोति यत्|
विशोध्य द्रुमशाखाग्रैरास्यं प्रक्षाल्य चासकृत्||१५९||
मस्त्विक्षुरसमद्याद्यैर्यथाहारमवाप्नुयात्|१६०|
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tataḥ sātmyabalāpēkṣī bhōjayējjīrṇatarpaṇam||156||
tanunā mudgayūṣēṇa jāṅgalānāṁ rasēna vā|
annakālēṣu cāpyasmai vidhēyaṁ dantadhāvanam||157||
yō'sya vaktrarasastasmādviparītaṁ priyaṁ ca yat|
tadasya mukhavaiśadyaṁ prakāṅkṣāṁ cānnapānayōḥ||158||
dhattē rasaviśēṣāṇāmabhijñatvaṁ karōti yat|
viśōdhya drumaśākhāgrairāsyaṁ prakṣālya cāsakr̥t||159||
mastvikṣurasamadyādyairyathāhāramavāpnuyāt|160|
tataH sAtmyabalApekShI bhojayejjIrNatarpaNam||156||
tanunA mudgayUSheNa jA~ggalAnAM rasena vA|
annakAleShu cApyasmai vidheyaM dantadhAvanam||157||
yo~asya vaktrarasastasmAdviparItaM priyaM ca yat|
tadasya mukhavaishadyaM prakA~gkShAM cAnnapAnayoH||158||
dhatte rasavisheShANAmabhij~jatvaM karoti yat|
vishodhya drumashAkhAgrairAsyaM prakShAlya cAsakRut||159||
mastvikShurasamadyAdyairyathAhAramavApnuyAt|160|
</div></div>
<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>
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पाचनं शमनीयं वा कषायं पाययेद्भिषक्||१६०||
ज्वरितं षडहेऽतीते लघ्वन्नप्रतिभोजितम्|१६१|
<div class="mw-collapsible-content">
pācanaṁ śamanīyaṁ vā kaṣāyaṁ pāyayēdbhiṣak||160||
jvaritaṁ ṣaḍahē'tītē laghvannapratibhōjitam|161|
pAcanaM shamanIyaM vA kaShAyaM pAyayedbhiShak||160||
jvaritaM ShaDahe~atIte laghvannapratibhojitam|161|
</div></div>
<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]
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=== Contra-indications of ''kashaya'' (astringents) ===
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स्तभ्यन्ते न विपच्यन्ते कुर्वन्ति विषमज्वरम्||१६१||
दोषा बद्धाः कषायेण स्तम्भित्वात्तरुणे ज्वरे|
न तु कल्पनमुद्दिश्य कषायः प्रतिषिध्यते||१६२||
यः कषायकषायः स्यात् स वर्ज्यस्तरुणज्वरे|१६३|
<div class="mw-collapsible-content">
stabhyantē na vipacyantē kurvanti viṣamajvaram||161||
dōṣā baddhāḥ kaṣāyēṇa stambhitvāttaruṇē jvarē|
na tu kalpanamuddiśya kaṣāyaḥ pratiṣidhyatē||162||
yaḥ kaṣāyakaṣāyaḥ syāt sa varjyastaruṇajvarē|163|
stabhyante na vipacyante kurvanti viShamajvaram||161||
doShA baddhAH kaShAyeNa stambhitvAttaruNe jvare|
na tu kalpanamuddishya kaShAyaH pratiShidhyate||162||
yaH kaShAyakaShAyaH syAt sa varjyastaruNajvare|163|
</div></div>
<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 ===
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यूषैरम्लैरनम्लैर्वा जाङ्गलैर्वा रसैर्हितैः||१६३||
दशाहं यावदश्नीयाल्लघ्वन्नं ज्वरशान्तये|१६४|
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yūṣairamlairanamlairvā jāṅgalairvā rasairhitaiḥ||163||
daśāhaṁ yāvadaśnīyāllaghvannaṁ jvaraśāntayē|164|
yUShairamlairanamlairvA jA~ggalairvA rasairhitaiH||163||
dashAhaM yAvadashnIyAllaghvannaM jvarashAntaye|164|
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The patient should be given light diet along with ''yusha'' (soup) prepared from vegetables and pulses and ''rasa'' (soup) of the meat of animals inhabiting arid regions, for the alleviation of ''jwara'', up to the tenth day. ''Amla'' (sour) things may or may not be added to these ''yusha''. [163-164]
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=== Indications and contra-indications of ''ghrita'' ===
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अत ऊर्ध्वं कफे मन्दे वातपित्तोत्तरे ज्वरे||१६४||
परिपक्वेषु दोषेषु सर्पिष्पानं यथाऽमृतम्|
निर्दशाहमपि ज्ञात्वा कफोत्तरमलङ्घितम्||१६५||
न सर्पिः पाययेद्वैद्यः कषायैस्तमुपाचरेत् |
यावल्लघुत्वादशनं दद्यान्मांसरसेन च||१६६||
बलं ह्यलं निग्रहाय दोषाणां, बलकृच्च तत् |१६७|
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ata ūrdhvaṁ kaphē mandē vātapittōttarē jvarē||164||
paripakvēṣu dōṣēṣu sarpiṣpānaṁ yathā'mr̥tam|
nirdaśāhamapi jñātvā kaphōttaramalaṅghitam||165||
na sarpiḥ pāyayēdvaidyaḥ kaṣāyaistamupācarēt |
yāvallaghutvādaśanaṁ dadyānmāṁsarasēna ca||166||
balaṁ hyalaṁ nigrahāya dōṣāṇāṁ, balakr̥cca tat |167|
ata UrdhvaM kaphe mande vAtapittottare jvare||164||
paripakveShu doSheShu sarpiShpAnaM yathA~amRutam|
nirdashAhamapi j~jAtvA kaphottaramala~gghitam||165||
na sarpiH pAyayedvaidyaH kaShAyaistamupAcaret |
yAvallaghutvAdashanaM dadyAnmAMsarasena ca||166||
balaM hyalaM nigrahAya doShANAM, balakRucca tat |167|
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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]
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=== Indication of milk ===
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दाहतृष्णापरीतस्य वातपित्तोत्तरं ज्वरम्||१६७||
बद्धप्रच्युतदोषं वा निरामं पयसा जयेत्|१६८|
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dāhatr̥ṣṇāparītasya vātapittōttaraṁ jvaram||167||
baddhapracyutadōṣaṁ vā nirāmaṁ payasā jayēt|168|
dAhatRuShNAparItasya vAtapittottaraM jvaram||167||
baddhapracyutadoShaM vA nirAmaM payasA jayet|168|
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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
*If ''[[vata]]'' and ''[[pitta dosha]]'' predominate the patient is suffering from ''jwara''
*If the [[dosha]] are either ''baddha'' (static), or ''prachyuta'' (slightly dislodged). [167]
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=== Indication of ''[[virechana]]'' ===
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क्रियाभिराभिः प्रशमं न प्रयाति यदा ज्वरः||१६८||
अक्षीणबलमांसाग्नेः शमयेत्तं विरेचनैः|१६९|
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kriyābhirābhiḥ praśamaṁ na prayāti yadā jvaraḥ||168||
akṣīṇabalamāṁsāgnēḥ śamayēttaṁ virēcanaiḥ|169|
kriyAbhirAbhiH prashamaM na prayAti yadA jvaraH||168||
akShINabalamAMsAgneH shamayettaM virecanaiH|169|
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If the ''jwara'' does not subside by the therapies described before, then ''[[virechana]]'' (purgation) should be given for its alleviation provided, the patient is neither emaciated, weak, depleted of muscle tissue nor has reduced digestive power. [168-169]
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=== Indications of ''niruha'' (enema with decoction) ===
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ज्वरक्षीणस्य न हितं वमनं न विरेचनम्||१६९||
कामं तु पयसा तस्य निरूहैर्वा हरेन्मलान्|
निरूहो बलमग्निं च विज्वरत्वं मुदं रुचिम्||१७०||
परिपक्वेषु दोषेषु प्रयुक्तः शीघ्रमावहेत्|
पित्तं वा कफपित्तं वा पित्ताशयगतं हरेत्||१७१||
स्रंसनं त्रीन्मलान् बस्तिर्हरेत् पक्वाशयस्थितान्|१७२|
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jvarakṣīṇasya na hitaṁ vamanaṁ na virēcanam||169||
kāmaṁ tu payasā tasya nirūhairvā harēnmalān|
nirūhō balamagniṁ ca vijvaratvaṁ mudaṁ rucim||170||
paripakvēṣu dōṣēṣu prayuktaḥ śīghramāvahēt|
pittaṁ vā kaphapittaṁ vā pittāśayagataṁ harēt||171||
sraṁsanaṁ trīnmalān bastirharēt pakvāśayasthitān|172|
jvarakShINasya na hitaM vamanaM na virecanam||169||
kAmaM tu payasA tasya nirUhairvA harenmalAn|
nirUho balamagniM ca vijvaratvaM mudaM rucim||170||
paripakveShu doSheShu prayuktaH shIghramAvahet|
pittaM vA kaphapittaM vA pittAshayagataM haret||171||
sraMsanaM trInmalAn bastirharet pakvAshayasthitAn|172|
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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]
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=== Indication of ''anuvasana'' (unctuous enema) ===
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ज्वरे पुराणे सङ्क्षीणे कफपित्ते दृढाग्नये||१७२||
रूक्षबद्धपुरीषाय प्रदद्यादनुवासनम्|१७३|
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jvarē purāṇē saṅkṣīṇē kaphapittē dr̥ḍhāgnayē||172||
rūkṣabaddhapurīṣāya pradadyādanuvāsanam|173|
jvare purANe sa~gkShINe kaphapitte dRuDhAgnaye||172||
rUkShabaddhapurIShAya pradadyAdanuvAsanam|173|
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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 ununctuousness (''rukshata'') and ''bandhatwa'' (obstruction, compactness) in the feces. [172-173]
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=== Indications of ''murdha-virechana'' (nasal errhines) ===
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गौरवे शिरसः शूले विबद्धेष्विन्द्रियेषु च||१७३||
जीर्णज्वरे रुचिकरं कुर्यान्मूर्धविरेचनम्|१७४|
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gauravē śirasaḥ śūlē vibaddhēṣvindriyēṣu ca||173||
jīrṇajvarē rucikaraṁ kuryānmūrdhavirēcanam|174|
gaurave shirasaH shUle vibaddheShvindriyeShu ca||173||
jIrNajvare rucikaraM kuryAnmUrdhavirecanam|174|
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<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]
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=== Various external procedures ===
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अभ्यङ्गांश्च प्रदेहांश्च परिषेकावगाहने||१७४||
विभज्य शीतोष्णकृतं कुर्याज्जीर्णे ज्वरे भिषक्|
तैराशु प्रशमं याति बहिर्मार्गगतो ज्वरः||१७५||
लभन्ते सुखमङ्गानि बलं वर्णश्च वर्धते|१७६|
धूपनाञ्जनयोगैश्च यान्ति जीर्णज्वराः शमम्||१७६||
त्वङ्मात्रशेषा येषां च भवत्यागन्तुरन्वयः|१७७|
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abhyaṅgāṁśca pradēhāṁśca pariṣēkāvagāhanē||174||
vibhajya śītōṣṇakr̥taṁ kuryājjīrṇē jvarē bhiṣak|
tairāśu praśamaṁ yāti bahirmārgagatō jvaraḥ||175||
labhantē sukhamaṅgāni balaṁ varṇaśca vardhatē|
dhūpanāñjanayōgaiśca yānti jīrṇajvarāḥ śamam||176||
tvaṅmātraśēṣā yēṣāṁ ca bhavatyāganturanvayaḥ|177|
abhya~ggAMshca pradehAMshca pariShekAvagAhane||174||
vibhajya shItoShNakRutaM kuryAjjIrNe jvare bhiShak|
tairAshu prashamaM yAti bahirmArgagato jvaraH||175||
labhante sukhama~ggAni balaM varNashca vardhate|
dhUpanA~jjanayogaishca yAnti jIrNajvarAH shamam||176||
tva~gmAtrasheShA yeShAM ca bhavatyAganturanvayaH|177|
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<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.
''Jirna jwara'' (chronic stage) also gets alleviated by the administration of ''dhupana'' (fumigation) and ''anjana'' (collyrium).
''Jwara'' located in skin and of exogenous nature or types can be treated with same. [174-177]
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=== Various dietary articles used in treatment ===
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इति क्रियाक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१७७||
येषां त्वेष क्रमस्तानि द्रव्याण्यूर्ध्वमतः शृणु|
रक्तशाल्यादयः शस्ताः पुराणाः षष्टिकैः सह||१७८||
यवाग्वोदनलाजार्थे ज्वरितानां ज्वरापहाः|१७९|
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iti kriyākramaḥ siddhō jvaraghnaḥ samprakāśitaḥ||177||
yēṣāṁ tvēṣa kramastāni dravyāṇyūrdhvamataḥ śr̥ṇu|
raktaśālyādayaḥ śastāḥ purāṇāḥ ṣaṣṭikaiḥ saha||178||
yavāgvōdanalājārthē jvaritānāṁ jvarāpahāḥ|179|
iti kriyAkramaH siddho jvaraghnaH samprakAshitaH||177||
yeShAM tveSha kramastAni dravyANyUrdhvamataH shRuNu|
raktashAlyAdayaH shastAH purANAH ShaShTikaiH saha||178||
yavAgvodanalAjArthe jvaritAnAM jvarApahAH|179|
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<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.
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]
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=== Ten types of ''yavagu'' (gruel) in ''jwara'' ===
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लाजपेयां सुखजरां पिप्पलीनागरैः शृताम्||१७९||
पिबेज्ज्वरी ज्वरहरां क्षुद्वानल्पाग्निरादितः|
अम्लाभिलाषी तामेव दाडिमाम्लां सनागराम्||१८०||
सृष्टविट् पैत्तिको वाऽथ शीतां मधुयुतां पिबेत्|
पेयां वा रक्तशालीनां पार्श्वबस्तिशिरोरुजि||१८१||
श्वदंष्ट्राकण्टकारिभ्यां सिद्धां ज्वरहरां पिबेत्|
ज्वरातिसारी पेयां वा पिबेत् साम्लां शृतां नरः||१८२||
पृश्निपर्णीबलाबिल्वनागरोत्पलधान्यकैः|
शृतां विदारीगन्धाद्यैर्दीपनीं स्वेदनीं नरः||१८३||
कासी श्वासी च हिक्की च यवागूं ज्वरितः पिबेत्|
विबद्धवर्चाः सयवां पिप्पल्यामलकैः शृताम्||१८४||
सर्पिष्मतीं पिबेत् पेयां ज्वरी दोषानुलोमनीम्|
कोष्ठे विबद्धे सरुजि पिबेत् पेयां शृतां ज्वरी||१८५||
मृद्वीकापिप्पलीमूलचव्यामलकनागरैः|
पिबेत् सबिल्वां पेयां वा ज्वरे सपरिकर्तिके||१८६||
बलावृक्षाम्लकोलाम्लकलशीधावनीशृताम्|
अस्वेदनिद्रस्तृष्णार्तः पिबेत् पेयां सशर्कराम्||१८७||
नागरामलकैः सिद्धां घृतभृष्टां ज्वरापहाम्|१८८|
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lājapēyāṁ sukhajarāṁ pippalīnāgaraiḥ śr̥tām||179||
pibējjvarī jvaraharāṁ kṣudvānalpāgnirāditaḥ|
amlābhilāṣī tāmēva dāḍimāmlāṁ sanāgarām||180||
sr̥ṣṭaviṭ paittikō vā'tha śītāṁ madhuyutāṁ pibēt|
pēyāṁ vā raktaśālīnāṁ pārśvabastiśirōruji||181||
śvadaṁṣṭrākaṇṭakāribhyāṁ siddhāṁ jvaraharāṁ pibēt|
jvarātisārī pēyāṁ vā pibēt sāmlāṁ śr̥tāṁ naraḥ||182||
pr̥śniparṇībalābilvanāgarōtpaladhānyakaiḥ|
śr̥tāṁ vidārīgandhādyairdīpanīṁ svēdanīṁ naraḥ||183||
kāsī śvāsī ca hikkī ca yavāgūṁ jvaritaḥ pibēt|
vibaddhavarcāḥ sayavāṁ pippalyāmalakaiḥ śr̥tām||184||
sarpiṣmatīṁ pibēt pēyāṁ jvarī dōṣānulōmanīm|
kōṣṭhē vibaddhē saruji pibēt pēyāṁ śr̥tāṁ jvarī||185||
mr̥dvīkāpippalīmūlacavyāmalakanāgaraiḥ|
pibēt sabilvāṁ pēyāṁ vā jvarē saparikartikē||186||
balāvr̥kṣāmlakōlāmlakalaśīdhāvanīśr̥tām|
asvēdanidrastr̥ṣṇārtaḥ pibēt pēyāṁ saśarkarām||187||
nāgarāmalakaiḥ siddhāṁ ghr̥tabhr̥ṣṭāṁ jvarāpahām|188|
lAjapeyAM sukhajarAM pippalInAgaraiH shRutAm||179||
pibejjvarI jvaraharAM kShudvAnalpAgnirAditaH|
amlAbhilAShI tAmeva dADimAmlAM sanAgarAm||180||
sRuShTaviT paittiko vA~atha shItAM madhuyutAM pibet|
peyAM vA raktashAlInAM pArshvabastishiroruji||181||
shvadaMShTrAkaNTakAribhyAM siddhAM jvaraharAM pibet|
jvarAtisArI peyAM vA pibet sAmlAM shRutAM naraH||182||
pRushniparNIbalAbilvanAgarotpaladhAnyakaiH|
shRutAM vidArIgandhAdyairdIpanIM svedanIM naraH||183||
kAsI shvAsI ca hikkI ca yavAgUM jvaritaH pibet|
vibaddhavarcAH sayavAM pippalyAmalakaiH shRutAm||184||
sarpiShmatIM pibet peyAM jvarI doShAnulomanIm|
koShThe vibaddhe saruji pibet peyAM shRutAM jvarI||185||
mRudvIkApippalImUlacavyAmalakanAgaraiH|
pibet sabilvAM peyAM vA jvare saparikartike||186||
balAvRukShAmlakolAmlakalashIdhAvanIshRutAm|
asvedanidrastRuShNArtaH pibet peyAM sasharkarAm||187||
nAgarAmalakaiH siddhAM ghRutabhRuShTAM jvarApahAm|188|
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<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.
*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''.
*The above mentioned ''peya'' should be cooled and added with honey before administration in ''paittika'' type of patient.
*A patient suffering from ''shoola'' (pain) in the ''parshva'' (flanks), ''basti'' (urinary bladder) and ''shira'' (head) regions should be given ''peya'' prepared from red variety of ''shali'' rice and boiled with ''shvadashtra'' and ''kantakari'' as this alleviates ''jwara''.
*A person suffering from ''jwaratisara'' (fever associated with diarrhea) should be given ''peya'' which is sour and is boiled with ''prishniparni, bala, bilva, nagara, utpala'' and ''dhanyaka''.
*Patients suffering from ''jwara'' associated with ''kasa'' (bronchitis), ''shwasa'' (difficulty in breathing) and ''hikka'' (hiccups) should be given ''yavagu'' prepared by boiling with the group of drugs belonging to ''vidarigandhadi gana'', which acts as a stimulant of digestion and promotes sweating.
*''Peya'' prepared of ''yava'' (barley) boiled with ''pippali'' and ''amalaki'' should be given to a patient suffering from ''jwara'' associated with ''koshthabaddhata''(constipation). It causes ''anulomana'' (downward movement) of ''dosha''. This ''peya'' mixed with ghee should be taken by the patient suffering from ''jwara'' associated with constipation.
*The ''peya'' prepared by boiling with ''mridvika, pippali mula, chavya, amalaka'' and ''nagara'' should be taken by the patient suffering from ''jwara'' associated with constipation and 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]
</div>
=== Indications of soup ===
<div class="mw-collapsible mw-collapsed">
मुद्गान्मसूरांश्चणकान् कुलत्थान् समकुष्टकान्||१८८||
यूषार्थे यूषसात्म्यानां ज्वरितानां प्रदापयेत्|१८९|
<div class="mw-collapsible-content">
mudgānmasūrāṁścaṇakān kulatthān samakuṣṭakān||188||
yūṣārthē yūṣasātmyānāṁ jvaritānāṁ pradāpayēt|189|
mudgAnmasUrAMshcaNakAn kulatthAn samakuShTakAn||188||
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]
</div>
=== Indications of vegetables ===
<div class="mw-collapsible mw-collapsed">
पटोलपत्रं सफलं कुलकं पापचेलिकम्||१८९||
कर्कोटकं कठिल्लं च विद्याच्छाकं ज्वरे हितम्|१९०|
<div class="mw-collapsible-content">
paṭōlapatraṁ saphalaṁ kulakaṁ pāpacēlikam||189||
karkōṭakaṁ kaṭhillaṁ ca vidyācchākaṁ jvarē hitam|190|
paTolapatraM saphalaM kulakaM pApacelikam||189||
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]
</div>
=== Indication of animal meat soups ===
<div class="mw-collapsible mw-collapsed">
लावान् कपिञ्जलानेणांश्चकोरानुपचक्रकान्||१९०||
कुरङ्गान् कालपुच्छांश्च हरिणान् पृषताञ्छशान्|
प्रदद्यान्मांससात्म्याय ज्वरिताय ज्वरापहान्||१९१||
ईषदम्लाननम्लान् वा रसान् काले विचक्षणः|
कुक्कुटांश्च मयूरांश्च तित्तिरिक्रौञ्चवर्तकान्||१९२||
गुरूष्णत्वान्न शंसन्ति ज्वरे केचिच्चिकित्सकाः|
लङ्घनेनानिलबलं ज्वरे यद्यधिकं भवेत्||१९३||
भिषङ्मात्राविकल्पज्ञो दद्यात्तानपि कालवित्|१९४|
<div class="mw-collapsible-content">
lāvān kapiñjalānēṇāṁścakōrānupacakrakān||190||
kuraṅgān kālapucchāṁśca hariṇān pr̥ṣatāñchaśān|
pradadyānmāṁsasātmyāya jvaritāya jvarāpahān||191||
īṣadamlānanamlān vā rasān kālē vicakṣaṇaḥ|
kukkuṭāṁśca mayūrāṁśca tittirikrauñcavartakān||192||
gurūṣṇatvānna śaṁsanti jvarē kēciccikitsakāḥ|
laṅghanēnānilabalaṁ jvarē yadyadhikaṁ bhavēt||193||
bhiṣaṅmātrāvikalpajñō dadyāttānapi kālavit|194|
lAvAn kapi~jjalAneNAMshcakorAnupacakrakAn||190||
kura~ggAn kAlapucchAMshca hariNAn pRuShatA~jchashAn|
pradadyAnmAMsasAtmyAya jvaritAya jvarApahAn||191||
IShadamlAnanamlAn vA rasAn kAle vicakShaNaH|
kukkuTAMshca mayUrAMshca tittirikrau~jcavartakAn||192||
gurUShNatvAnna shaMsanti jvare keciccikitsakAH|
la~gghanenAnilabalaM jvare yadyadhikaM bhavet||193||
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.
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||
मद्यं वा मद्यसात्म्याय यथादोषं यथाबलम्|१९५|
<div class="mw-collapsible-content">
gharmāmbu cānupānārthaṁ tr̥ṣitāya pradāpayēt||194||
madyaṁ vā madyasātmyāya yathādōṣaṁ yathābalam|195|
gharmAmbu cAnupAnArthaM tRuShitAya pradApayet||194||
madyaM vA madyasAtmyAya yathAdoShaM yathAbalam|195|
</div></div>
<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||
आहारान् दोषपक्त्यर्थं प्रायशः परिवर्जयेत्|
अन्नपानक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१९६||
<div class="mw-collapsible-content">
gurūṣṇasnigdhamadhurān kaṣāyāṁśca navajvarē||195||
āhārān dōṣapaktyarthaṁ prāyaśaḥ parivarjayēt|
annapānakramaḥ siddhō jvaraghnaḥ samprakāśitaḥ||196||
gurUShNasnigdhamadhurAn kaShAyAMshca navajvare||195||
AhArAn doShapaktyarthaM prAyashaH parivarjayet|
annapAnakramaH siddho jvaraghnaH samprakAshitaH||196||
</div></div>
<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]
</div>
=== Decoctions indicated in ''jwara'' ===
<div class="mw-collapsible mw-collapsed">
अत ऊर्ध्वं प्रवक्ष्यन्ते कषाया ज्वरनाशनाः|
पाक्यं शीतकषायं वा मुस्तपर्पटकं पिबेत्||१९७||
सनागरं पर्पटकं पिबेद्वा सदुरालभम्|
किराततिक्तकं मुस्तं गुडूचीं विश्वभेषजम्||१९८||
पाठामुशीरं सोदीच्यं पिबेद्वा ज्वरशान्तये|
ज्वरघ्ना दीपनाश्चैते कषाया दोषपाचनाः||१९९||
तृष्णारुचिप्रशमना मुखवैरस्यनाशनाः|२००|
<div class="mw-collapsible-content">
ata ūrdhvaṁ pravakṣyantē kaṣāyā jvaranāśanāḥ|
pākyaṁ śītakaṣāyaṁ vā mustaparpaṭakaṁ pibēt||197||
sanāgaraṁ parpaṭakaṁ pibēdvā sadurālabham|
kirātatiktakaṁ mustaṁ guḍūcīṁ viśvabhēṣajam||198||
pāṭhāmuśīraṁ sōdīcyaṁ pibēdvā jvaraśāntayē|
jvaraghnā dīpanāścaitē kaṣāyā dōṣapācanāḥ||199||
tr̥ṣṇārucipraśamanā mukhavairasyanāśanāḥ|200|
ata UrdhvaM pravakShyante kaShAyA jvaranAshanAH|
pAkyaM shItakaShAyaM vA mustaparpaTakaM pibet||197||
sanAgaraM parpaTakaM pibedvA sadurAlabham|
kirAtatiktakaM mustaM guDUcIM vishvabheShajam||198||
pAThAmushIraM sodIcyaM pibedvA jvarashAntaye|
jvaraghnA dIpanAshcaite kaShAyA doShapAcanAH||199||
tRuShNAruciprashamanA mukhavairasyanAshanAH|200|
</div></div>
<div style="text-align:justify;">
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).
*''Parpataka'' decoction may be given to the patient along with ''nagara'' and ''duralabha''.
*The decoction made from ''kirata tikta, musta, guduchi'' and ''vishva bheshaja''.
*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 ''[[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||
पटोलः सारिवा मुस्तं पाठा कटुकरोहिणी|
निम्बः पटोलस्त्रिफला मृद्वीका मुस्तवत्सकौ|| २०१||
किराततिक्तममृता चन्दनं विश्वभेषजम्|
गुडूच्यामलकं मुस्तमर्धश्लोकसमापनाः||c०२||
कषायाः शमयन्त्याशु पञ्च पञ्चविधाञ्ज्वरान्|
सन्ततं सततान्येद्युस्तृतीयकचतुर्थकान्||२०३||
<div class="mw-collapsible-content">
kaliṅgakāḥ paṭōlasya patraṁ kaṭukarōhiṇī||200||
paṭōlaḥ sārivā mustaṁ pāṭhā kaṭukarōhiṇī|
nimbaḥ paṭōlastriphalā mr̥dvīkā mustavatsakau||101||
kirātatiktamamr̥tā candanaṁ viśvabhēṣajam|
guḍūcyāmalakaṁ mustamardhaślōkasamāpanāḥ||202||
kaṣāyāḥ śamayantyāśu pañca pañcavidhāñjvarān|
santataṁ satatānyēdyustr̥tīyakacaturthakān||203||
kali~ggakAH paTolasya patraM kaTukarohiNI||200||
paTolaH sArivA mustaM pAThA kaTukarohiNI|
nimbaH paTolastriphalA mRudvIkA mustavatsakau||201||
kirAtatiktamamRutA candanaM vishvabheShajam|
guDUcyAmalakaM mustamardhashlokasamApanAH||202||
kaShAyAH shamayantyAshu pa~jca pa~jcavidhA~jjvarAn|
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:
#''Kalingaka, patola'' leaves and ''katuka rohini''
#''Patola, sariva, musta, patha'' and ''katuka rohini''
#''Nimba, patola, triphala, mrudvika, musta'' and ''vatsaka''
#''Kiratatikta, amrita, chandana, vishva bheshaja''; and
#''Guduchi, amalaka'' and ''musta''. [200-203]
</div>
<div class="mw-collapsible mw-collapsed">
वत्सकारग्वधौ पाठां षड्ग्रन्थां कटुरोहिणीम्|
मूर्वां सातिविषां निम्बं पटोलं धन्वयासकम्||२०४||
वचां मुस्तमुशीरं च मधुकं त्रिफलां बलाम्|
पाक्यं शीतकषायं वा पिबेज्ज्वरहरं नरः||२०५||
मधूकमुस्तमृद्वीकाकाश्मर्याणि परूषकम्|
त्रायमाणामुशीरं च त्रिफलां कटुरोहिणीम्||२०६||
पीत्वा निशिस्थितं जन्तुर्ज्वराच्छीघ्रं विमुच्यते|२०७|
<div class="mw-collapsible-content">
vatsakāragvadhau pāṭhāṁ ṣaḍgranthāṁ kaṭurōhiṇīm|
mūrvāṁ sātiviṣāṁ nimbaṁ paṭōlaṁ dhanvayāsakam||204||
vacāṁ mustamuśīraṁ ca madhukaṁ triphalāṁ balām|
pākyaṁ śītakaṣāyaṁ vā pibējjvaraharaṁ naraḥ||205||
madhūkamustamr̥dvīkākāśmaryāṇi parūṣakam|
trāyamāṇāmuśīraṁ ca triphalāṁ kaṭurōhiṇīm||206||
pītvā niśisthitaṁ janturjvarācchīghraṁ vimucyatē|207|
vatsakAragvadhau pAThAM ShaDgranthAM kaTurohiNIm|
mUrvAM sAtiviShAM nimbaM paTolaM dhanvayAsakam||204||
vacAM mustamushIraM ca madhukaM triphalAM balAm|
pAkyaM shItakaShAyaM vA pibejjvaraharaM naraH||205||
madhUkamustamRudvIkAkAshmaryANi parUShakam|
trAyamANAmushIraM ca triphalAM kaTurohiNIm||206||
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:''
#''vatsaka, aragavadha, patha, shad grantha'' and ''katurohini''
#''murva'' along with ''ativisha, nimbi, patola'' and ''dhanavayasaka''
#''vacha, musta, ushira, madhuka, triphala'' and ''bala''
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||
विबद्धदोषो ज्वरितः कषायं सगुडं पिबेत्|
त्रिफलां त्रायमाणां च मृद्वीकां कटुरोहिणीम्||२०८||
पित्तश्लेष्महरस्त्वेष कषायो ह्यानुलोमिकः|
त्रिवृताशर्करायुक्तः पित्तश्लेष्मज्वरापहः||२०९||
<div class="mw-collapsible-content">
jātyāmalakamustāni tadvaddhanvayavāsakam||207||
vibaddhadōṣō jvaritaḥ kaṣāyaṁ saguḍaṁ pibēt|
triphalāṁ trāyamāṇāṁ ca mr̥dvīkāṁ kaṭurōhiṇīm||208||
pittaślēṣmaharastvēṣa kaṣāyō hyānulōmikaḥ|
trivr̥tāśarkarāyuktaḥ pittaślēṣmajvarāpahaḥ||209||
jAtyAmalakamustAni tadvaddhanvayavAsakam||207||
vibaddhadoSho jvaritaH kaShAyaM saguDaM pibet|
triphalAM trAyamANAM ca mRudvIkAM kaTurohiNIm||208||
pittashleShmaharastveSha kaShAyo hyAnulomikaH|
|header3 =
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>
=== Formulations used in ''sannipata jwara'' ===
<div class="mw-collapsible mw-collapsed">
बृहत्यौ वत्सकं मुस्तं देवदारु महौषधम्|
कोलवल्ली च योगोऽयं सन्निपातज्वरापहः||२१०||
शटी पुष्करमूलं च व्याघ्री शृङ्गी दुरालभा|
गुडूची नागरं पाठा किरातं कटुरोहिणी||२११||
एष शट्यादिको वर्गः सन्निपातज्वरापहः|
कासहृद्ग्रहपार्श्वार्तिश्वासतन्द्रासु शस्यते||२१२||
बृहत्यौ पौष्करं भार्गी शटी शृङ्गी दुरालभा|
वत्सकस्य च बीजानि पटोलं कटुरोहिणी||२१३||
बृहत्यादिर्गणः प्रोक्तः सन्निपातज्वरापहः|
कासादिषु च सर्वेषु दद्यात् सोपद्रवेषु च||२१४||
<div class="mw-collapsible-content">
br̥hatyau vatsakaṁ mustaṁ dēvadāru mahauṣadham|
kōlavallī ca yōgō'yaṁ sannipātajvarāpahaḥ||210||
śaṭī puṣkaramūlaṁ ca vyāghrī śr̥ṅgī durālabhā|
guḍūcī nāgaraṁ pāṭhā kirātaṁ kaṭurōhiṇī||211||
ēṣa śaṭyādikō vargaḥ sannipātajvarāpahaḥ|
kāsahr̥dgrahapārśvārtiśvāsatandrāsu śasyatē||212||
br̥hatyau pauṣkaraṁ bhārgī śaṭī śr̥ṅgī durālabhā|
vatsakasya ca bījāni paṭōlaṁ kaṭurōhiṇī||213||
br̥hatyādirgaṇaḥ prōktaḥ sannipātajvarāpahaḥ|
kāsādiṣu ca sarvēṣu dadyāt sōpadravēṣu ca||214||
bRuhatyau vatsakaM mustaM devadAru mahauShadham|
kolavallI ca yogo~ayaM sannipAtajvarApahaH||210||
shaTI puShkaramUlaM ca vyAghrI shRu~ggI durAlabhA|
guDUcI nAgaraM pAThA kirAtaM kaTurohiNI||211||
eSha shaTyAdiko vargaH sannipAtajvarApahaH|
kAsahRudgrahapArshvArtishvAsatandrAsu shasyate||212||
bRuhatyau pauShkaraM bhArgI shaTI shRu~ggI durAlabhA|
vatsakasya ca bIjAni paTolaM kaTurohiNI||213||
bRuhatyAdirgaNaH proktaH sannipAtajvarApahaH|
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).
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|
निर्दिष्टा भेषजाध्याये भिषक्तानपि योजयेत्||२१५||
<div class="mw-collapsible-content">
kaṣāyāśca yavāgvaśca pipāsājvaranāśanāḥ|
nirdiṣṭā bhēṣajādhyāyē bhiṣaktānapi yōjayēt||215||
kaShAyAshca yavAgvashca pipAsAjvaranAshanAH|
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]
</div>
=== Advantage of ghee ===
<div class="mw-collapsible mw-collapsed">
ज्वराः कषायैर्वमनैर्लङ्घनैर्लघुभोजनैः|
रूक्षस्य ये न शाम्यन्ति सर्पिस्तेषां भिषग्जितम्||२१६||
रूक्षं तेजो ज्वरकरं तेजसा रूक्षितस्य च|
यः स्यादनुबलो धातुः स्नेहवध्यः स चानिलः||२१७||
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jvarāḥ kaṣāyairvamanairlaṅghanairlaghubhōjanaiḥ|
rūkṣasya yē na śāmyanti sarpistēṣāṁ bhiṣagjitam||216||
rūkṣaṁ tējō jvarakaraṁ tējasā rūkṣitasya ca|
yaḥ syādanubalō dhātuḥ snēhavadhyaḥ [1] sa cānilaḥ||217||
jvarAH kaShAyairvamanairla~gghanairlaghubhojanaiH|
rUkShasya ye na shAmyanti sarpisteShAM bhiShagjitam||216||
rUkShaM tejo jvarakaraM tejasA rUkShitasya ca|
yaH syAdanubalo dhAtuH snehavadhyaH [1] sa cAnilaH||217||
</div></div>
<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|
प्रयोज्या ज्वरशान्त्यर्थमग्निसन्धुक्षणाः शिवाः||२१८||
<div class="mw-collapsible-content">
kaṣāyāḥ sarva ēvaitē sarpiṣā saha yōjitāḥ|
prayōjyā jvaraśāntyarthamagnisandhukṣaṇāḥ śivāḥ||218||
kaShAyAH sarva evaite sarpiShA saha yojitAH|
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]
</div>
=== Various medicated ghee formulations ===
<div class="mw-collapsible mw-collapsed">
पिप्पल्यश्चन्दनं मुस्तमुशीरं कटुरोहिणी|
कलिङ्गकास्तामलकी सारिवाऽतिविषा स्थिरा||२१९||
द्राक्षामलकबिल्वानि त्रायमाणा निदिग्धिका|
सिद्धमितैर्घृतं सद्यो जीर्णज्वरमपोहति||२२०||
क्षयं कासं शिरःशूलं पार्श्वशूलं हलीमकम्|
अंसाभितापमाग्निं च विषमं सन्नियच्छति||२२१||
<div class="mw-collapsible-content">
pippalyaścandanaṁ mustamuśīraṁ kaṭurōhiṇī|
kaliṅgakāstāmalakī sārivā'tiviṣā sthirā||219||
drākṣāmalakabilvāni trāyamāṇā nidigdhikā|
siddhamitairghr̥taṁ sadyō jīrṇajvaramapōhati||220||
kṣayaṁ kāsaṁ śiraḥśūlaṁ pārśvaśūlaṁ halīmakam|
aṁsābhitāpamāgniṁ ca viṣamaṁ sanniyacchati||221||
pippalyashcandanaM mustamushIraM kaTurohiNI|
kali~ggakAstAmalakI sArivA~ativiShA sthirA||219||
drAkShAmalakabilvAni trAyamANA nidigdhikA|
siddhamitairghRutaM sadyo jIrNajvaramapohati||220||
kShayaM kAsaM shiraHshUlaM pArshvashUlaM halImakam|
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]
</div>
<div class="mw-collapsible mw-collapsed">
वासां गुडूचीं त्रिफलां त्रायमाणां यवासकम्|
पक्त्वा तेन कषायेण पयसा द्विगुणेन च||२२२||
पिप्पलीमुस्तमृद्वीकाचन्दनोत्पलनागरैः|
कल्कीकृतैश्च विपचेद्धृतं जीर्णज्वरापहम्||२२३||
<div class="mw-collapsible-content">
vāsāṁ guḍūcīṁ triphalāṁ trāyamāṇāṁ yavāsakam|
paktvā tēna kaṣāyēṇa payasā dviguṇēna ca||222||
pippalīmustamr̥dvīkācandanōtpalanāgaraiḥ|
kalkīkr̥taiśca vipacēddhr̥taṁ jīrṇajvarāpaham||223||
vAsAM guDUcIM triphalAM trAyamANAM yavAsakam|
paktvA tena kaShAyeNa payasA dviguNena ca||222||
pippalImustamRudvIkAcandanotpalanAgaraiH|
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]
</div>
<div class="mw-collapsible mw-collapsed">
बलां श्वदंष्ट्रां बृहतीं कलसीं धावनीं स्थिराम्|
निम्बं पर्पटकं मुस्तं त्रायमाणां दुरालभाम्||२२४||
कृत्वा कषायं पेष्यार्थे दद्यात्तामलकीं शटीम्|
द्राक्षां पुष्करमूलं च मेदामामलकानि च||२२५||
घृतं पयश्च तत् सिद्धं सर्पिर्ज्वरहरं परम्|
क्षयकासशिरःशूलपार्श्वशूलांसतापनुत् ||२२६||
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balāṁ śvadaṁṣṭrāṁ br̥hatīṁ kalasīṁ dhāvanīṁ sthirām|
nimbaṁ parpaṭakaṁ mustaṁ trāyamāṇāṁ durālabhām||224||
kr̥tvā kaṣāyaṁ pēṣyārthē dadyāttāmalakīṁ śaṭīm|
drākṣāṁ puṣkaramūlaṁ ca mēdāmāmalakāni ca||225||
ghr̥taṁ payaśca tat siddhaṁ sarpirjvaraharaṁ param|
kṣayakāsaśiraḥśūlapārśvaśūlāṁsatāpanut ||226||
balAM shvadaMShTrAM bRuhatIM kalasIM dhAvanIM sthirAm|
nimbaM parpaTakaM mustaM trAyamANAM durAlabhAm||224||
kRutvA kaShAyaM peShyArthe dadyAttAmalakIM shaTIm|
drAkShAM puShkaramUlaM ca medAmAmalakAni ca||225||
ghRutaM payashca tat siddhaM sarpirjvaraharaM param|
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]
</div>
=== Formulations used in purification therapies ===
<div class="mw-collapsible mw-collapsed">
ज्वरिभ्यो बहुदोषेभ्य ऊर्ध्वं चाधश्च बुद्धिमान्|
दद्यात् संशोधनं काले कल्पे यदुपदेक्ष्यते||२२७||
मदनं पिप्पलीभिर्वा कलिङ्गैर्मधुकेन वा|
युक्तमुष्णाम्बुना पेयं वमनं ज्वरशान्तये||२२८||
क्षौद्राम्बुना रसेनेक्षोरथवा लवणाम्बुना|
ज्वरे प्रच्छर्दनं शस्तं मद्यैर्वा तर्पणेन वा||२२९||
मृद्वीकामलकानां वा रसं प्रस्कन्दनं पिबेत्|
रसमामलकानां वा घृतभृष्टं ज्वरापहम्||२३०||
लिह्याद्वा त्रैवृतं चूर्णं संयुक्तं मधुसर्पिषा|
पिबेद्वा क्षौद्रमावाप्य सघृतं त्रिफलारसम्||२३१||
आरग्वधं वा पयसा मृद्वीकानां रसेन वा|
त्रिवृतां त्रायमाणां वा पयसा ज्वरितः पिबेत्||२३२||
ज्वराद्विमुच्यते पीत्वा मृद्वीकाभिः सहाभयाम्|
पयोऽनुपानमुष्णं वा पीत्वा द्राक्षारसं नरः||२३३||
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jvaribhyō bahudōṣēbhya ūrdhvaṁ cādhaśca buddhimān|
dadyāt saṁśōdhanaṁ kālē kalpē yadupadēkṣyatē||227||
madanaṁ pippalībhirvā kaliṅgairmadhukēna vā|
yuktamuṣṇāmbunā pēyaṁ vamanaṁ jvaraśāntayē||228||
kṣaudrāmbunā rasēnēkṣōrathavā lavaṇāmbunā|
jvarē pracchardanaṁ śastaṁ madyairvā tarpaṇēna vā||229||
mr̥dvīkāmalakānāṁ vā rasaṁ praskandanaṁ pibēt|
rasamāmalakānāṁ vā ghr̥tabhr̥ṣṭaṁ jvarāpaham||230||
lihyādvā traivr̥taṁ cūrṇaṁ saṁyuktaṁ madhusarpiṣā|
pibēdvā kṣaudramāvāpya saghr̥taṁ triphalārasam||231||
āragvadhaṁ vā payasā mr̥dvīkānāṁ rasēna vā|
trivr̥tāṁ trāyamāṇāṁ vā payasā jvaritaḥ pibēt||232||
jvarādvimucyatē pītvā mr̥dvīkābhiḥ sahābhayām|
payō'nupānamuṣṇaṁ vā pītvā drākṣārasaṁ naraḥ||233||
jvaribhyo bahudoShebhya UrdhvaM cAdhashca buddhimAn|
dadyAt saMshodhanaM kAle kalpe yadupadekShyate||227||
madanaM pippalIbhirvA kali~ggairmadhukena vA|
yuktamuShNAmbunA peyaM vamanaM jvarashAntaye||228||
kShaudrAmbunA rasenekShorathavA lavaNAmbunA|
jvare pracchardanaM shastaM madyairvA tarpaNena vA||229||
mRudvIkAmalakAnAM vA rasaM praskandanaM pibet|
rasamAmalakAnAM vA ghRutabhRuShTaM jvarApaham||230||
lihyAdvA traivRutaM cUrNaM saMyuktaM madhusarpiShA|
pibedvA kShaudramAvApya saghRutaM triphalArasam||231||
AragvadhaM vA payasA mRudvIkAnAM rasena vA|
trivRutAM trAyamANAM vA payasA jvaritaH pibet||232||
jvarAdvimucyate pItvA mRudvIkAbhiH sahAbhayAm|
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''.
A patient suffering from ''jwara'' can also be given the juice of ''mridvika'' and ''amalaka'' for purgation.
The juice of ''āmalaka'' fried with ''ghrita'' also cures ''jwara''.
Following recipes are also useful for purgation in a patient suffering from ''jwara'':
*powder of ''trivrita'' mixed with honey and ''ghṛita'' prepared in the form of linctus.
*Juice of ''triphalā'' mixed with honey and ''ghrita''
*''Āragvadha'' along with milk or the juice of ''mṛdvikā''
*''tṛvrita'' and ''trāyamāṇa'' along with milk
*''mṛdvikā'' and ''abhayā'' along with warm milk or the juice of ''drākṡā'' as ''anupāna''. [227-233]
</div>
=== Formulations with medicated milk ===
<div class="mw-collapsible mw-collapsed">
कासाच्छ्वासाच्छिरःशूलात्पार्श्वशूलाच्चिरज्वरात्|
मुच्यते ज्वरितः पीत्वा पञ्चमूलीशृतं पयः||२३४||
एरण्डमूलोत्क्वथितं ज्वरात् सपरिकर्तिकात्|
पयो विमुच्यते पीत्वा तद्वद्बिल्वशलाटुभिः||२३५||
त्रिकण्टकबलाव्याघ्रीगुडनागरसाधितम्|
वर्चोमूत्रविबन्धघ्नं शोफज्वरहरं पयः||२३६||
सनागरं समृद्वीकं सघृतक्षौद्रशर्करम्|
शृतं पयः सखर्जूरं पिपासाज्वरनाशनम्||२३७||
चतुर्गुणेनाम्भसा वा शृतं ज्वरहरं पयः|
धारोष्णं वा पयः सद्यो वातपित्तज्वरं जयेत्||२३८||
जीर्णज्वराणां सर्वेषां पयः प्रशमनं परम्|
पेयं तदुष्णं शीतं वा यथास्वं भेषजैः शृतम्||२३९||
<div class="mw-collapsible-content">
kāsācchvāsācchiraḥśūlātpārśvaśūlāccirajvarāt|
mucyatē jvaritaḥ pītvā pañcamūlīśr̥taṁ payaḥ||234||
ēraṇḍamūlōtkvathitaṁ jvarāt saparikartikāt|
payō vimucyatē pītvā tadvadbilvaśalāṭubhiḥ||235||
trikaṇṭakabalāvyāghrīguḍanāgarasādhitam|
varcōmūtravibandhaghnaṁ śōphajvaraharaṁ payaḥ||236||
sanāgaraṁ samr̥dvīkaṁ saghr̥takṣaudraśarkaram|
śr̥taṁ payaḥ sakharjūraṁ pipāsājvaranāśanam||237||
caturguṇēnāmbhasā vā śr̥taṁ jvaraharaṁ payaḥ|
dhārōṣṇaṁ vā payaḥ sadyō vātapittajvaraṁ jayēt||238||
jīrṇajvarāṇāṁ sarvēṣāṁ payaḥ praśamanaṁ param|
pēyaṁ taduṣṇaṁ śītaṁ vā yathāsvaṁ bhēṣajaiḥ śr̥tam||239||
kAsAcchvAsAcchiraHshUlAtpArshvashUlAccirajvarAt|
mucyate jvaritaH pItvA pa~jcamUlIshRutaM payaH||234||
eraNDamUlotkvathitaM jvarAt saparikartikAt|
payo vimucyate pItvA tadvadbilvashalATubhiH||235||
trikaNTakabalAvyAghrIguDanAgarasAdhitam|
varcomUtravibandhaghnaM shophajvaraharaM payaH||236||
sanAgaraM samRudvIkaM saghRutakShaudrasharkaram|
shRutaM payaH sakharjUraM pipAsAjvaranAshanam||237||
caturguNenAmbhasA vA shRutaM jvaraharaM payaH|
dhAroShNaM vA payaH sadyo vAtapittajvaraM jayet||238||
jIrNajvarANAM sarveShAM payaH prashamanaM param|
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'').
Milk boiled either with the root of ''eranda'' or the ''shalatu'' (unripe fruit cut into pieces) of ''bilva'' when taken cures fever along with ''parikartika'' in the abdomen (sawing pain).
Milk boiled with ''trikantaka, bala, vyaghri, gud'' and ''nagara'' cures ''jwara'' along with ''shopha'' (edema) and obstruction of the urine and feces.
The medicine prepared by boiling milk with ''nagara, mridika, khajura'' and added with ''ghrita'', honey and sugar cures ''jwara'' associated with thirst.
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]]''.
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 ===
<div class="mw-collapsible mw-collapsed">
प्रयोजयेज्ज्वरहरान्निरूहान् सानुवासनान्|
पक्वाशयगते दोषे वक्ष्यन्ते ये च सिद्धिषु||२४०||
पटोलारिष्टपत्राणि सोशीरश्चतुरङ्गुलः|
ह्रीबेरं रोहिणी तिक्ता श्वदंष्ट्रा मदनानि च||२४१||
स्थिरा बला च तत् सर्वं पयस्यर्धोदके शृतम्|
क्षीरावशेषं निर्यूहं संयुक्तं मधुसर्पिषा||२४२||
कल्कैर्मदनमुस्तानां पिप्पल्या मधुकस्य च|
वत्सकस्य च संयुक्तं बस्तिं दद्याज्ज्वरापहम्||२४३||
शुद्धे मार्गे हृते दोषे विप्रसन्नेषु धातुषु|
गताङ्गशूलो लघ्वङ्गः सद्यो भवति विज्वरः||२४४||
आरग्वधमुशीरं च मदनस्य फलं तथा|
चतस्रः पर्णिनीश्चैव [१] निर्यूहमुपकल्पयेत्||२४५||
प्रियङ्गुर्मदनं मुस्तं शताह्वा मधुयष्टिका|
कल्कः सर्पिर्गुडः क्षौद्रं ज्वरघ्नो बस्तिरुत्तमः||२४६||
गुडूचीं त्रायमाणां च चन्दनं मधुकं वृषम्|
स्थिरां बलां पृश्निपर्णीं मदनं चेति साधयेत्||२४७||
रसं जाङ्गलमांसस्य रसेन सहितं भिषक्|
पिप्पलीफलमुस्तानां कल्केन मधुकस्य च||२४८||
ईषत्सलवणं युक्त्या निरूहं मधुसर्पिषा|
ज्वरप्रशमनं दद्याद्बलस्वेदरुचिप्रदम्||२४९||
जीवन्तीं मधुकं मेदां पिप्पलीं मदनं वचाम्|
ऋद्धिं रास्नां बलां विश्वं [२] शतपुष्पां शतावरीम्||२५०||
पिष्ट्वा क्षीरं जलं सर्पिस्तैलं च विपचेद्भिषक्|
आनुवासनिकं स्नेहमेतं विद्याज्ज्वरापहम्||२५१||
पटोलपिचुमर्दाभ्यां गुडूच्या मधुकेन च|
मदनैश्च शृतः स्नेहो ज्वरघ्नमनुवासनम्||२५२||
चन्दनागुरुकाश्मर्यपटोलमधुकोत्पलैः|
सिद्धः स्नेहो ज्वरहरः स्नेहबस्तिः प्रशस्यते||२५३||
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prayōjayējjvaraharānnirūhān sānuvāsanān|
pakvāśayagatē dōṣē vakṣyantē yē ca siddhiṣu||240||
paṭōlāriṣṭapatrāṇi sōśīraścaturaṅgulaḥ|
hrībēraṁ rōhiṇī tiktā śvadaṁṣṭrā madanāni ca||241||
sthirā balā ca tat sarvaṁ payasyardhōdakē śr̥tam|
kṣīrāvaśēṣaṁ niryūhaṁ saṁyuktaṁ madhusarpiṣā||242||
kalkairmadanamustānāṁ pippalyā madhukasya ca|
vatsakasya ca saṁyuktaṁ bastiṁ dadyājjvarāpaham||243||
śuddhē mārgē hr̥tē dōṣē viprasannēṣu dhātuṣu|
gatāṅgaśūlō laghvaṅgaḥ sadyō bhavati vijvaraḥ||244||
āragvadhamuśīraṁ ca madanasya phalaṁ tathā|
catasraḥ parṇinīścaiva [1] niryūhamupakalpayēt||245||
priyaṅgurmadanaṁ mustaṁ śatāhvā madhuyaṣṭikā|
kalkaḥ sarpirguḍaḥ kṣaudraṁ jvaraghnō bastiruttamaḥ||246||
guḍūcīṁ trāyamāṇāṁ ca candanaṁ madhukaṁ vr̥ṣam|
sthirāṁ balāṁ pr̥śniparṇīṁ madanaṁ cēti sādhayēt||247||
rasaṁ jāṅgalamāṁsasya rasēna sahitaṁ bhiṣak|
pippalīphalamustānāṁ kalkēna madhukasya ca||248||
īṣatsalavaṇaṁ yuktyā nirūhaṁ madhusarpiṣā|
jvarapraśamanaṁ dadyādbalasvēdarucipradam||249||
jīvantīṁ madhukaṁ mēdāṁ pippalīṁ madanaṁ vacām|
r̥ddhiṁ rāsnāṁ balāṁ viśvaṁ [2] śatapuṣpāṁ śatāvarīm||250||
piṣṭvā kṣīraṁ jalaṁ sarpistailaṁ ca vipacēdbhiṣak|
ānuvāsanikaṁ snēhamētaṁ vidyājjvarāpaham||251||
paṭōlapicumardābhyāṁ guḍūcyā madhukēna ca|
madanaiśca śr̥taḥ snēhō jvaraghnamanuvāsanam||252||
candanāgurukāśmaryapaṭōlamadhukōtpalaiḥ|
siddhaḥ snēhō jvaraharaḥ snēhabastiḥ praśasyatē||253||
prayojayejjvaraharAnnirUhAn sAnuvAsanAn|
pakvAshayagate doShe vakShyante ye ca siddhiShu||240||
paTolAriShTapatrANi soshIrashcatura~ggulaH|
hrIberaM rohiNI tiktA shvadaMShTrA madanAni ca||241||
sthirA balA ca tat sarvaM payasyardhodake shRutam|
kShIrAvasheShaM niryUhaM saMyuktaM madhusarpiShA||242||
kalkairmadanamustAnAM pippalyA madhukasya ca|
vatsakasya ca saMyuktaM bastiM dadyAjjvarApaham||243||
shuddhe mArge hRute doShe viprasanneShu dhAtuShu|
gatA~ggashUlo laghva~ggaH sadyo bhavati vijvaraH||244||
AragvadhamushIraM ca madanasya phalaM tathA|
catasraH parNinIshcaiva [1] niryUhamupakalpayet||245||
priya~ggurmadanaM mustaM shatAhvA madhuyaShTikA|
kalkaH sarpirguDaH kShaudraM jvaraghno bastiruttamaH||246||
guDUcIM trAyamANAM ca candanaM madhukaM vRuSham|
sthirAM balAM pRushniparNIM madanaM ceti sAdhayet||247||
rasaM jA~ggalamAMsasya rasena sahitaM bhiShak|
pippalIphalamustAnAM kalkena madhukasya ca||248||
IShatsalavaNaM yuktyA nirUhaM madhusarpiShA|
jvaraprashamanaM dadyAdbalasvedarucipradam||249||
jIvantIM madhukaM medAM pippalIM madanaM vacAm|
RuddhiM rAsnAM balAM vishvaM [2] shatapuShpAM shatAvarIm||250||
piShTvA kShIraM jalaM sarpistailaM ca vipacedbhiShak|
AnuvAsanikaM snehametaM vidyAjjvarApaham||251||
paTolapicumardAbhyAM guDUcyA madhukena ca|
madanaishca shRutaH sneho jvaraghnamanuvAsanam||252||
candanAgurukAshmaryapaTolamadhukotpalaiH|
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.
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 ''guduchi, trayamana, chandana, madhuka, vrisha, sthira, bala, prishniparni'' and ''madana'', to which meat soup of ''jangala'' type of animals (those inhabiting in arid lands) and the paste of ''pippali, phala, musta'' and ''madhuka'' has been added.
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''.
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]
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=== Indications of ''shiro-virechana'' (nasal errhines) ===
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यदुक्तं भेषजाध्याये विमाने रोगभेषजे|
शिरोविरेचनं कुर्याद्युक्तिज्ञस्तज्ज्वरापहम्||२५४||
यच्च नावनिकं तैलं याश्च तैलं याश्च प्राग्धूमवर्तयः|
मात्राशितीये निर्दिष्टाः प्रयोज्यास्ता ज्वरेष्वपि||२५५||
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yaduktaṁ bhēṣajādhyāyē vimānē rōgabhēṣajē|
śirōvirēcanaṁ kuryādyuktijñastajjvarāpaham||254||
yacca nāvanikaṁ tailaṁ yāśca tailaṁ yāśca prāgdhūmavartayaḥ|
mātrāśitīyē nirdiṣṭāḥ prayōjyāstā jvarēṣvapi||255||
yaduktaM bheShajAdhyAye vimAne rogabheShaje|
shirovirecanaM kuryAdyuktij~jastajjvarApaham||254||
yacca nAvanikaM tailaM yAshca tailaM yAshca prAgdhUmavartayaH|
mAtrAshitIye nirdiShTAH prayojyAstA jvareShvapi||255||
</div></div>
<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]
</div>
=== External applications ===
<div class="mw-collapsible mw-collapsed">
अभ्यङ्गांश्च प्रदेहांश्च परिषेकांश्च कारयेत्|
यथाभिलाषं शीतोष्णं विभज्य द्विविधं ज्वरम्||२५६||
सहस्रधौतं सर्पिर्वा तैलं वा चन्दनादिकम्|
दाहज्वरप्रशमनं दद्यादभ्यञ्जनं भिषक्||२५७||
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abhyaṅgāṁśca pradēhāṁśca pariṣēkāṁśca kārayēt|
yathābhilāṣaṁ śītōṣṇaṁ vibhajya dvividhaṁ jvaram||256||
sahasradhautaṁ sarpirvā tailaṁ vā candanādikam|
dāhajvarapraśamanaṁ dadyādabhyañjanaṁ bhiṣak||257||
abhya~ggAMshca pradehAMshca pariShekAMshca kArayet|
yathAbhilAShaM shItoShNaM vibhajya dvividhaM jvaram||256||
sahasradhautaM sarpirvA tailaM vA candanAdikam|
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.
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'' ===
<div class="mw-collapsible mw-collapsed">
अथ चन्दनाद्यं तैलमुपदेक्ष्यामः-
चन्दनभद्रश्रीकालानुसार्यकालीयकपद्मापद्मकोशीरसारिवामधुकप्रपौण्डरीकनागपुष्पोदीच्यवन्यपद्मोत्पलनलिनकुमुद-सौगन्धिकपुण्डरीकशतपत्रबिसमृणालशालूकशैवालकशेरुकानन्ताकुशकाशेक्षुदर्भशरनलशालिमूलजम्बुवेतसवानीरगुन्द्रा-ककुभासनाश्वकर्णस्यन्दनवातपोथशालतालधवतिनिशखदिरकदरकदम्बकाश्मर्यफलसर्जप्लक्षवटकपीतनोदुम्बराश्वत्थ-न्यग्रोधधातकीदूर्वेत्कटशृङ्गाटकमञ्जिष्ठाज्योतिष्मतीपुष्करबीजक्रौञ्चादनबदरीकोविदारकदली-संवर्तकारिष्टशतपर्वाशीतकुम्भिकाशतावरीश्रीपर्णीश्रावणीमहाश्रावणीरोहिणीशीतपाक्योदनपाकीकालबलापयस्याविदारी-जीवकर्षभकमेदामहामेदामधुरसर्ष्यप्रोक्तातृणशून्यमोचरसाटरूषकबकुलकुटजपटोलनिम्बशाल्मलीनारिकेल-खर्जूरमृद्वीकाप्रियालप्रियङ्गुधन्वनात्मागुप्तामधूकानामन्येषां च शीतवीर्याणां यथालाभमौषधानां कषायं कारयेत्|
तेन कषायेण द्विगुणितपयसा तेषामेव च कल्केन कषायार्धमात्रं मृद्वग्निना साधयेत्तैलम्|
एतत्तैलमभ्यङ्गात् सद्यो दाहज्वरमपनयति|
एतैरेव चौषधैरश्लक्ष्णपिष्टैः सुशीतैः प्रदेहं कारयेत्|
एतैरेव च शृतशीतं सलिलमवगाहपरिषेकार्थं प्रयुञ्जीत||२५८||
इति चन्दनाद्यं तैलम्|
मध्वारनालक्षीरदधिघृतसलिलसेकावगाहाश्च सद्यो दाहज्वरमपनयन्ति शीतस्पर्शत्वात्||२५९||
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atha candanādyaṁ tailamupadēkṣyāmaḥ-
candanabhadraśrīkālānusāryakālīyakapadmāpadmakōśīrasārivāmadhukaprapauṇḍarīkanāgapuṣpōdīcyavanyapadmōtpalanalinakumuda-saugandhikapuṇḍarīkaśatapatrabisamr̥ṇālaśālūkaśaivālakaśērukānantākuśakāśēkṣudarbhaśaranalaśālimūlajambuvētasavānīragundrā-kakubhāsanāśvakarṇasyandanavātapōthaśālatāladhavatiniśakhadirakadarakadambakāśmaryaphalasarjaplakṣavaṭakapītanōdumbarāśvattha-nyagrōdhadhātakīdūrvētkaṭaśr̥ṅgāṭakamañjiṣṭhājyōtiṣmatīpuṣkarabījakrauñcādanabadarīkōvidārakadalī-saṁvartakāriṣṭaśataparvāśītakumbhikāśatāvarīśrīparṇīśrāvaṇīmahāśrāvaṇīrōhiṇīśītapākyōdanapākīkālabalāpayasyāvidārī-jīvakarṣabhakamēdāmahāmēdāmadhurasarṣyaprōktātr̥ṇaśūnyamōcarasāṭarūṣakabakulakuṭajapaṭōlanimbaśālmalīnārikēla-kharjūramr̥dvīkāpriyālapriyaṅgudhanvanātmāguptāmadhūkānāmanyēṣāṁ [1] ca śītavīryāṇāṁ yathālābhamauṣadhānāṁ kaṣāyaṁ kārayēt|
tēna kaṣāyēṇa dviguṇitapayasā tēṣāmēva ca kalkēna kaṣāyārdhamātraṁ mr̥dvagninā sādhayēttailam|
ētattailamabhyaṅgāt sadyō dāhajvaramapanayati|
ētairēva cauṣadhairaślakṣṇapiṣṭaiḥ suśītaiḥ pradēhaṁ kārayēt|
ētairēva ca śr̥taśītaṁ salilamavagāhapariṣēkārthaṁ prayuñjīta||258||
iti candanādyaṁ tailam|
madhvāranālakṣīradadhighr̥tasalilasēkāvagāhāśca sadyō dāhajvaramapanayanti śītasparśatvāt||259||
atha candanAdyaM tailamupadekShyAmaH-
candanabhadrashrIkAlAnusAryakAlIyakapadmApadmakoshIrasArivAmadhukaprapauNDarIkanAgapuShpodIcyavanyapadmotpalanalinakumuda-saugandhikapuNDarIkashatapatrabisamRuNAlashAlUkashaivAlakasherukAnantAkushakAshekShudarbhasharanalashAlimUlajambuvetasavAnIragundrA-kakubhAsanAshvakarNasyandanavAtapothashAlatAladhavatinishakhadirakadarakadambakAshmaryaphalasarjaplakShavaTakapItanodumbarAshvattha-nyagrodhadhAtakIdUrvetkaTashRu~ggATakama~jjiShThAjyotiShmatIpuShkarabIjakrau~jcAdanabadarIkovidArakadalI-saMvartakAriShTashataparvAshItakumbhikAshatAvarIshrIparNIshrAvaNImahAshrAvaNIrohiNIshItapAkyodanapAkIkAlabalApayasyAvidArI-jIvakarShabhakamedAmahAmedAmadhurasarShyaproktAtRuNashUnyamocarasATarUShakabakulakuTajapaTolanimbashAlmalInArikela-kharjUramRudvIkApriyAlapriya~ggudhanvanAtmAguptAmadhUkAnAmanyeShAM [1] ca shItavIryANAM yathAlAbhamauShadhAnAM kaShAyaM kArayet|
tena kaShAyeNa dviguNitapayasA teShAmeva ca kalkena kaShAyArdhamAtraM mRudvagninA sAdhayettailam|
etattailamabhya~ggAt sadyo dAhajvaramapanayati|
etaireva cauShadhairashlakShNapiShTaiH sushItaiH pradehaM kArayet|
etaireva ca shRutashItaM salilamavagAhapariShekArthaM prayu~jjIta||258||
iti candanAdyaM tailam|
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.
Massage of this medicated oil instantaneously cures ''daha jwara''.
The above mentioned drugs should be made in the form of a fine paste and then used as a ''pradeha'' when it has cooled. The water boiled with these drugs should be used when cooled for ''avagaha'' and ''parisheka'' (bathing and sprinkling over the body respectively).
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-
पौष्करेषु सुशीतेषु पद्मोत्पलदलेषु च|
कदलीनां च पत्रेषु क्षौमेषु विमलेषु च||२६०||
चन्दनोदकशीतेषु शीते धारागृहेऽपि वा|
हिमाम्बुसिक्ते सदने दाहार्तः संविशेत् सुखम्||२६१||
हेमशङ्खप्रवालानां मणीनां मौक्तिकस्य च|
चन्दनोदकशीतानां संस्पर्शानुरसान् स्पृशेत्||२६२||
स्रग्भिर्नीलोत्पलैः पद्मैर्व्यजनैर्विविधैरपि|
शीतवातावहैर्व्यज्ज्येच्चन्दनोदकवर्षिभिः ||२६३||
नद्यस्तडागाः पद्मिन्यो ह्रदाश्च विमलोदकाः|
अवगाहे हिता दाहतृष्णाग्लानिज्वरापहाः||२६४||
प्रियाः प्रदक्षिणाचाराः प्रमदाश्चन्दनोक्षिताः|
सान्त्वयेयुः परैः कामैर्मणिमौक्तिकभूषणाः||२६५||
शीतानि चान्नपानानि शीतान्युपवनानि च|
वायवश्चन्द्रपादाश्च शीता दाहज्वरापहाः||२६६||
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bhavanti cātra-
pauṣkarēṣu suśītēṣu padmōtpaladalēṣu ca|
kadalīnāṁ ca patrēṣu kṣaumēṣu vimalēṣu ca||260||
candanōdakaśītēṣu śītē dhārāgr̥hē'pi vā|
himāmbusiktē sadanē dāhārtaḥ saṁviśēt sukham||261||
hēmaśaṅkhapravālānāṁ maṇīnāṁ mauktikasya ca|
candanōdakaśītānāṁ saṁsparśānurasān spr̥śēt||262||
sragbhirnīlōtpalaiḥ padmairvyajanairvividhairapi|
śītavātāvahairvyajjyēccandanōdakavarṣibhiḥ ||263||
nadyastaḍāgāḥ padminyō hradāśca vimalōdakāḥ|
avagāhē hitā dāhatr̥ṣṇāglānijvarāpahāḥ||264||
priyāḥ pradakṣiṇācārāḥ pramadāścandanōkṣitāḥ|
sāntvayēyuḥ paraiḥ kāmairmaṇimauktikabhūṣaṇāḥ||265||
śītāni cānnapānāni śītānyupavanāni ca|
vāyavaścandrapādāśca śītā dāhajvarāpahāḥ||266||
bhavanti cAtra-
pauShkareShu sushIteShu padmotpaladaleShu ca|
kadalInAM ca patreShu kShaumeShu vimaleShu ca||260||
candanodakashIteShu shIte dhArAgRuhe~api vA|
himAmbusikte sadane dAhArtaH saMvishet sukham||261||
hemasha~gkhapravAlAnAM maNInAM mauktikasya ca|
candanodakashItAnAM saMsparshAnurasAn spRushet||262||
sragbhirnIlotpalaiH padmairvyajanairvividhairapi|
shItavAtAvahairvyajjyeccandanodakavarShibhiH ||263||
nadyastaDAgAH padminyo hradAshca vimalodakAH|
avagAhe hitA dAhatRuShNAglAnijvarApahAH||264||
priyAH pradakShiNAcArAH pramadAshcandanokShitAH|
sAntvayeyuH paraiH kAmairmaNimauktikabhUShaNAH||265||
shItAni cAnnapAnAni shItAnyupavanAni ca|
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.
He should take bath in rivers, ponds, ponds having lotus plant and lakes having clean water. This bath alleviates burning sensation, morbid thirst, ''glāni'' and ''jwara''.
Such patient should also be comforted with the touch of ladies smeared with sandalwood paste, wearing desirable jewels and pearls; which are affectionate and skilled with polite manners.
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|
तेन सुखोष्णेन तैलेनोष्णाभिप्रायिणं ज्वरितमभ्यञ्ज्यात्, तथा शीतज्वरः प्रशाम्यति; एतैरेव चौषधैः श्लक्ष्णपिष्टैः सुखोष्णैः प्रदेहंकारयेत्, एतैरेव च शृतं सुखोष्णं सलिलमवगाहनार्थं परिषेकार्थं च प्रयुञ्जीत शीतज्वरप्रशमार्थम्||२६७||
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|
tēna sukhōṣṇēna tailēnōṣṇābhiprāyiṇaṁ jvaritamabhyañjyāt, tathā śītajvaraḥ praśāmyati; ētairēva cauṣadhaiḥ ślakṣṇapiṣṭaiḥ sukhōṣṇaiḥ pradēhaṁkārayēt, ētairēva ca śr̥taṁ sukhōṣṇaṁ salilamavagāhanārthaṁ pariṣēkārthaṁ ca prayuñjīta śītajvarapraśamārtham||267||
ityagurvādyaṁ tailam
athoShNAbhiprAyiNAM jvaritAnAmabhya~ggAdInupakramAnupadekShyAmaH-agurukuShThatagarapatranaladashaileyadhyAmakahareNukAsthauNeyakakShemakailAvarA~ggadalapuratamAlapatrabhUtIkarohiShasaralashallakI-devadArvagnimanthabilvasyonAkakAshmaryapATalApunarnavAvRushcIrakaNTakArIbRuhatIshAlaparNIpRushniparNImAShaparNImudgaparNIgokShurakairaNDa-shobhA~jjanakavaruNArkacirabilvatilvakashaTIpuShkaramUlagaNDIrorubUkapattUrAkShIvAshmAntakashigrumAtulu~ggapIlukamUlakaparNI-tilaparNIpIluparNImeShashRu~ggIhiMsrAdantashaThairAvatakabhallAtakAsphotakANDIrAtmajaikeShIkAkara~jjadhAnyakAjamoda-pRuthvIkAsumukhasurasakuTherakakAlamAlakaparNAsakShavakaphaNijjhakabhUstRuNashRu~ggaverapippalIsarShapAshvagandhArAsnAruhArohAvacAbalAtibalA-guDUcIshatapuShpAshItavallInAkulIgandhanAkulIshvetAjyotiShmatIcitrakAdhyaNDAmlacA~ggerI- tilabadarakulatthamAShANAmevaMvidhAnAmanyeShAM coShNavIryANAM yathAlAbhamauShadhAnAM kaShAyaM kArayet, tena kaShAyeNa teShAmeva ca kalkenasurAsauvIrakatuShodakamaireyamedakadadhimaNDAranAlakaTvaraprativinItena tailapAtraM vipAcayet|
tena sukhoShNena tailenoShNAbhiprAyiNaM jvaritamabhya~jjyAt, tathA shItajvaraH prashAmyati; etaireva cauShadhaiH shlakShNapiShTaiH sukhoShNaiHpradehaM kArayet, etaireva ca shRutaM sukhoShNaM salilamavagAhanArthaM pariShekArthaM ca prayu~jjIta shItajvaraprashamArtham||267||
ityagurvAdyaM tailam
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<div style="text-align:justify;">
Now, we will explain the therapies for patients of ''jwara'' for whom hot treatment is desirable –
A decoction prepared from ''aguru, kuṡṭha, tagara, patra, nalada, shaileya, dhyāmaka, hareṇuka, sthauṇeyaka, kṡemaka, elā, varāñga, dala, pura, tamāla patra, bhūtika, rohiṡa, sarala, shallakī, devadārū, agnimantha, bilva, shyonāka, kāshmarya, pāṭalā, punarnavā, vṛṡcīra, kanṭakārī, bṛhatī, shālaparṇī, pṛshniparṇī, māṡaparṇī, mudgaparṇī, gokṡur, eranda, shobhānjana, varuṇa, arka, cirabilva, tilvaka, shaṭī, puṡkaramūla, ganḍīra, urūbaka, pattūra, akṡīva, aṡmantaka, shigru, mātulunga, pīlūka, mūlaka prṇī, tila parṇī, pīlu parṇī, meṡa shṛngī, hiṁsrā, danta shaṭha, airāvata, bhallātaka, āsphoṭaka, āndḍīra, ātmajā, ekaiṡikā'' (''ambaṡṭhā'') ''karanja, dhānyaka, ajamodā, pṛthvīkā, sumukhā, surasā, kuṭheraka, kāla mālaka, parṇāsa, kṡavaka, phaṇijjhaka, bhūstṛṇa, shṛngabera, pippalī, sarṡapa, ashvagandhā, rāsnā, ruhā'' (''vṛkṡa rūhā''), ''rohā'' (''añjalīkārikā''), ''vacā, balā, atibalā, guḍucī, shatapuṡpā, shita vallī, nākulī, gandha nākulī, shvetā, jyotiṡmatī, citraka, adhyaṇdā, amla cāngerī, tila, badara, kulattha, māṡa,'' and such other drugs which are hot in potency.
A decoction and paste should be prepared from all the drugs described or those amongst them which are available. These decoction and paste should be added with ''surā'' (alcoholic drinks), ''sauvīraka'' (vinegar), ''tuṡodaka'' (a type of vinegar), ''maireya'' (an alcoholic drink), ''dadhi manḍa'' (scum of curd), ''ārnāla'' (sour gruel recipe), ''kaṭvara'' (watery curd along with the fat content) should be boiled in one ''pātra'' of oil (3.072 l). When this oil is still lukewarm, it should be massaged to the patient suffering from ''jwara'' for whom hot therapy is indicated. This will cure ''shīta jwara'' .
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-
त्रयोदशविधः स्वेदः स्वेदाध्याये निदर्शितः|
मात्राकालविदा युक्तः स च शीतज्वरापहः||२६८||
सा कुटी तच्च शयनं तच्चावच्छादनं ज्वरम्|
शीतं प्रशमयन्त्याशु धूपाश्चागुरुजा घनाः||२६९||
चारूपचितगात्र्यश्च तरुण्यो यौवनोष्मणा|
आश्लेषाच्छमयन्त्याशु प्रमदाः शिशिरज्वरम्||२७०||
स्वेदनान्यन्नपानानि वातश्लेष्महराणि च|
शीतज्वरं जयन्त्याशु संसर्गबलयोजनात्||२७१||
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bhavanti cātra-
trayōdaśavidhaḥ svēdaḥ svēdādhyāyē nidarśitaḥ|
mātrākālavidā yuktaḥ sa ca śītajvarāpahaḥ||268||
sā kuṭī tacca śayanaṁ taccāvacchādanaṁ jvaram|
śītaṁ praśamayantyāśu dhūpāścāgurujā ghanāḥ||269||
cārūpacitagātryaśca taruṇyō yauvanōṣmaṇā|
āślēṣācchamayantyāśu pramadāḥ śiśirajvaram||270||
svēdanānyannapānāni vātaślēṣmaharāṇi ca|
śītajvaraṁ jayantyāśu saṁsargabalayōjanāt||271||
bhavanti cAtra-
trayodashavidhaH svedaH svedAdhyAye nidarshitaH|
mAtrAkAlavidA yuktaH sa ca shItajvarApahaH||268||
sA kuTI tacca shayanaM taccAvacchAdanaM jvaram|
shItaM prashamayantyAshu dhUpAshcAgurujA ghanAH||269||
cArUpacitagAtryashca taruNyo yauvanoShmaNA|
AshleShAcchamayantyAshu pramadAH shishirajvaram||270||
svedanAnyannapAnAni vAtashleShmaharANi ca|
shItajvaraM jayantyAshu saMsargabalayojanAt||271||
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<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''.
Sleeping on a bed and covering oneself with clothes in the ''kuthi sweda'' (fomentation technique by keeping the patient in a cottage) immediately alleviates ''sheeta''. Similarly, the strong fumigation by ''aguru'' also alleviates ''shīta''.
''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 ''[[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|
लङ्घनं न हितं विद्याच्छमनैस्तानुपाचरेत्||२७२||
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vātajē śramajē caiva purāṇē kṣatajē jvarē|
laṅghanaṁ na hitaṁ vidyācchamanaistānupācarēt||272||
vAtaje shramaje caiva purANe kShataje jvare|
la~gghanaM na hitaM vidyAcchamanaistAnupAcaret||272||
</div></div>
<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]
</div>
=== Guidelines for improving ''agni'' (digestive strength) ===
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विक्षिप्यामाशयोष्माणं यस्माद्गत्वा रसं नृणाम्|
ज्वरं कुर्वन्ति दोषास्तु हीयतेऽग्निबलं ततः||२७३||
यथा प्रज्वलितो वह्निः स्थाल्यामिन्धनवानपि|
न पचत्योदनं सम्यगनिलप्रेरितो बहिः||२७४||
पक्तिस्थानात्तथा दोषैरूष्मा क्षिप्तो बहिर्नृणाम्|
न पचत्यभ्यवहृतं कृच्छ्रात् पचति वा लघु||२७५||
अतोऽग्निबलरक्षार्थं लङ्घनादिक्रमो हितः|
सप्ताहेन हि पच्यन्ते सप्तधातुगता मलाः||२७६||
निरामश्चाप्यतः प्रोक्तो ज्वरः प्रायोऽष्टमेऽहनि|
उदीर्णदोषस्त्वल्पाग्निरश्नन् गुरु विशेषतः||२७७||
मुच्यते सहसा प्राणैश्चिरं क्लिश्यति वा नरः|
एतस्मात्कारणाद्विद्वान् वातिकेऽप्यादितो ज्वरे||२७८||
नाति गुर्वति वा स्निग्धं भोजयेत् सहसा नरम्|
ज्वरे मारुतजे त्वादावनपेक्ष्यापि हि क्रमम्||२७९||
कुर्यान्निरनुबन्धानामभ्यङ्गादीनुपक्रमान्|
पाययित्वा कषायं च भोजयेद्रसभोजनम्||२८०||
जीर्णज्वरहरं कुर्यात् सर्वशश्चाप्युपक्रमम्|
श्लेष्मलानामवातानां ज्वरोऽनुष्णः कफाधिकः||२८१||
परिपाकं न सप्ताहेनापि याति मृदूष्मणाम्|
तं क्रमेण यथोक्तेन लङ्घनाल्पाशनादिना||२८२||
आदशाहमुपक्रम्य कषायाद्यैरुपाचरेत्|२८३|
<div class="mw-collapsible-content">
vikṣipyāmāśayōṣmāṇaṁ yasmādgatvā rasaṁ nr̥ṇām|
jvaraṁ kurvanti dōṣāstu hīyatē'gnibalaṁ tataḥ||273||
yathā prajvalitō vahniḥ sthālyāmindhanavānapi|
na pacatyōdanaṁ samyaganilaprēritō bahiḥ||274||
paktisthānāttathā dōṣairūṣmā kṣiptō bahirnr̥ṇām|
na pacatyabhyavahr̥taṁ kr̥cchrāt pacati vā laghu||275||
atō'gnibalarakṣārthaṁ laṅghanādikramō hitaḥ|
saptāhēna hi pacyantē saptadhātugatā malāḥ||276||
nirāmaścāpyataḥ prōktō jvaraḥ prāyō'ṣṭamē'hani|
udīrṇadōṣastvalpāgniraśnan guru viśēṣataḥ||277||
mucyatē sahasā prāṇaiściraṁ kliśyati vā naraḥ|
ētasmātkāraṇādvidvān vātikē'pyāditō jvarē||278||
nāti gurvati vā snigdhaṁ bhōjayēt sahasā naram|
jvarē mārutajē tvādāvanapēkṣyāpi hi kramam||279||
kuryānniranubandhānāmabhyaṅgādīnupakramān|
pāyayitvā kaṣāyaṁ ca bhōjayēdrasabhōjanam||280||
jīrṇajvaraharaṁ kuryāt sarvaśaścāpyupakramam|
ślēṣmalānāmavātānāṁ jvarō'nuṣṇaḥ [1] kaphādhikaḥ||281||
paripākaṁ na saptāhēnāpi yāti mr̥dūṣmaṇām|
taṁ kramēṇa yathōktēna laṅghanālpāśanādinā||282||
ādaśāhamupakramya kaṣāyādyairupācarēt|283|
vikShipyAmAshayoShmANaM yasmAdgatvA rasaM nRuNAm|
jvaraM kurvanti doShAstu hIyate~agnibalaM tataH||273||
yathA prajvalito vahniH sthAlyAmindhanavAnapi|
na pacatyodanaM samyaganilaprerito bahiH||274||
paktisthAnAttathA doShairUShmA kShipto bahirnRuNAm|
na pacatyabhyavahRutaM kRucchrAt pacati vA laghu||275||
ato~agnibalarakShArthaM la~gghanAdikramo hitaH|
saptAhena hi pacyante saptadhAtugatA malAH||276||
nirAmashcApyataH prokto jvaraH prAyo~aShTame~ahani|
udIrNadoShastvalpAgnirashnan guru visheShataH||277||
mucyate sahasA prANaishciraM klishyati vA naraH|
etasmAtkAraNAdvidvAn vAtike~apyAdito jvare||278||
nAti gurvati vA snigdhaM bhojayet sahasA naram|
jvare mArutaje tvAdAvanapekShyApi hi kramam||279||
kuryAnniranubandhAnAmabhya~ggAdInupakramAn|
pAyayitvA kaShAyaM ca bhojayedrasabhojanam||280||
jIrNajvaraharaM kuryAt sarvashashcApyupakramam|
shleShmalAnAmavAtAnAM jvaro~anuShNaH kaphAdhikaH||281||
paripAkaM na saptAhenApi yAti mRudUShmaNAm|
taM krameNa yathoktena la~gghanAlpAshanAdinA||282||
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 ''[[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 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||
लङ्घनं लङ्घनीयोक्तं तेषु कार्यं प्रति प्रति|२८४|
वमनैश्च विरेकैश्च बस्तिभिश्च यथाक्रमम्||२८४||
ज्वरानुपचरेद्धीमान् कफपित्तानिलोद्भवान्|
संसृष्टान् सन्निपतितान् बुद्ध्वा तरतमैः समैः||२८५||
ज्वरान् दोषक्रमापेक्षी यथोक्तैरौषधैर्जयेत्|
वर्धनेनैकदोषस्य क्षपणेनोच्छ्रितस्य वा||२८६||
कफस्थानानुपूर्व्या वा सन्निपातज्वरं जयेत्|२८७|
<div class="mw-collapsible-content">
sāmā yē yē ca kaphajāḥ kaphapittajvarāśca yē||283||
laṅghanaṁ laṅghanīyōktaṁ tēṣu kāryaṁ prati prati|
vamanaiśca virēkaiśca bastibhiśca yathākramam||284||
jvarānupacarēddhīmān kaphapittānilōdbhavān|
saṁsr̥ṣṭān sannipatitān buddhvā taratamaiḥ samaiḥ||285||
jvarān dōṣakramāpēkṣī yathōktairauṣadhairjayēt|
vardhanēnaikadōṣasya kṣapaṇēnōcchritasya vā||286||
kaphasthānānupūrvyā vā sannipātajvaraṁ jayēt|287|
sAmA ye ye ca kaphajAH kaphapittajvarAshca ye||283||
la~gghanaM la~gghanIyoktaM teShu kAryaM prati prati|
vamanaishca virekaishca bastibhishca yathAkramam||284||
jvarAnupacareddhImAn kaphapittAnilodbhavAn|
saMsRuShTAn sannipatitAn buddhvA taratamaiH samaiH||285||
jvarAn doShakramApekShI yathoktairauShadhairjayet|
vardhanenaikadoShasya kShapaNenocchritasya vA||286||
kaphasthAnAnupUrvyA vA sannipAtajvaraM jayet|287|
</div></div>
<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 ''jwara'' is produced by the aggravated ''[[kapha dosha]]''
*When both the ''[[kapha]]'' and the ''[[pitta dosha]]'' are aggravated together
''[[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 ''[[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 ''[[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||
शोथः सञ्जायते तेन कश्चिदेव प्रमुच्यते|
रक्तावसेचनैः शीघ्रं सर्पिष्पानैश्च तं जयेत्||२८८||
प्रदेहैः कफपित्तघ्नैर्नावनैः कवलग्रहैः|२८९|
<div class="mw-collapsible-content">
sannipātajvarasyāntē karṇamūlē sudārūṇaḥ||287||
śōthaḥ sañjāyatē tēna kaścidēva pramucyatē|
raktāvasēcanaiḥ śīghraṁ sarpiṣpānaiśca taṁ jayēt||288||
pradēhaiḥ kaphapittaghnairnāvanaiḥ kavalagrahaiḥ|289
sannipAtajvarasyAnte karNamUle sudArUNaH||287||
shothaH sa~jjAyate tena kashcideva pramucyate|
raktAvasecanaiH shIghraM sarpiShpAnaishca taM jayet||288||
pradehaiH kaphapittaghnairnAvanaiH kavalagrahaiH|289|
</div></div>
<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||
शाखानुसारी रक्तस्य सोऽवसेकात् प्रशाम्यति|२९०|
<div class="mw-collapsible-content">
śītōṣṇasnigdharūkṣādyairjvarō yasya na śāmyati||289||
śākhānusārī raktasya sō'vasēkāt praśāmyati|290|
shItoShNasnigdharUkShAdyairjvaro yasya na shAmyati||289||
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]
</div>
=== Indication of consumption of ghee ===
<div class="mw-collapsible mw-collapsed">
विसर्पेणाभिघातेन यश्च विस्फोटकैर्ज्वरः||२९०||
तत्रादौ सर्पिषः पानं कफपित्तोत्तरो न चेत्|२९१|
<div class="mw-collapsible-content">
visarpēṇābhighātēna yaśca visphōṭakairjvaraḥ||290||
tatrādau sarpiṣaḥ pānaṁ kaphapittōttarō na cēt|291|
visarpeNAbhighAtena yashca visphoTakairjvaraH||290||
tatrAdau sarpiShaH pAnaM kaphapittottaro na cet|291|
</div></div>
<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||
बल्येः सम्बृंहणैस्तस्मादाहारैस्तमुपाचरेत्|२९२|
<div class="mw-collapsible-content">
daurbalyāddēhadhātūnāṁ jvarō jīrṇō'nuvartatē||291||
balyēḥ sambr̥ṁhaṇaistasmādāhāraistamupācarēt|292|
daurbalyAddehadhAtUnAM jvaro jIrNo~anuvartate||291||
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]
</div>
=== Management of ''[[dosha]]'' dominance in ''vishamajwara'' ===
<div class="mw-collapsible mw-collapsed">
कर्म साधारणं जह्यात्तृतीयकचतुर्थकौ ||२९२||
आगन्तुरनुबन्धो हि प्रायशो विषमज्वरे|
वातप्रधानं सर्पिर्भिर्बस्तिभिः सानुवासनैः||२९३||
स्निग्धोष्णैरन्नपानैश्च शमयेद्विषमज्वरम्|
विरेचनेन पयसा सर्पिषा संस्कृतेन च||२९४||
विषमं तिक्तशीतैश्च ज्वरं पित्तोत्तरं जयेत्|
वमनं पाचनं रूक्षमन्नपानं विलङ्घनम्||२९५||
कषायोष्णं च विषमे ज्वरे शस्तं कफोत्तरे|२९६|
<div class="mw-collapsible-content">
karma sādhāraṇaṁ jahyāttr̥tīyakacaturthakau ||292||
āganturanubandhō hi prāyaśō viṣamajvarē|
vātapradhānaṁ sarpirbhirbastibhiḥ sānuvāsanaiḥ||293||
snigdhōṣṇairannapānaiśca śamayēdviṣamajvaram|
virēcanēna payasā sarpiṣā saṁskr̥tēna ca||294||
viṣamaṁ tiktaśītaiśca jvaraṁ pittōttaraṁ jayēt|
vamanaṁ pācanaṁ rūkṣamannapānaṁ vilaṅghanam||295||
kaṣāyōṣṇaṁ ca viṣamē jvarē śastaṁ kaphōttarē|296|
karma sAdhAraNaM jahyAttRutIyakacaturthakau ||292||
Aganturanubandho hi prAyasho viShamajvare|
vAtapradhAnaM sarpirbhirbastibhiH sAnuvAsanaiH||293||
snigdhoShNairannapAnaishca shamayedviShamajvaram|
virecanena payasA sarpiShA saMskRutena ca||294||
viShamaM tiktashItaishca jvaraM pittottaraM jayet|
vamanaM pAcanaM rUkShamannapAnaM vila~gghanam||295||
kaShAyoShNaM ca viShame jvare shastaM kaphottare|296|
</div></div>
<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||
प्रयोक्तव्या मतिमता दोषादीन् प्रविभज्य ते|
सुरा समण्डा पानार्थे भक्ष्यार्थे चरणायुधः||२९७||
तित्तिरिश्च मयूरश्च प्रयोज्या विषमज्वरे|
पिबेद्वा षट्पलं सर्पिरभयां वा प्रयोजयेत्||२९८||
त्रिफलायाः कषायं वा गुडूच्या रसमेव वा|
नीलिनीमजगन्धां च त्रिवृतां कटुरोहिणीम्||२९९||
पिबेज्ज्वरागमे युक्त्या स्नेहस्वेदोपपादितः|
सर्पिषो महतीं मात्रां पीत्वा वा छर्दयेत् पुनः||३००||
उपयुज्यान्नपानं वा प्रभूतं पुनरुल्लिखेत्|
सान्नं मद्यं प्रभूतं वा पीत्वा स्वप्याज्ज्वरागमे||३०१||
आस्थापनं यापनं वा कारयेद्विषमज्वरे|
पयसा वृषदंशस्य शकृद्वा तदहः पिबेत्||३०२||
वृषस्य दधिमण्डेन सुरया वा ससैन्धवम्|
पिप्पल्यास्त्रिफलायाश्च दध्नस्तक्रस्य सर्पिषः||३०३||
पञ्चगव्यस्य पयसः प्रयोगो विषमज्वरे|
रसोनस्य सतैलस्य प्राग्भक्तमुपसेवनम्||३०४||
मेद्यानामुष्णवीर्याणामामिषाणां च भक्षणम्|
हिङ्गुतुल्या तु वैयाघ्री वसा नस्यं ससैन्धवा||३०५||
पुराणसर्पिः सिंहस्य वसा तद्वत् ससैन्धवा|
सैन्धवं पिप्पलीनां च तण्डुलाः समनःशिलाः||३०६||
नेत्राञ्जनं तैलपिष्टं शस्यते विषमज्वरे|
पलङ्कषा निम्बपत्रं वचा कुष्ठं हरीतकी||३०७||
सर्षपाः सयवाः सर्पिर्धूपनं ज्वरनाशनम्|
ये धूमा धूपनं यच्च नावनं चाञ्जनं च यत्||३०८||
मनोविकारे निर्दिष्टं कार्यं तद्विषमज्वरे|
मणीनामोषधीनां च मङ्गल्यानां विषस्य च||३०९||
धारणादगदानां च सेवनान्न भवेज्ज्वरः|३१०|
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yōgāḥ parāḥ pravakṣyantē viṣamajvaranāśanāḥ||296||
prayōktavyā matimatā dōṣādīn pravibhajya tē|
surā samaṇḍā pānārthē bhakṣyārthē caraṇāyudhaḥ||297||
tittiriśca mayūraśca prayōjyā viṣamajvarē|
pibēdvā ṣaṭpalaṁ sarpirabhayāṁ vā prayōjayēt||298||
triphalāyāḥ kaṣāyaṁ vā guḍūcyā rasamēva vā|
nīlinīmajagandhāṁ ca trivr̥tāṁ kaṭurōhiṇīm||299||
pibējjvarāgamē yuktyā snēhasvēdōpapāditaḥ|
sarpiṣō mahatīṁ mātrāṁ pītvā vā chardayēt punaḥ||300||
upayujyānnapānaṁ vā prabhūtaṁ punarullikhēt|
sānnaṁ madyaṁ prabhūtaṁ vā pītvā svapyājjvarāgamē||301||
āsthāpanaṁ yāpanaṁ vā kārayēdviṣamajvarē|
payasā vr̥ṣadaṁśasya śakr̥dvā tadahaḥ pibēt||302||
vr̥ṣasya dadhimaṇḍēna surayā vā sasaindhavam|
pippalyāstriphalāyāśca dadhnastakrasya sarpiṣaḥ||303||
pañcagavyasya payasaḥ prayōgō viṣamajvarē|
rasōnasya satailasya prāgbhaktamupasēvanam||304||
mēdyānāmuṣṇavīryāṇāmāmiṣāṇāṁ ca bhakṣaṇam|
hiṅgutulyā tu vaiyāghrī vasā nasyaṁ sasaindhavā||305||
purāṇasarpiḥ siṁhasya vasā tadvat sasaindhavā|
saindhavaṁ pippalīnāṁ ca taṇḍulāḥ samanaḥśilāḥ||306||
nētrāñjanaṁ tailapiṣṭaṁ śasyatē viṣamajvarē|
palaṅkaṣā nimbapatraṁ vacā kuṣṭhaṁ harītakī||307||
sarṣapāḥ sayavāḥ sarpirdhūpanaṁ jvaranāśanam|
yē dhūmā dhūpanaṁ yacca nāvanaṁ cāñjanaṁ ca yat||308||
manōvikārē nirdiṣṭaṁ kāryaṁ tadviṣamajvarē|
maṇīnāmōṣadhīnāṁ ca maṅgalyānāṁ viṣasya ca||309||
dhāraṇādagadānāṁ ca sēvanānna bhavējjvaraḥ|310|
yogAH parAH pravakShyante viShamajvaranAshanAH||296||
prayoktavyA matimatA doShAdIn pravibhajya te|
surA samaNDA pAnArthe bhakShyArthe caraNAyudhaH||297||
tittirishca mayUrashca prayojyA viShamajvare|
pibedvA ShaTpalaM sarpirabhayAM vA prayojayet||298||
triphalAyAH kaShAyaM vA guDUcyA rasameva vA|
nIlinImajagandhAM ca trivRutAM kaTurohiNIm||299||
pibejjvarAgame yuktyA snehasvedopapAditaH|
sarpiSho mahatIM mAtrAM pItvA vA chardayet punaH||300||
upayujyAnnapAnaM vA prabhUtaM punarullikhet|
sAnnaM madyaM prabhUtaM vA pItvA svapyAjjvarAgame||301||
AsthApanaM yApanaM vA kArayedviShamajvare|
payasA vRuShadaMshasya shakRudvA tadahaH pibet||302||
vRuShasya dadhimaNDena surayA vA sasaindhavam|
pippalyAstriphalAyAshca dadhnastakrasya sarpiShaH||303||
pa~jcagavyasya payasaH prayogo viShamajvare|
rasonasya satailasya prAgbhaktamupasevanam||304||
medyAnAmuShNavIryANAmAmiShANAM ca bhakShaNam|
hi~ggutulyA tu vaiyAghrI vasA nasyaM sasaindhavA||305||
purANasarpiH siMhasya vasA tadvat sasaindhavA|
saindhavaM pippalInAM ca taNDulAH samanaHshilAH||306||
netrA~jjanaM tailapiShTaM shasyate viShamajvare|
pala~gkaShA nimbapatraM vacA kuShThaM harItakI||307||
sarShapAH sayavAH sarpirdhUpanaM jvaranAshanam|
ye dhUmA dhUpanaM yacca nAvanaM cA~jjanaM ca yat||308||
manovikAre nirdiShTaM kAryaM tadviShamajvare|
maNInAmoShadhInAM ca ma~ggalyAnAM viShasya ca||309||
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 –
*''Sura'' along with its ''manda'' (alcohol along with its supernatant part) as drink
*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).
*Emesis after the administration of ghee in large quantity
*Emesis after taking large quantity of food and drinks
*Sleeping after taking large quantity of alcohol along with food when the attack of fever is due
*Administration of ''āsthāpana'' and ''yāpanā bastīs''
*Intake of cat’s stool mixed with milk on the same day
*Intake of cat’s stool mixed with either ''dadhi manḍa'' (scum of curd) or alcohol or rock salt or ''pippalī'' or ''triphalā'' or curd or butter or milk or ghee or ''panchagavya'' (mixture of five products obtained from cow);
*Intake of ''rasona'' along with oil immediately before food
*Intake of meat of animals which are fatty and hot in potency
*Inhalation of ''hingu'' and ''vasā'' of ''vyāghra'' (tiger) taken in equal quantity and mixed with rock salt.
*Inhalation of old ghee and ''vasā'' of ''siṁha'' (lion) taken in equal quantity and mixed with rock salt.
*Application of ''anjana'' prepared of rock salt, seeds of ''pippalī'' and ''manaḥshilā'' mixed with oil
*Fumigation by ''palaṅkaṡā'', leaves of ''nimba, vacā, kuṡṭha, harītakī, sarṡapa, yava'' and ghee
*Administration of formulations of ''dhūma'' (medicated smoking), ''dhūpana'' (fumigation), ''nāvana'' (nasal instillation of medicine), and ''anjana'' (collyrium) which are prescribed in the treatment of ''manovikāra'' or psychic ailments like ''unmāda'' and ''apasamāra''.
*Wearing of ''maṇis'' (precious stones and jewels), ''auṡadha'' (drugs), ''mangalya'' (auspicious talisman) and ''viṡa'' (poisonous substances)
*Intake of ''agada'' (antidote like drugs).[296-309]
</div>
=== Spiritual therapy ===
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सोमं सानुचरं देवं समातृगणमीश्वरम्||३१०||
पूजयन् प्रयतः शीघ्रं मुच्यते विषमज्वरात्|
विष्णुं सहस्रमूर्धानं चराचरपतिं विभुम्||३११||
स्तुवन्नामसहस्रेण ज्वरान् सर्वानपोहति|
ब्रह्माणमश्विनाविन्द्रं हुतभक्षं हिमाचलम्||३१२||
गङ्गां मरुद्गणांश्चेष्ट्या पूजयञ्जयति ज्वरान्|
भक्त्या मातुः पितुश्चैव गुरूणां पूजनेन च||३१३||
ब्रह्मचर्येण तपसा सत्येन नियमेन च|
जपहोमप्रदानेन वेदानां श्रवणेन च||३१४||
ज्वराद्विमुच्यते शीघ्रं साधूनां दर्शनेन च|
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sōmaṁ sānucaraṁ dēvaṁ samātr̥gaṇamīśvaram||310||
pūjayan prayataḥ śīghraṁ mucyatē viṣamajvarāt|
viṣṇuṁ sahasramūrdhānaṁ carācarapatiṁ vibhum||311||
stuvannāmasahasrēṇa jvarān sarvānapōhati|
brahmāṇamaśvināvindraṁ hutabhakṣaṁ himācalam||312||
gaṅgāṁ marudgaṇāṁścēṣṭyā [5] pūjayañjayati jvarān|
bhaktyā mātuḥ pituścaiva gurūṇāṁ pūjanēna ca||313||
brahmacaryēṇa tapasā satyēna niyamēna ca|
japahōmapradānēna vēdānāṁ śravaṇēna ca||314||
somaM sAnucaraM devaM samAtRugaNamIshvaram||310||
pUjayan prayataH shIghraM mucyate viShamajvarAt|
viShNuM sahasramUrdhAnaM carAcarapatiM vibhum||311||
stuvannAmasahasreNa jvarAn sarvAnapohati|
brahmANamashvinAvindraM hutabhakShaM himAcalam||312||
ga~ggAM marudgaNAMshceShTyA [5] pUjaya~jjayati jvarAn|
bhaktyA mAtuH pitushcaiva gurUNAM pUjanena ca||313||
brahmacaryeNa tapasA satyena niyamena ca|
japahomapradAnena vedAnAM shravaNena ca||314||
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''.
Recitation of the ''sahasra nāma'' (one thousand names) of Lord Viṡnū, who has one thousand heads, who is the chief of the ''carācara'' (moving and non-moving things of the universe) and who is omnipresent cures all type of ''jwara''.
Offering prayers through ''iṡṭī'' or ''yajña'' (fire ritual) to Brahmā, the Ashvinīs, īndra, āgni, the Himalayās, the Ganges and the followers of Māruts cures the ''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]
</div>
=== Management of ''jwara'' located in various ''[[dhatu]]'' ===
<div class="mw-collapsible mw-collapsed">
ज्वरे रसस्थे वमनमुपवासं च कारयेत्||३१५||
सेकप्रदेहौ रक्तस्थे तथा संशमनानि च|
विरेचनं सोपवासं मांसमेदःस्थिते हितम्||३१६||
अस्थिमज्जगते देया निरूहाः सानुवासनाः|३१७|
<div class="mw-collapsible-content">
jvarādvimucyatē śīghraṁ sādhūnāṁ darśanēna ca|
jvarē rasasthē vamanamupavāsaṁ ca kārayēt||315||
sēkapradēhau raktasthē tathā saṁśamanāni ca|
virēcanaṁ sōpavāsaṁ māṁsamēdaḥsthitē hitam||316||
asthimajjagatē dēyā nirūhāḥ sānuvāsanāḥ|317|
jvare rasasthe vamanamupavAsaM ca kArayet||315||
sekapradehau raktasthe tathA saMshamanAni ca|
virecanaM sopavAsaM mAMsamedaHsthite hitam||316||
asthimajjagate deyA nirUhAH sAnuvAsanAH|317|
</div></div>
<div style="text-align:justify;">
When the ''[[dosha]]s'' causing ''jwara'' are located in –
*the ''[[rasa dhatu]]'', then ''[[vamana]]'' and ''upavāsa'' (emesis and fasting) should be done.
*the ''[[rakta dhatu]]'', then ''seka'' and ''pradeha'' (pouring of hot medicated liquids and ointment application) should be done.
*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||
दैवव्यपाश्रयं तत्र सर्वमौषधमिष्यते|
<div class="mw-collapsible-content">
śāpābhicārādbhūtānāmabhiṣaṅgācca yō jvaraḥ||317||
daivavyapāśrayaṁ tatra sarvamauṣadhamiṣyatē|
shApAbhicArAdbhUtAnAmabhiSha~ggAcca yo jvaraH||317||
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]
</div>
=== Management of ''abhighataja jwara'' ===
<div class="mw-collapsible mw-collapsed">
अभिघातज्वरो नश्येत् पानाभ्यङ्गेन सर्पिषः||३१८||
रक्तावसेकैर्मद्यैश्च सात्म्यैर्मांसरसौदनैः|
सानाहो मद्यसात्म्यानां मदिरारसभोजनैः||३१९||
क्षतानां व्रणितानां च क्षतव्रणचिकित्सया|
<div class="mw-collapsible-content">
abhighātajvarō naśyēt pānābhyaṅgēna sarpiṣaḥ||318||
raktāvasēkairmadyaiśca sātmyairmāṁsarasaudanaiḥ|
sānāhō madyasātmyānāṁ madirārasabhōjanaiḥ||319||
kṣatānāṁ vraṇitānāṁ ca kṣatavraṇacikitsayā|
abhighAtajvaro nashyet pAnAbhya~ggena sarpiShaH||318||
raktAvasekairmadyaishca sAtmyairmAMsarasaudanaiH|
sAnAho madyasAtmyAnAM madirArasabhojanaiH||319||
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]
</div>
=== Management of ''agantuja jwara'' due to mental factors ===
<div class="mw-collapsible mw-collapsed">
आश्वासेनेष्टलाभेन वायोः प्रशमनेन च||३२०||
हर्षणैश्च शमं यान्ति कामशोकभयज्वराः|
काम्यैरर्थैर्मनोज्ञैश्च पित्तघ्नैश्चाप्युपक्रमैः||३२१||
सद्वाक्यैश्च शमं याति ज्वरः क्रोधसमुत्थितः|
कामात् क्रोधज्वरो नाशं क्रोधात् कामसमुद्भवः||३२२||
याति ताभ्यामुभाभ्यां च भयशोकसमुत्थितः|
ज्वरस्य वेगं कालं च चिन्तयञ्ज्वर्यते तु यः||३२३||
तस्येष्टैस्तु विचित्रैश्च विषयैर्नाशयेत् स्मृतिम्|३२४|
<div class="mw-collapsible-content">
āśvāsēnēṣṭalābhēna vāyōḥ praśamanēna ca||320||
harṣaṇaiśca śamaṁ yānti kāmaśōkabhayajvarāḥ|
kāmyairarthairmanōjñaiśca pittaghnaiścāpyupakramaiḥ||321||
sadvākyaiśca śamaṁ yāti jvaraḥ krōdhasamutthitaḥ|
kāmāt krōdhajvarō nāśaṁ krōdhāt kāmasamudbhavaḥ||322||
yāti tābhyāmubhābhyāṁ ca bhayaśōkasamutthitaḥ|
jvarasya vēgaṁ kālaṁ ca cintayañjvaryatē tu yaḥ||323||
tasyēṣṭaistu vicitraiśca viṣayairnāśayēt smr̥tim|324|
AshvAseneShTalAbhena vAyoH prashamanena ca||320||
harShaNaishca shamaM yAnti kAmashokabhayajvarAH|
kAmyairarthairmanoj~jaishca pittaghnaishcApyupakramaiH||321||
sadvAkyaishca shamaM yAti jvaraH krodhasamutthitaH|
kAmAt krodhajvaro nAshaM krodhAt kAmasamudbhavaH||322||
yAti tAbhyAmubhAbhyAM ca bhayashokasamutthitaH|
jvarasya vegaM kAlaM ca cintaya~jjvaryate tu yaH||323||
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 ''krodha'' gets subsided by providing the ''kamya artha'' (desired object), ''manojna artha'' (pleasing object), therapies for the alleviation of ''pitta'' and ''sadvakya'' (correct advice).
The ''jwara'' caused by ''krodha'' gets subsided by ''kama'' and that caused by ''kama'' gets cured by ''krodha. Jwara'' caused by ''bhaya'' (fear) and ''shoka'' (grief or sorrow) gets subsided by both ''kama'' and ''krodha''.
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||
प्रलपत्युष्णसर्वाङ्गः शीताङ्गश्च भवत्यपि|
विसञ्ज्ञो ज्वरवेगार्तः सक्रोध इव वीक्ष्यते ||३२५||
सदोषशब्दं च शकृद्द्रवं स्रवति वेगवत्|
लिङ्गान्येतानि जानीयाज्ज्वरमोक्षे विचक्षणः||३२६||
बहुदोषस्य बलवान् प्रायेणाभिनवो ज्वरः|
सत्क्रियादोषपक्त्या चेद्विमुञ्चति सुदारुणम्||३२७||
कृत्वा दोषवशाद्वेगं क्रमादुपरमन्ति ये|
तेषामदारुणो मोक्षो ज्वराणां चिरकारिणाम्||३२८||
<div class="mw-collapsible-content">
jvarapramōkṣē puruṣaḥ kūjan vamati cēṣṭatē|
śvasanvivarṇaḥ svinnāṅgō vēpatē līyatē muhuḥ||324||
pralapatyuṣṇasarvāṅgaḥ śītāṅgaśca bhavatyapi|
visañjñō jvaravēgārtaḥ sakrōdha iva vīkṣyatē ||325||
sadōṣaśabdaṁ ca śakr̥ddravaṁ sravati vēgavat|
liṅgānyētāni jānīyājjvaramōkṣē vicakṣaṇaḥ||326||
bahudōṣasya balavān prāyēṇābhinavō jvaraḥ|
satkriyādōṣapaktyā cēdvimuñcati sudāruṇam||327||
kr̥tvā dōṣavaśādvēgaṁ kramāduparamanti yē|
tēṣāmadāruṇō mōkṣō jvarāṇāṁ cirakāriṇām||328||
jvarapramokShe puruShaH kUjan vamati ceShTate|
shvasanvivarNaH svinnA~ggo vepate lIyate muhuH||324||
pralapatyuShNasarvA~ggaH shItA~ggashca bhavatyapi|
visa~jj~jo jvaravegArtaH sakrodha iva vIkShyate ||325||
sadoShashabdaM ca shakRuddravaM sravati vegavat|
li~ggAnyetAni jAnIyAjjvaramokShe vicakShaNaH||326||
bahudoShasya balavAn prAyeNAbhinavo jvaraH|
satkriyAdoShapaktyA cedvimu~jcati sudAruNam||327||
kRutvA doShavashAdvegaM kramAduparamanti ye|
teShAmadAruNo mokSho jvarANAM cirakAriNAm||328||
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<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]
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=== Signs of completely cured ''jwara'' patient ===
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विगतक्लमसन्तापमव्यथं विमलेन्द्रियम्|
युक्तं प्रकृतिसत्त्वेन विद्यात् पुरुषमज्वरम्||३२९||
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vigataklamasantāpamavyathaṁ vimalēndriyam|
yuktaṁ prakr̥tisattvēna vidyāt puruṣamajvaram||329||
vigataklamasantApamavyathaM vimalendriyam|
yuktaM prakRutisattvena vidyAt puruShamajvaram||329||
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<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]
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=== Precautions after being cured from ''jwara'' ===
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सज्वरो ज्वरमुक्तश्च विदाहीनि गुरूणि च|
असात्म्यान्यन्नपानानि विरुद्धानि च वर्जयेत्||३३०||
व्यवायमतिचेष्टाश्च स्नानमत्यशनानि च|
तथा ज्वरः शमं याति प्रशान्तो जायते न च||३३१||
व्यायामं च व्यवायं च स्नानं चङ्क्रमणानि च|
ज्वरमुक्तो न सेवेत यावन्न बलवान् भवेत्||३३२||
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sajvarō jvaramuktaśca vidāhīni gurūṇi ca|
asātmyānyannapānāni viruddhāni ca varjayēt||330||
vyavāyamaticēṣṭāśca snānamatyaśanāni ca|
tathā jvaraḥ śamaṁ yāti praśāntō jāyatē na ca||331||
vyāyāmaṁ ca vyavāyaṁ ca snānaṁ caṅkramaṇāni ca|
jvaramuktō na sēvēta yāvanna balavān bhavēt||332||
sajvaro jvaramuktashca vidAhIni gurUNi ca|
asAtmyAnyannapAnAni viruddhAni ca varjayet||330||
vyavAyamaticeShTAshca snAnamatyashanAni ca|
tathA jvaraH shamaM yAti prashAnto jAyate na ca||331||
vyAyAmaM ca vyavAyaM ca snAnaM ca~gkramaNAni ca|
jvaramukto na seveta yAvanna balavAn bhavet||332||
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<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.
Exercise, sexual intercourse, bath, ''chankramana'' (brisk walk) – these should be avoided by the person who has become free from ''jwara'' till he regains strength. [330-332]
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=== ''Punaravarti jwara'' (recurrent ''jwara'') ===
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असञ्जातबलो यस्तु ज्वरमुक्तो निषेवते|
वर्ज्यमेतन्नरस्तस्य पुनरावर्तते ज्वरः||३३३||
दुर्हृतेषु च दोषेषु यस्य वा विनिवर्तते|
स्वल्पेनप्यपचारेण तस्य व्यावर्तते पुनः||३३४||
चिरकालपरिक्लिष्टं दुर्बलं हीनतेजसम् [१] |
अचिरेणैव कालेन स हन्ति पुनरागतः||३३५||
अथवाऽपि परीपाकं धातुष्वेव क्रमान्मलाः|
यान्ति ज्वरमकुर्वन्तस्ते तथाऽप्यपकुर्वते||३३६||
दीनतां श्वयथुं ग्लानिं पाण्डुतां नान्नकामताम्|
कण्डूरुत्कोठपिडकाः कुर्वन्त्यग्निं च ते मृदुम्||३३७||
एवमन्येऽपि च गदा व्यावर्तन्ते पुनर्गताः|
अनिर्घातेन दोषाणामल्पैरप्यहितैर्नृणाम्||३३८||
निर्वृत्तेऽपि ज्वरे तस्माद्यथावस्थं यथाबलम्|
यथाप्राणं हरेद्दोषं प्रयोगैर्वा शमं नयेत्||३३९||
मृदुभिः शोधनैः शुद्धिर्यापना बस्तयो हिताः|
हिताश्च लघवो यूषा जाङ्गलामिषजा रसाः||३४०||
अभ्यङ्गोद्वर्तनस्नानधूपनान्यञ्जनानि च|
हितानि पुनरावृत्ते ज्वरे तिक्तघृतानि च||३४१||
गुर्व्यभिष्यन्द्यसात्म्यानां भोजनात् पुनरागते|
लङ्घनोष्णोपचारादिः क्रमः कार्यश्च पूर्ववत्||३४२||
किराततिक्तकं तिक्ता मुस्तं पर्पटकोऽमृता|
घ्नन्ति पीतानि चाभ्यासात् पुनरावर्तकं ज्वरम्||३४३||
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asañjātabalō yastu jvaramuktō niṣēvatē|
varjyamētannarastasya punarāvartatē jvaraḥ||333||
durhr̥tēṣu ca dōṣēṣu yasya vā vinivartatē|
svalpēnapyapacārēṇa tasya vyāvartatē punaḥ||334||
cirakālaparikliṣṭaṁ durbalaṁ hīnatējasam |
acirēṇaiva kālēna sa hanti punarāgataḥ||335||
athavā'pi parīpākaṁ dhātuṣvēva kramānmalāḥ|
yānti jvaramakurvantastē tathā'pyapakurvatē||336||
dīnatāṁ śvayathuṁ glāniṁ pāṇḍutāṁ nānnakāmatām|
kaṇḍūrutkōṭhapiḍakāḥ kurvantyagniṁ ca tē mr̥dum||337||
ēvamanyē'pi ca gadā vyāvartantē punargatāḥ|
anirghātēna dōṣāṇāmalpairapyahitairnr̥ṇām||338||
nirvr̥ttē'pi jvarē tasmādyathāvasthaṁ yathābalam|
yathāprāṇaṁ harēddōṣaṁ prayōgairvā śamaṁ nayēt||339||
mr̥dubhiḥ śōdhanaiḥ śuddhiryāpanā bastayō hitāḥ|
hitāśca laghavō yūṣā jāṅgalāmiṣajā rasāḥ||340||
abhyaṅgōdvartanasnānadhūpanānyañjanāni ca|
hitāni punarāvr̥ttē jvarē tiktaghr̥tāni ca||341||
gurvyabhiṣyandyasātmyānāṁ bhōjanāt punarāgatē|
laṅghanōṣṇōpacārādiḥ kramaḥ kāryaśca pūrvavat||342||
kirātatiktakaṁ tiktā mustaṁ parpaṭakō'mr̥tā|
ghnanti pītāni cābhyāsāt punarāvartakaṁ jvaram||343||
asa~jjAtabalo yastu jvaramukto niShevate|
varjyametannarastasya punarAvartate jvaraH||333||
durhRuteShu ca doSheShu yasya vA vinivartate|
svalpenapyapacAreNa tasya vyAvartate punaH||334||
cirakAlaparikliShTaM durbalaM hInatejasam [1] |
acireNaiva kAlena sa hanti punarAgataH||335||
athavA~api [2] parIpAkaM dhAtuShveva kramAnmalAH|
yAnti jvaramakurvantaste tathA~apyapakurvate||336||
dInatAM shvayathuM glAniM pANDutAM nAnnakAmatAm|
kaNDUrutkoThapiDakAH kurvantyagniM ca te mRudum||337||
evamanye~api ca gadA vyAvartante punargatAH|
anirghAtena doShANAmalpairapyahitairnRuNAm||338||
nirvRutte~api jvare tasmAdyathAvasthaM yathAbalam|
yathAprANaM hareddoShaM prayogairvA shamaM nayet||339||
mRudubhiH shodhanaiH shuddhiryApanA bastayo hitAH|
hitAshca laghavo yUShA jA~ggalAmiShajA rasAH||340||
abhya~ggodvartanasnAnadhUpanAnya~jjanAni ca|
hitAni punarAvRutte jvare tiktaghRutAni ca||341||
gurvyabhiShyandyasAtmyAnAM bhojanAt punarAgate|
la~gghanoShNopacArAdiH kramaH kAryashca pUrvavat||342||
kirAtatiktakaM tiktA mustaM parpaTako~amRutA|
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>
=== Guidelines for management ===
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तस्यां तस्यामवस्थायां ज्वरितानां विचक्षणः|
ज्वराक्रियाक्रमापेक्षी कुर्यात्तत्तच्चिकित्सितम्||३४४||
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tasyāṁ tasyāmavasthāyāṁ jvaritānāṁ vicakṣaṇaḥ|
jvarākriyākramāpēkṣī kuryāttattaccikitsitam||344||
tasyAM tasyAmavasthAyAM jvaritAnAM vicakShaNaH|
jvarAkriyAkramApekShI kuryAttattaccikitsitam||344||
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The wise physician should treat the patient in different stages of ''jwara'', according to the line of treatment of ''jwara''. [344]
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रोगराट् सर्वभूतानामन्तकृद्दारुणो ज्वरः|
तस्माद्विशेषतस्तस्य यतेत प्रशमे भिषक्||३४५||
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rōgarāṭ sarvabhūtānāmantakr̥ddāruṇō jvaraḥ|
tasmādviśēṣatastasya yatēta praśamē bhiṣak||345||
rogarAT sarvabhUtAnAmantakRuddAruNo jvaraH|
tasmAdvisheShatastasya yateta prashame bhiShak||345||
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<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]
</div>
=== Summary ===
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तत्र श्लोकः-
यथाक्रमं यथाप्रश्नमुक्तं ज्वरचिकित्सितम्|
आत्रेयेणाग्निवेशाय भूतानां हितकाम्यया||३४६||
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tatra ślōkaḥ-
yathākramaṁ yathāpraśnamuktaṁ jvaracikitsitam|
ātrēyēṇāgnivēśāya bhūtānāṁ hitakāmyayā||346||
tatra shlokaH-
yathAkramaM yathAprashnamuktaM jvaracikitsitam|
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]
== 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.
*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.
*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.
*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 ''[[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.
*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''.
*''[[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.
*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.
*''[[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 [[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.
*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 ''[[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.
*''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).
*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.
*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.
*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.
*If a person, who has become free from jwara, resorts to prohibited factors (as described before) before gaining strength, then the jwara reappears.
</div>
== Vidhi Vimarsha (Applied Inferences) ==
The clinical applications of jwara and different types of fevers are described in details in a separate article on [[Jwara]].
=== Related Chapters ===
*[[Jwara Nidana]] [[Jwara]]
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