Changes

The origin of jwara is because of the tendency for greed or attachment (parigraha). It has been described earlier in the nidana section that the origin of jwara resulted from the ferocious wrath of Rudra (lord Shiva).

The origin of jwara is because of the tendency for greed or attachment (parigraha). It has been described earlier in the nidana section 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 mischieves 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 organised a yajna (ritual of sacrifice) in which he did not offer any share to lord Shiva inspite 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 percieved whole of this situation regarding Daksha Prajapati’s non observance of rules and became angry. He then brought forward his Raudra (wrathful) bhava (nature) and opened his third eye, destroying all those demons by burning them and further gave rise to a child like form named ‘Virabhadra’ to his wrath, who was stuffed with his anger and was capable of destroying the yajna of Daksha. That child demolished the yajna of daksha prajapati as a result of which the gods got afflicted with burning sensation and pain and started running in different directions and became afflicted. Then the gods along with the seven rishis offered those substantial hymns to lord Shiva till he became pleased and switched over to his Shiva (the compassionate or benevolent and auspicious) form. When it was known that lord Shiva is returned to his auspicious disposition, then  Virabhadra who was produced from the wrathful fire of lord Shiva, who had three heads and nine eyes, used ash as his weapon, had the flame of his fire as his garland, was wrathful, had frightful and small thighs and stomach approached lord Shiva with folded hands and enquired about his future work. Lord Shiva replied to him that “you will become jwara in this world and afflict people in the beginning of life – at birth and at the time of death and will also afflict those who will resort to erratic regimen.”(14-25)

During the Treta yuga (second age) lord Shiva took a vow of not manifesting anger or wrath for one thousand celestial years. During this time the asuras (the demons) indulged in the creating obstruction, playing mischieves 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 organised a yajna (ritual of sacrifice) in which he did not offer any share to lord Shiva inspite 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 percieved whole of this situation regarding Daksha Prajapati’s non observance of rules and became angry. He then brought forward his Raudra (wrathful) bhava (nature) and opened his third eye, destroying all those demons by burning them and further gave rise to a child like form named ‘Virabhadra’ to his wrath, who was stuffed with his anger and was capable of destroying the yajna of Daksha. That child demolished the yajna of daksha prajapati as a result of which the gods got afflicted with burning sensation and pain and started running in different directions and became afflicted. Then the gods along with the seven rishis offered those substantial hymns to lord Shiva till he became pleased and switched over to his Shiva (the compassionate or benevolent and auspicious) form. When it was known that lord Shiva is returned to his auspicious disposition, then  Virabhadra who was produced from the wrathful fire of lord Shiva, who had three heads and nine eyes, used ash as his weapon, had the flame of his fire as his garland, was wrathful, had frightful and small thighs and stomach approached lord Shiva with folded hands and enquired about his future work. Lord Shiva replied to him that “you will become jwara in this world and afflict people in the beginning of life – at birth and at the time of death and will also afflict those who will resort to erratic regimen.”(14-25)

  Prabhava, the sequels of the disease:

 

==== Prabhava, the sequels of the disease ====

 

सन्तापः सारुचिस्तृष्णा साङ्गमर्दो हृदि व्यथा|  

सन्तापः सारुचिस्तृष्णा साङ्गमर्दो हृदि व्यथा|  

ज्वरप्रभावो, जन्मादौ निधने च महत्तमः||२६||  

ज्वरप्रभावो, जन्मादौ निधने च महत्तमः||२६||  

nidAne kAraNAnyaShTau pUrvoktAni  vibhAgashaH||27||   

nidAne kAraNAnyaShTau pUrvoktAni  vibhAgashaH||27||   

Earlier in the Nidana Sthana the etiological factors for each of the eight varieties of jwara have been described separately. (27)

Earlier in the Nidana Sthana the etiological factors for each of the eight varieties of jwara have been described separately. (27)

Premonitory symptoms of jwara:

 

==== Premonitory symptoms of jwara ====

 

आलस्यं नयने सास्रे जृम्भणं गौरवं क्रमः|  

आलस्यं नयने सास्रे जृम्भणं गौरवं क्रमः|  

ज्वलनातपवाय्वम्बुभक्तिद्वेषावनिश्चितौ||२८||  

ज्वलनातपवाय्वम्बुभक्तिद्वेषावनिश्चितौ||२८||  

–  

–  

Laziness, lacrimation, yawning, heaviness, mental fatigue, uncertainty and intolerance about the liking and disliking for the heat, sun, wind and water; indigestion, anorexia, depletion in strength, complexion, and slight change in conduct, are the premonitory signs and symptoms of jwara.(28-29)  

Laziness, lacrimation, yawning, heaviness, mental fatigue, uncertainty and intolerance about the liking and disliking for the heat, sun, wind and water; indigestion, anorexia, depletion in strength, complexion, and slight change in conduct, are the premonitory signs and symptoms of jwara.(28-29)  

Sites of jwara:

 

==== Sites of jwara ====

 

केवलं समनस्कं च ज्वराधिष्ठानमुच्यते|  

केवलं समनस्कं च ज्वराधिष्ठानमुच्यते|  

शरीरं, बलकालस्तु निदाने सम्प्रदर्शितः||३०||  

शरीरं, बलकालस्तु निदाने सम्प्रदर्शितः||३०||  

The whole body and the mind are the sites of manifestation of jwara. The severity and the time of manifestation of jwara have been described in Nidana sthana.(30)

The whole body and the mind are the sites of manifestation of jwara. The severity and the time of manifestation of jwara have been described in Nidana sthana.(30)

Cardinal feature:

 

==== Cardinal feature ====

 

ज्वरप्रत्यात्मिकं लिङ्गं सन्तापो देहमानसः|  

ज्वरप्रत्यात्मिकं लिङ्गं सन्तापो देहमानसः|  

ज्वरेणाविशता भूतं न हि किञ्चिन्न तप्यते||३१||  

ज्वरेणाविशता भूतं न हि किञ्चिन्न तप्यते||३१||  

The clinical features invariably associated with jwara are the feeling of heat or increased body temperature and discomfort in body and mind. Jwara afflicts the whole body including mind and sensory organs in all living beings. (31)

The clinical features invariably associated with jwara are the feeling of heat or increased body temperature and discomfort in body and mind. Jwara afflicts the whole body including mind and sensory organs in all living beings. (31)

Classification :

 

==== Classification ====

 

द्विविधो विधिभेदेन ज्वरः शारीरमानसः|  

द्विविधो विधिभेदेन ज्वरः शारीरमानसः|  

पुनश्च द्विविधो दृष्टः सौम्यश्चाग्नेय एव वा||३२||  

पुनश्च द्विविधो दृष्टः सौम्यश्चाग्नेय एव वा||३२||  

Depending upon the ashraya (site of manifestation in the body) among the seven dhatus (body tissues) jwara is again classified into seven categories.

Depending upon the ashraya (site of manifestation in the body) among the seven dhatus (body tissues) jwara is again classified into seven categories.

Jwara is classified into eight types on the basis of eight causes of jwara (dosa predominance). (32-35)  

Jwara is classified into eight types on the basis of eight causes of jwara (dosa predominance). (32-35)  

Clinical features of somatic and psychic jwara:

 

==== Clinical features of somatic and psychic jwara ====

 

शारीरो जायते पूर्वं देहे, मनसि मानसः|  

शारीरो जायते पूर्वं देहे, मनसि मानसः|  

वैचित्त्यमरतिर्ग्लानिर्मनसस्तापलक्षणम्||३६||  

वैचित्त्यमरतिर्ग्लानिर्मनसस्तापलक्षणम्||३६||  

vaicittyamaratirglānirmanasastāpalakṣaṇam||36||  

vaicittyamaratirglānirmanasastāpalakṣaṇam||36||  

indriyāṇāṁ ca vaikr̥tyaṁ jñēyaṁ  santāpalakṣaṇam|37|

indriyāṇāṁ ca vaikr̥tyaṁ jñēyaṁ  santāpalakṣaṇam|37|

shArIro jAyate pUrvaM dehe, manasi mAnasaH|  

shArIro jAyate pUrvaM dehe, manasi mAnasaH|  

The sharira type of jwara first appears in the body and the manasa type, first appears in the mind. Vaichitya (mental unstability), arati (disliking for everything) and glani (feeling of weakness in the body) are the signs and symptoms of the manas tapa (mental affliction of jwara). The loss of ease in sensing the objects is the feature of the santapa of the indriya. (36-37)

The sharira type of jwara first appears in the body and the manasa type, first appears in the mind. Vaichitya (mental unstability), arati (disliking for everything) and glani (feeling of weakness in the body) are the signs and symptoms of the manas tapa (mental affliction of jwara). The loss of ease in sensing the objects is the feature of the santapa of the indriya. (36-37)

Desires of patient to diagnose dosha dominance:

 

==== Desires of patient to diagnose dosha dominance ====

 

वातपित्तात्मकः शीतमुष्णं वातकफात्मकः||३७||  

वातपित्तात्मकः शीतमुष्णं वातकफात्मकः||३७||  

इच्छत्युभयमेतत्तु ज्वरो व्यामिश्रलक्षणः|३८|  

इच्छत्युभयमेतत्तु ज्वरो व्यामिश्रलक्षणः|३८|  

A patient suffering from vatapittaja vareity of jwara desires for cold things, while, a patient suffering from jwara caused by vata and kapha dosa longs for hot things. However, when both of these types of doshas get mixed then such patient manifests both the kinds of symptoms. (37-38)

A patient suffering from vatapittaja vareity of jwara desires for cold things, while, a patient suffering from jwara caused by vata and kapha dosa longs for hot things. However, when both of these types of doshas get mixed then such patient manifests both the kinds of symptoms. (37-38)

Attenuating nature of vata dosha:

==== Attenuating nature of vata dosha ====

 

योगवाहः परं वायुः संयोगादुभयार्थकृत्||३८||  

योगवाहः परं वायुः संयोगादुभयार्थकृत्||३८||  

दाहकृत्तेजसा युक्तः, शीतकृत् सोमसंश्रयात्|३९|  

दाहकृत्तेजसा युक्तः, शीतकृत् सोमसंश्रयात्|३९|  

Vata dosha is exceedingly yogavahi (which accentuates the properties of others) in nature. It produces both type of effects on combination with the two doshas. On combining with tejas it produces burning sensation while in combination with soma it produces cooling effect. (38-39)

Vata dosha is exceedingly yogavahi (which accentuates the properties of others) in nature. It produces both type of effects on combination with the two doshas. On combining with tejas it produces burning sensation while in combination with soma it produces cooling effect. (38-39)

अन्तर्दाहोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||३९||  

अन्तर्दाहोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||३९||  

सन्ध्यस्थिशूलमस्वेदो दोषवर्चोविनिग्रहः|  

सन्ध्यस्थिशूलमस्वेदो दोषवर्चोविनिग्रहः|  

Excessive burning sensation inside the body, morbid thirst, delirium, dyspnea, giddiness, pain in bones and joints, absence of sweating, non-excretion of doshas and the faeces – are the clinical features of antarvegi jwara (internal manifestation of jwara).  

Excessive burning sensation inside the body, morbid thirst, delirium, dyspnea, giddiness, pain in bones and joints, absence of sweating, non-excretion of doshas and the faeces – are the clinical features of antarvegi jwara (internal manifestation of jwara).  

Excessive rise in the body temperature and above features in mild form are the features of bahirvegi (external type of jwara) and this type of jwara is easily curable. (39-41)

Excessive rise in the body temperature and above features in mild form are the features of bahirvegi (external type of jwara) and this type of jwara is easily curable. (39-41)

Prakrita jwara(seasonal jwara):

 

==== Prakrita jwara(seasonal jwara) ====

 

प्राकृतः सुखसाध्यस्तु वसन्तशरदुद्भवः|  

प्राकृतः सुखसाध्यस्तु वसन्तशरदुद्भवः|  

उष्णमुष्णेन संवृद्धं पित्तं शरदि कुप्यति||४२||  

उष्णमुष्णेन संवृद्धं पित्तं शरदि कुप्यति||४२||  

prAyeNAnilajo duHkhaH kAleShvanyeShu vaikRutaH|  

prAyeNAnilajo duHkhaH kAleShvanyeShu vaikRutaH|  

hetavo vividhAstasya nidAne sampradarshitAH||49||  

hetavo vividhAstasya nidAne sampradarshitAH||49||  

 

Jwara manifesting in the vasanta or spring season and sharada or autumn season is called prakrita (seasonal) jwara and is easily curable.  

Jwara manifesting in the vasanta or spring season and sharada or autumn season is called prakrita (seasonal) jwara and is easily curable.  

Pitta gets aggravated during autumn season because of its inherent hot properties and hot environment. Kapha gets accumulated in winters and gets aggravated during spring season.  

Pitta gets aggravated during autumn season because of its inherent hot properties and hot environment. Kapha gets accumulated in winters and gets aggravated during spring season.  

¨ kaphaja jwara occurring in seasons other than spring.  

¨ 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)

The causative factors of the different types of jwara have been described in nidana sthana (in jwara). (42-49)

Prognosis of jwara:

 

==== Prognosis of jwara ====

 

बलवत्स्वल्पदोषेषु ज्वरः साध्योऽनुपद्रवः|

बलवत्स्वल्पदोषेषु ज्वरः साध्योऽनुपद्रवः|

हेतुभिर्बहुभिर्जातो बलिभिर्बहुलक्षणः||५०||  

हेतुभिर्बहुभिर्जातो बलिभिर्बहुलक्षणः||५०||  

  Tikshna jwara (severe, associated with delirium, giddiness and breathlessness causes death of the patient either on the seventh, tenth or twelth day.

  Tikshna jwara (severe, associated with delirium, giddiness and breathlessness causes death of the patient either on the seventh, tenth or twelth 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)

Jwara occurring in a weak and emaciated person (kshina), associated with edema (shunasya), seated in deeper body tissues (gambhira), severe (balvan) and that occurring for very long durations (dirgha ratrika) are incurable ones. The jwara in which, the mid hair part of scalp becomes visible, is also considered incurable (kesha simanta krita).(49-53)

Five types of jwara as per frequency:

 

==== Five types of jwara as per frequency ====

Santata jwara:

Santata jwara:

स्रोतोभिर्विसृता दोषा गुरवो रसवाहिभिः||५३||  

स्रोतोभिर्विसृता दोषा गुरवो रसवाहिभिः||५३||