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Line 253: − − ===Clinical features of remission=== − − Following features are observed for remission. − Decrease in body temperature and intensity of disease symptoms, lightness in body and proper bowel movements. [Su.Sa.Uttara Sthana.39/115]<ref name=Susruta/> Line 350:
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Line 651: − + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + − [Cha.Sa.[[Chikitsa Sthana]].3/75-82] [Su.Sa.Uttarasthana.39/83-88]<ref name=Susruta/> − {| class="wikitable" − |+ Table 6: Clinical features and management of dhatugatajwara − |- − ! [[Dhatu]] affected !! Clinical features !! Treatment of choice [Cha.Sa.[[Chikitsa Sthana]].3/315-17]!!Drug of choice <ref name=Ranade/> − |- − | | Nutrient fluids ([[rasa dhatu]]) || Heaviness, miserable feeling, anxiety, exhaustion, vomiting, anorexia, increase in external temperature, body ache and yawning || Therapeutic emesis (vamana) and fasting (langhana)|| Piper longum (pippali) − |- − | | Blood ([[rakta dhatu]]) || Increase in body temperature, eruptions, thirst, frequent hemoptysis, burning sensation, discoloration, giddiness, intoxication and incoherent speech || External application of medicaments like pouring decoctions and anointing medicines over body || Hemidesmus indicus (sariva) − |- − | | Muscle tissue ([[mamsa dhatu]]) || Internal feeling of burning, thirst, unconsciousness, weakness, diarrhea, bad body odor and abnormal muscle movements like throwing away limbs || Therapeutic purgation ([[virechana]]) and fasting || Tinospora cordifolia (guduchi) − |- − | | Adipose tissue ([[meda dhatu]]) || Excessive sweating, thirst, incoherent speech, frequent vomiting, inability to tolerate own body odor, fatigue and anorexia || Therapeutic purgation ([[virechana]]) and fasting || Azadirachta indica (nimba) − |- − | | Bone tissue ([[asthi dhatu]]) || Diarrhea, emesis, pain in the bones, cooing sound (kujana), convulsive movements of the body and limbs, dyspnea || Decoction enema and untuous enema || Triphala (Terminalia chebula, Treminalia bellirica and Phyllanthus emblica) − |- − | | Bone marrow ([[majja dhatu]]) || Hiccup, severe dyspnea, cough, feeling of entering into darkness frequently, cutting pain in the vital organs (marma), feeling of cold externally and internal burning sensation || Decoction enema and untuous enema || Iron (lauha) − |- − | | Reproductive fluid/semen ([[shukra]]) || Rigidity of penis, ejaculation and destruction of semen resulting in the extinction of life || Incurable || -- − |- − |}
no edit summary
Jwara is an important disease. The term ‘Jwara’ implies the ability of a disease to cause anguish to body and mind. [SAT-C.7]<ref>http://namstp.ayush.gov.in/#/sat</ref> This suggests suffering or illness. Based on the similarity in clinical features, Jwara is often considered as fever or pyrexia in medical terminologies. However, according to Ayurveda,the classical description of jwara includes variety of other clinical conditions with or without rise in body temperature. Therefore, fever or hyperpyrexia is considered as only one among the many features of jwara.
Jwara is an important disease. The term ‘Jwara’ implies the ability of a disease to cause anguish to body and mind. [SAT-C.7]<ref>http://namstp.ayush.gov.in/#/sat</ref> This suggests suffering or illness. Based on the similarity in clinical features, Jwara is often considered as fever or pyrexia in medical terminologies. However, according to Ayurveda,the classical description of jwara includes variety of other clinical conditions with or without rise in body temperature. Therefore, fever or hyperpyrexia is considered as only one among the many features of jwara.
Keywords: Jwara, fever, roga, rise in body temperature, hyperpyrexia, infectious disease, noninfectious diseases in Ayurveda.
Keywords: Jwara, fever, roga, rise in body temperature, hyperpyrexia, infectious disease, noninfectious diseases in Ayurveda.
=Jwara=
==Causes==
==Causes==
==Pathogenesis==
==Pathogenesis==
[[File:Jwara_samprapti.JPG|500px|'''Image 1: Samprapti of Jwara'''|thumb]]
[[File:Jwara_samprapti.JPG|500px|'''Image 1: Samprapti of Jwara'''|thumb]]
If the strength of the individual is normal, then the medicines are administered at a suitable stage and only if required. The general period for natural remission is one week. If jwara does not subside and deterioration in condition is observed due to acute aggravation of [[pitta]] [[dosha]], then medicines are prescribed. [Su.Sa.Uttara Sthana.39/119]<ref name=Susruta/>
If the strength of the individual is normal, then the medicines are administered at a suitable stage and only if required. The general period for natural remission is one week. If jwara does not subside and deterioration in condition is observed due to acute aggravation of [[pitta]] [[dosha]], then medicines are prescribed. [Su.Sa.Uttara Sthana.39/119]<ref name=Susruta/>
'''Consumption of ghee'''
'''Consumption of ghee'''
Jwara in initial and acute stage with recent onset (less than seven days) is nava jwara. The dosha are afflicted with [[ama]].
Jwara in initial and acute stage with recent onset (less than seven days) is nava jwara. The dosha are afflicted with [[ama]].
Synonyms: Tarunajwara, ama jwara, acute state
'''Synonyms:''' Tarunajwara, ama jwara, acute state
==Clinical features==
==Clinical features==
|+ Table 2: Sannipataja Jwara
|+ Table 2: Sannipataja Jwara
|-
|-
! State of [[dosha]] !! Clinical features
! State of [[dosha]] !! Clinical features*
|-
|-
| | [[Vata]] and [[pitta]] are codominant, while [[kapha]] is recessive || Giddiness, thirst, burning sensation, heaviness and excessive headache.
| | [[Vata]] and [[pitta]] are codominant, while [[kapha]] is recessive || Giddiness, thirst, burning sensation, heaviness and excessive headache.
|-
|-
|}
|}
[Cha.Sa.[[Chikitsa Sthana]].3/91-109]
*[Cha.Sa.[[Chikitsa Sthana]].3/91-109]
===Abhinyasa/hataujasa jwara===
===Abhinyasa/hataujasa jwara===
==General clinical features==
==General clinical features==
Irregular onset, irregular symptoms and irregular time of appearance may stay for longer duration in vishamajwara. [A.Hr.NidanaSthana 2/69]<ref name=Hridaya/>
Irregular onset, irregular symptoms and irregular time of appearance may stay for longer duration in vishamajwara. [A.Hr.Nidana Sthana 2/69]<ref name=Hridaya/>
{| class="wikitable"
{| class="wikitable"
[[Kapha]] predominant vishamajwara is managed through therapeutic emesis ([[vamana]]). Fasting, administration of hot decoction and digestive medicines are done. Diet and drinks should not be unctuous in nature. [Cha.Sa.[[Chikitsa Sthana]].3/293-96]
[[Kapha]] predominant vishamajwara is managed through therapeutic emesis ([[vamana]]). Fasting, administration of hot decoction and digestive medicines are done. Diet and drinks should not be unctuous in nature. [Cha.Sa.[[Chikitsa Sthana]].3/293-96]
Commonly used herbs:
'''Commonly used herbs:'''
Phyllanthus emblica (amalaki), Terminalia bellirica (bibitaki), Terminalia chebula (haritaki), Picrorhiza kurroa (katukarohini), Trichosanthes cucumerina (patola), Swertia chirayata (kiratatikta), Holarrhena pubescens (vatsaka).
Phyllanthus emblica (amalaki), Terminalia bellirica (bibitaki), Terminalia chebula (haritaki), Picrorhiza kurroa (katukarohini), Trichosanthes cucumerina (patola), Swertia chirayata (kiratatikta), Holarrhena pubescens (vatsaka).
Medicated ghee: Shatpalagrita, Kalyanakagrita, Tiktakagrita
'''Medicated ghee:''' Shatpalagrita, Kalyanakagrita, Tiktakagrita
[[Panchakarma]] procedures:
'''[[Panchakarma]] procedures:'''
*Fumigation with medicines like Aparajitadhuma [A.Hr.Chikitsa Sthana.1/164]<ref name=Hridaya/>
*Fumigation with medicines like Aparajitadhuma [A.Hr.Chikitsa Sthana.1/164]<ref name=Hridaya/>
*If jwara is not responding by the above said procedures, venesection ([[raktamokshana]])is indicated. [A.Hr.Chikitsa Sthana.1/166]<ref name=Hridaya/>
*If jwara is not responding by the above said procedures, venesection ([[raktamokshana]])is indicated. [A.Hr.Chikitsa Sthana.1/166]<ref name=Hridaya/>
Specific formulations for five types:
'''Specific formulations for five types:'''
The five types of vishamajwara are managed by five decoctions made from drugs described below:
The five types of vishama jwara are managed by five decoctions made from drugs described below:
#In santatajwara, Kalingaka, patola leaves and katukarohini)
#In santatajwara, Kalingaka, patola leaves and katukarohini)
#In satatajwara,Patola, sariva, musta, patha and katukarohini)
#In satatajwara,Patola, sariva, musta, patha and katukarohini)
[Chikitsapradeepa]<ref>Gokhale B.V. Jwararoga.In: Chikitsapradeep.Pune:Dhanwantary Pratishthan;1989:1-3.</ref>
[Chikitsapradeepa]<ref>Gokhale B.V. Jwararoga.In: Chikitsapradeep.Pune:Dhanwantary Pratishthan;1989:1-3.</ref>
[[Rasayana]] therapy:
'''[[Rasayana]] therapy:'''
Vardhamanapippali rasayana to prevent recurrence is advised.
Vardhamanapippali rasayana to prevent recurrence is advised.
=Jwara affecting body tissues (dhatugata jwara)=
=Jwara affecting body tissues (dhatugata jwara)=
When jwara affects body tissues, it produces tissue specific clinical features. These conditions of lodging pathogenic factors of jwara at different tissues ([[dhatu]]) are termed as ‘dhatugatajwara’. This suggests progressive stages of disease affecting deeper tissues.
When jwara affects body tissues, it produces tissue specific clinical features. These conditions of lodging pathogenic factors of jwara at different tissues ([[dhatu]]) are termed as ‘dhatugatajwara’. This suggests progressive stages of disease affecting deeper tissues.[Cha.Sa.[[Chikitsa Sthana]].3/75-82] [Su.Sa.Uttarasthana.39/83-88]<ref name=Susruta/>
==Jwara affecting nutrient fluids ([[rasa dhatu]])==
===Clinical features===
Heaviness, miserable feeling, anxiety, exhaustion, vomiting, anorexia, increase in external temperature, body ache and yawning
===Treatment of choice===
Therapeutic emesis (vamana) and fasting (langhana)[Cha.Sa.[[Chikitsa Sthana]].3/315-17]
Drug of choice: Piper longum (pippali) <ref name=Ranade/>
==Jwara affecting Blood ([[rakta dhatu]])==
===Clinical features===
Increase in body temperature, eruptions, thirst, frequent hemoptysis, burning sensation, discoloration, giddiness, intoxication and incoherent speech
===Treatment of choice===
External application of medicaments like pouring decoctions and anointing medicines over body [Cha.Sa.[[Chikitsa Sthana]].3/315-17]
Drug of choice: Hemidesmus indicus (sariva) <ref name=Ranade/>
==Jwara affecting Muscle tissue ([[mamsa dhatu]])==
===Clinical features===
Internal feeling of burning, thirst, unconsciousness, weakness, diarrhea, bad body odor and abnormal muscle movements like throwing away limbs
===Treatment of choice===
Therapeutic purgation ([[virechana]]) and fasting [Cha.Sa.[[Chikitsa Sthana]].3/315-17]
Drug of choice: Tinospora cordifolia (guduchi) <ref name=Ranade/>
==Jwara affecting Adipose tissue ([[meda dhatu]])==
===Clinical features===
Excessive sweating, thirst, incoherent speech, frequent vomiting, inability to tolerate own body odor, fatigue and anorexia
===Treatment of choice===
Therapeutic purgation ([[virechana]]) and fasting [Cha.Sa.[[Chikitsa Sthana]].3/315-17]
Drug of choice: Azadirachta indica (nimba) <ref name=Ranade/>
==Jwara affecting Bone tissue ([[asthi dhatu]]) ==
===Clinical features===
Diarrhea, emesis, pain in the bones, cooing sound (kujana), convulsive movements of the body and limbs, dyspnea
===Treatment of choice===
Decoction enema and untuous enema [Cha.Sa.[[Chikitsa Sthana]].3/315-17]
Drug of choice: Triphala (Terminalia chebula, Treminalia bellirica and Phyllanthus emblica) <ref name=Ranade/>
==Jwara affecting Bone marrow ([[majja dhatu]])==
===Clinical features===
Hiccup, severe dyspnea, cough, feeling of entering into darkness frequently, cutting pain in the vital organs (marma), feeling of cold externally and internal burning sensation
===Treatment of choice===
Decoction enema and untuous enema [Cha.Sa.[[Chikitsa Sthana]].3/315-17]
Drug of choice: Iron (lauha) <ref name=Ranade/>
==Jwara affecting Reproductive fluid/semen ([[shukra]]) ==
===Clinical features===
Rigidity of penis, ejaculation and destruction of semen resulting in the extinction of life
===Treatment of choice===
Incurable [Cha.Sa.[[Chikitsa Sthana]].3/315-17]
==Prognosis==
==Prognosis==