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Line 399: − + − − ===Medicinal preparations=== − − '''Medicated water with six herbs (shadangapaniya):''' − − Six herbs viz. Cyperus rotundus ([[musta]]), Fumaria parviflora (parpata), Chrysopogon zizanioides (ushira), Santalum album ([[chandana]]), Plectranthus vettiveroides (udichya) and Zingiber officinale ([[nagara]]) are boiled in water and then cooled. This water is prescribed for drinking. It helps to normalize body temperature and satisfy thirst. [Cha.Sa.[[Chikitsa Sthana]] 3/145] − − '''Medicated gruels (yavagu):''' − − Medicated gruels are prescribed after fasting. This dietary preparation is light to digest, promotes sweating, pacifies thirst and sustains vitality by providing nourishment. [Cha.Sa.[[Chikitsa Sthana]] 3/152] This can be continued for 6 days. − − The medicated gruel is contraindicated in cases of excessive intake of alcohol, bleeding disorders especially through the upper orifices, in summer season and aggravation of [[pitta]] and [[kapha dosha]].[Cha.Sa.[[Chikitsa Sthana]] 3/154] In such conditions, food including powdered roasted grains mixed with fruit juices, sugar or honey are prescribed for nourishment. [Cha.Sa.[[Chikitsa Sthana]] 3/155] − − ===Panchakarma procedures=== − − *Fomentation ([[swedana]]): Mild fomentation by using a thick blanket to cover body and induce sweating is advised. It removes obstruction in sweat pores, releases trapped body heat and promotes normal movement of [[dosha]]. − − *Therapeutic emesis ([[vamana]]): It is indicated only in conditions of jwara with excessively aggravated [[kapha dosha]]. [Cha.Sa.[[Chikitsa Sthana]] 3/147] − − ===Precautions in diet and lifestyle=== − − In this stage, the patient shall avoid daytime sleep, head bath, external application of oils, sexual intercourse, direct exposure to wind, excessive physical activities, heavy to digest food, overuse of astringent and sweet taste, food items with hot potency and unctuous property, anger. [Cha.Sa.[[Chikitsa Sthana]] 3/138-39] [Cha.Sa.[[Chikitsa Sthana]] 3/195] − − =Jeerna jwara (Chronic stage)= − − Jwara lasting for more than seven days leading to a chronic disease is jeerna jwara. The acute stage is converted into chronic after therapeutic fasting is over and the [[dosha]] are not afflicted with [[ama]] state. [A.Hr.Nidana Sthana.2/56]<ref name=Hridaya/> Some opine a period of more than three weeks to term the condition as jeerna jwara [M.Ni.2/65]<ref name=Madava>Madhavakara. Madhava Nidanam (Roga vinischaya). Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007</ref> − − ==Clinical feature== − − Presence of mild features of jwara with weak digestion.[M.Ni.2/65]<ref name=Madava/> − − ==Pathogenesis== − − If the tolerance or immunity of body tissues ([[dhatu]]) is weak, the jwara affects them for a longer duration leading to chronic stage. [Cha.Sa.[[Chikitsa Sthana]] 3/291] − − ==Management== − − Fasting is contraindicated in chronic stage. The weakened body tissues do not tolerate fasting. Therefore, nourishing and strength promoting diet is advised. [Cha.Sa.[[Chikitsa Sthana]] 3/292] − − In chronic stage due to aggravation of [[vata]] and [[pitta dosha]], internal administration of medicated ghee is recommended. [Cha.Sa.[[Chikitsa Sthana]] 3/164] The unctuous property and cold potency of medicated ghee pacifiers [[vata]] and [[pitta dosha]]. [Cha.Sa.[[Nidana Sthana]] 1/37] − − Consumption of milk is also indicated in chronic stage. Choice of using it either hot or cold or processed with appropriate herbs depends on dominance of [[dosha]] in conditions. [Cha.Sa.[[Chikitsa Sthana]] 3/239] − − ===[[Panchakarma]] procedures=== − − Purification therapies are indicated in chronic stage, only if the patient does not respond to pacification therapies. [Cha.Sa. [[Chikitsa Sthana]] 3/168] − − '''Therapeutic purgation ([[virechana]]):''' It is indicated only if the patient’s muscle mass, digestion and strength are not depleted. [Cha.Sa. [[Chikitsa Sthana]] 3/169] − − '''Decoction enema (niruha basti):''' It is indicated in chronic debilitated conditions where therapeutic emesis ([[vamana]]) and purgation ([[virechana]]) are contraindicated. It promotes strength and power of digestion. [Cha.Sa.[[Chikitsa Sthana]] 3/170] − − '''Unctuous enema (anuvasana basti):''' It is indicated in case of aggravation of [[vata dosha]], depletion of [[kapha]] and [[pitta dosha]]. It is suitable for those having strong digestive power, but dry stools and difficulty in defecation. [Cha.Sa.[[Chikitsa Sthana]] 3/172-73] − − '''Intranasal drug administration ([[nasya]]):'''It is indicated for patients having heaviness, headache and impaired sensoria. [Cha.Sa.[[Chikitsa Sthana]] 1/173-74] − − '''Currently used herbal formulations:'''<ref name=Ranade>Jwara. In: Ranade S,ed.1 Kayachikitsa.Delhi: Chaukhamba Sanskrit pratishthan; 2005</ref> Dashaashtanga churna, Samshamani Vati. − − '''Currently used herbo-mineral formulations:''' Laghumalini vasant [R.T.S Kharaliya rasayana]<ref name=rasatantrasara> Krishnanand Maharaj. Rasatantrasara and Siddhaprayoga sangraha. 15th ed. Kalera-Krishna Gopal: Krishnagopal Ayurved Bhavan:2001</ref> Jeernajwarankusha rasa, Suvarnamalini vasanta [R.T.S Kharaliya rasayana]<ref name=rasatantrasara/>, Arogyavardhini rasa [R.R.S Chapter 20]<ref name=RRS> Vagbhata, Rasa ratna samucchaya. Edited by Ambikadatta Sastri. 9th ed. Varanasi: Chaukhambha Amarabharati Prakashan; 1995</ref>. − − =Sannipata jwara (vitiation of all three [[dosha]])= − − The condition of jwara in which all three [[dosha]] are vitiated simultaneously is known as “sannipata jwara”. [Cha.Sa.[[Nidana Sthana]] 1/29] The proportion of [[dosha]] involved in the pathogenesis may be different or equal based on exposure to causes. − − ==General clinical features== − − Following are general clinical features observed in sannipataja jwara conditions: − − Insomnia, giddiness, dyspnea, drowsiness, numbness, anorexia, thirst, fainting, rigidity, frequent sensation of burning and cold, cardiac pain, delayed response of transformation of [[dosha]], insanity, blackish teeth, rough and blackish tongue; pain in joints, head and bones; crooked and dirty eyes; sticky eyelashes; tinnitus and pain in ears; delirium; inflammation of body channels; cooing sound; loss of consciousness; delayed elimination and depletion of sweat, urine and feces.[Su.Sa.Uttara Sthana.39/35-39]<ref name=Susruta/> − − ==Classification== − The sannipataja jwara is presented in thirteen types of clinical presentations due to variable vitiated states of [[dosha]]. The clinical features are described as below: − {| class="wikitable" − |+ Table 2: Sannipataja Jwara − |- − ! State of [[dosha]] !! Clinical features* − |- − | | [[Vata]] and [[pitta]] are codominant, while [[kapha]] is recessive || Giddiness, thirst, burning sensation, heaviness and excessive headache. − |- − | | [[Vata]] and [[kapha]] are codominant, while [[pitta]] is recessive || Coldness, cough, anorexia, drowsiness, thirst, burning sensation and pain. − |- − | | [[Pitta]] and [[kapha]] are codominant, while [[vata]] is recessive || Emesis, coldness, frequent burning sensation, thirst, unconsciousness and pain in the bones. − |- − | | [[Vata]] predominant condition || Pain in the joints, bones and head; delirium, heaviness, giddiness, thirst and dryness of the throat as well as the mouth. − |- − | | [[Pitta]] predominant condition || Blood in stool and urine, burning sensation, vomiting, disliking for doing any work, giddiness, drowsiness and cough. − |- − | | [[Kapha]] predominant condition || Laziness, anorexia, nausea, burning sensation, vomiting, restlessness, giddiness, drowsiness and cough. − |- − | | [[Kapha]] is excessively vitiated, [[pitta]] moderately vitiated and [[vata]] is less vitiated || Coryza, vomiting, laziness, drowsiness, anorexia and weak digestion. − |- − | | [[Pitta]] is excessively vitiated, [[kapha]] moderately vitiated and [[vata]] is less vitiated || Yellowish discoloration of urine and eyes, burning sensation, thirst, giddiness and anorexia. − |- − | | [[Vata]] is excessively vitiated, [[kapha]] moderately vitiated and [[pitta]] is less vitiated || Headache, trembling, breathlessness, delirium, vomiting and anorexia. − |- − | | [[Kapha]] is excessively vitiated, [[vata]] moderately vitiated and [[pitta]] is less vitiated || Coldness, heaviness, drowsiness, delirium and excessive pain in bones as well as head. − |- − | | [[Vata]] is excessively vitiated, [[pitta]] moderately vitiated and [[kapha]] is less vitiated || Dyspnea, cough, coryza, dryness of the mouth and excessive pain in the flanks. − |- − | | [[Pitta]] is excessively vitiated, [[vata]] moderately vitiated and [[kapha]] is less vitiated || Diarrhea, weak digestion, thirst, burning sensation, anorexia and giddiness. − |- − | | All the three [[dosha]]s vitiated to equal extent || 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]]); Makes cooing sound constantly; Urticaria and bluish-black or reddish circular patches appear on the skin; Patient speaks less or unable to speak; Inflammation of passages; Heaviness in the abdomen; The [[dosha]] return to its [[ama]] free state or normal state after a very long time. − |- − |} − − *[Cha.Sa.[[Chikitsa Sthana]] 3/91-109] − − '''Abhinyasa/hataujasa jwara''' − − The specific condition of sannipata jwara in which [[ojas]] is affected is known as hatojasa jwara or abhinyasa jwara. It is presented with following clinical features: − − Moderate rise in body temperature, lowered state of consciousness, illusion, feeble voice, rough tongue, sore throat, absence of sweating, constipation, watering of eyes, cardiac pain, aversion to food, loss of luster and the person lies down panting, delirium and other complications. [Su.Sa.Uttara Sthana.39/39-40]<ref name=Susruta/> − − This condition is difficult to cure. − − {| class="wikitable" − |+ Table 3: Cardinal feature of Sannipataja jwara* − |- − ! Cardinal feature !! Type of sannipatajwara − |- − | | Excessive sleep || Abinyasa − |- − | | Weakness or wasting || Hataujasa − |- − | | Immovable limbs || Sanyaasa − |- − |} − *[Su.Sa.Uttara Tantra 39/42]<ref name=Susruta/> − − ==Prognosis== − − Sannipata jwara is incurable or difficult to cure if functions of [[dosha]] are obstructed, digestive capacity is very poor, and the condition is severe with presence of all clinical features.[A.Hr.Nidana Sthana.2/34]<ref name=Hridaya/> − − Sannipata jwara associated with development of swelling at the parotid site (root of ear) is incurable. [Cha.Sa.[[Chikitsa Sthana]] 3/287] − − ==Principles of management== − − The sannipata jwara is managed with following principles: − − #Improve the state of depleted [[dosha]] (by use of property, action, or substances similar to that [[dosha]]) − #Decrease the state of aggravated [[dosha]] (either by pacification or by purification treatments) − #Target the sites of [[kapha dosha]] primarily [Cha.Sa.[[Chikitsa Sthana]] 3/286-87] − − =Vishama jwara= − − The condition of jwara in which intermittent or irregular clinical features are observed with episodes is known as ‘vishama jwara’. The fundamental cause lies in the episodic or opportunistic aggravation of [[dosha]] involved in the pathogenesis. − − ==Causes and pathogenesis== − − If the initial stage of jwara is not treated well, and aggravated [[dosha]] are not evacuated properly, then the [[dosha]] reside in dormant state in the body channels. Whenever the person is exposed to etiological factors and/or to exogenous causes, the same opportunistic [[dosha]] are aggravated to cause vishama jwara. [Cha. Sa. [[Chikitsa Sthana]] 3/292] The episodes of vishama jwara are precipitated during favorable conditions of the [[dosha]] to exhibit its signs and symptoms. When the precipitating factors are absent, [[dosha]] lose their strength, and again attain dormant state at their respective site.[Cha.Sa.[[Chikitsa Sthana]] 3/70] − − The episodic clinical presentation is due to the other variable factors like time, body constitution, digestive capacity etc.[Su.Sa.Uttara Sthana.39/124]<ref name=Susruta/> − − This is similar to a seed germinates in fertile soil only at a time when it gets proper nourishment, in proper season. Similarly, the dormant [[dosha]] cause disease only when they get favorable vitiating factors and strength of opposing factors (host defense) is depleted. [ Cha.Sa.[[Chikitsa Sthana]] 3/68-69] − − ==General clinical features== − − Irregular onset, irregular symptoms and irregular time of appearance may stay for longer duration in vishama jwara. [A.Hr.Nidana Sthana 2/69]<ref name=Hridaya/> − − {| class="wikitable" − |+ Table 4: Classification, sites of vitiation and clinical patterns − |- − ! Type of vishama jwara !! Site !! Tissue ([[dhatu]]) involved !! Pattern of clinical presentation − |- − | | Santata || - || [[Rasa dhatu]] (nutritive fluid), [[Rakta dhatu]] (blood) || Continuously present for 7, 10 or 12 days − |- − | | Satata || Stomach || [[Rakta dhatu]] (blood) *, [[Rasa dhatu]] (nutritive fluid)<sup>#</sup> || Twice in 24 hours − |- − | | Anyedyushka || Chest || [[Meda dhatu]] (adipose tissue) *, [[Mamsa dhatu]] (muscle tissue) <sup>#</sup>|| Once in 24 hours − |- − | | Tritiyaka || Throat || [[Asthi dhatu]] (bone tissue)*, [[Meda dhatu]] (adipose tissue) <sup>#</sup> || Every third day (gap of one day) − |- − | | Chaturtaka || Head || [[Majja dhatu]] (bone marrow)*, [[Asthi dhatu]] (bone tissue) <sup>#</sup>|| Every fourth day (gap of two days) − |- − | | Chaturtakaviparyaya || - || [[Asthi dhatu]] and [[Majja dhatu]] (bone & bone marrow) <sup>*</sup>|| Continuous for two days (gap of one day)<sup>$</sup> − |- − |} − − *[Cha.Sa.[[Chikitsa Sthana]].3/61-62, 73], #[Su.Sa.Uttara Sthana 39/83-88], $[M.Ni.2/39]<ref name=Madava/> − − ==[[Dosha]] specific presentations== − − ===Tritiyakajwara (every third day)=== − − It affects different body parts depending on [[dosha]] specific aggravation as below: − *When [[kapha]] and [[pitta dosha]] are aggravated, it afflicts the sacral region (trika). − *When the [[vata]] and [[kapha dosha]] are aggravated, the upper back (prishtha) is affected. − *The head region is affected in the case of aggravation of [[vata]] and [[pitta dosha]]. [Cha.Sa.[[Chikitsa Sthana]] 3/71] − − ===Chaturthakajwara (every fourth day)=== − − If [[kapha dosha]] is affected, then the calf region is affected initially. In case of [[vata]] dominancy, head region is affected. [Cha.Sa.[[Chikitsa Sthana]] 3/72] − − ===Viparyaya vishamajwara=== − − If vitiated [[dosha]] is situated in two or more than two sites of [[kapha dosha]], it leads to viparyaya vishamajwara. [Su.Sa.Uttara Sthana.39/55]<ref name=Susruta/> − − If [[dosha]] is present in chest and stomach, it causes continuous jwara, which remits once in forenoon. − − [[Dosha]] present in throat, chest and stomach cause jwara, which remits on third day. [[Dosha]] in head, throat, chest and stomach, produces jwara, which remits on fourth day. − − ===Vatabalasaka jwara=== − − It is characterized by continuous mild jwara, dryness, edema and rigidity in body.[M.Ni.2/40]<ref name=Madava/> If [[vata]] and [[kapha]] are present in the skin, it causes rigor in the beginning and when they subside, [[pitta]] causes burning sensation and vice versa. [Su.Sa.Uttara Sthana.39/59]<ref name=Susruta/> − − ===Pralepaka jwara=== − − The person experiences mild jwara associated with heaviness and heat all over body. [M.Ni.2/41]<ref name=Madava/> It is caused by aggravated [[kapha]] and [[pitta]]. − − ==Prognosis== − − Santata jwara is extremely difficult to treat. [Cha.Sa.[[Chikitsa Sthana]] 3/55] − − ==Management== − − The management depends on dominance of [[dosha]] in the conditions. − − If [[vata]] is predominant in tritiyaka and chaturtakajwara, it is managed by the administration of ghee, medicated unctuous and non-unctuous enema. The diet and drinks administered should be hot in potency and unctuous. − − If [[pitta dosha]] is predominant, therapeutic purgation ([[virechana]]) is advised. Medicated ghee and milk can be given. The diet should be cold in character and bitter in taste. − − [[Kapha]] predominant vishama jwara 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:''' − − Phyllanthus emblica ([[amalaki]]), Terminalia bellirica (bibhitaki), Terminalia chebula (haritaki), Picrorhiza kurroa (katukarohini), Trichosanthes cucumerina ([[patola]]), Swertia chirayata (kiratatikta), Holarrhena pubescens (vatsaka). − − '''Medicated ghee:''' Shatpala grita [A.Hr Chikitsa Sthana 5/22-23]<ref name=Hridaya/>, Kalyanaka grita [A.Hr Uttara Tantra 6/26-31]<ref name=Hridaya/>, Tiktaka grita [A.Hr Chikitsa Sthana 19/2-6]<ref name=Hridaya/> − − '''[[Panchakarma]] procedures:''' − − *Fumigation with medicines like Aparajitadhuma [A.Hr.Chikitsa Sthana.1/164]<ref name=Hridaya/> − *Therapeutic emesis with ghee in maximum dose. [A.Hr. Chikitsa Sthana 1/159]<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:''' − − The five types of vishama jwara are managed by five decoctions made from drugs described below: − #In santatajwara, Kalingaka, patola leaves and katukarohini − #In satatajwara, Patola, sariva, musta, patha and katukarohini − #In anyedyushkajwara, Nimba, patola, triphala, mrudvika, musta and vatsaka − #In tritiyaka jwara, Kiratatikta, amrita, chandana, vishvabheshaja − #In chaturthaka jwara, Guduchi, amalaka and musta. [ Cha.Sa. [[Chikitsa Sthana]] 200-203] − − {| class="wikitable" − |+ Table 5: Herbal and herbo mineral formulation* − |- − ! Type !! Medicine − |- − | | Santata|| Lakshminarayana rasa [R.T.S Kharaliya rasayana]<ref name=rasatantrasara/>, Laxmivilasa rasa [B.R 5/1223-35]<ref name=Ratnavali/>, Guduchyadi kwatha [B.R 5/156]<ref name=Ratnavali/>, Drakshadi churnam − |- − | |Satata/ Anyedyushka/ Tritiyaka/ Chaturthaka || Mallasinduramisranam [R.T.S Kupipakwa prakarana]<ref name=rasatantrasara/>, Gandhaka druti<ref name=RRS/>, Tiktaka kwatha − |- − |} − *[Chikitsapradeepa]<ref>Gokhale B.V. Jwararoga.In: Chikitsapradeep.Pune:Dhanwantary Pratishthan;1989:1-3.</ref> − − '''[[Rasayana]] therapy:''' − − Vardhamanapippali rasayana [Cha.Sa.[[Chikitsa Sthana]] 1/3/36] to prevent recurrence is advised. − − =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 ‘dhatugata jwara’. This suggests progressive stages of disease affecting deeper tissues.[Cha.Sa.[[Chikitsa Sthana]] 3/75-82] [Su.Sa.Uttara Sthana.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== − − Jwara at the site of nutrient fluid ([[rasa]]), blood ([[rakta]]), muscle ([[mamsa]]) and adipose tissue ([[meda dhatu]]) are curable. Jwara affecting bones ([[asthi dhatu]]) and marrow ([[majja dhatu]]) are difficult to cure. Jwara affecting semen/reproductive fluid ([[shukra]] [[dhatu]]) is incurable. [Cha.Sa.[[Chikitsa Sthana]].3/83] − − ==Abbreviations== − − Cha. = Charak, Su. = Sushruta, A. = Ashtanga, S. = Sangraha, Hr. = Hridayam, Sa. = Samhita, M.Ni = Madava Nidana, R.T.S = Rasatantrasara and Siddhaprayoga sangraha, R.R.S = Rasaratnasamucchaya, B.R = Bhaishajya ratnavali − − == Related chapters == − − [[Jwara Nidana]], [[Jwara Chikitsa]] − − <big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big> − − =References= − − <div id="BackToTop" class="noprint" style="background-color:#DDEFDD; position:fixed; − bottom:32px; left:2%; z-index:9999; padding:0; margin:0;"><span style="color:blue; − font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7; − padding:0.1em; font-weight:bolder; -moz-border-radius:8px; "> − [[#top| Back to the Top ]]</span></div>
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|label2 = Authors
|label2 = Authors
|data2 = Deole Y.S.<sup>1</sup>,Aneesh E.G.<sup>2</sup>
|data2 = Deole Y.S.<sup>1</sup>, Aneesh E.G.<sup>2</sup>
|label3 = Reviewed and edited by
|label3 = Reviewed and edited by
|label4 = Affiliations
|label4 = Affiliations
|data4 = <sup>1</sup>Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabhvidya Nagar, Anand, Gujarat, India <sup>2</sup>[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar,India
|data4 = <sup>1</sup>Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabhvidya Nagar, Anand, Gujarat, India
<sup>2</sup>[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar, India
<sup>3</sup>Rheumatologist, Orlando, Florida, U.S.A.
<sup>3</sup>Rheumatologist, Orlando, Florida, U.S.A.
===Management principles===
===Management principles===
Therapeutic fasting after considering the strength of patient and severity of disease. This helps to promote digestion, transform [[ama]](undigested toxins) and regain normal states of [[dosha]][Cha.Sa.[[Chikitsa Sthana]] 3/140] Hot water, medicated gruels and herbs having bitter taste are prescribed to promote natural process of digestion and transformation of [[ama]] state [Cha.Sa.[[Chikitsa Sthana]] 3/142]
Therapeutic fasting after considering the strength of patient and severity of disease. This helps to promote digestion, transform [[ama]](undigested toxins) and regain normal state