Changes

Per Ayurvedic texts, a physician cannot treat a patient if he does not possess a complete understanding of a disease. [1] Accurate diagnosis of a disease is important before initiating any treatment, and any understanding of a disease’s manifestation is incomplete without understanding its ''nidana'' (etiology), ''poorvarupa'' (premonitory symptoms), ''linga'' (actual sign and symptoms), ''upashaya'' (pacifying factors) and ''samprapti'' (pathogenesis) – or the ''Nidana Panchaka'' (literally, the five components of ''nidana''). [2]  

Per Ayurvedic texts, a physician cannot treat a patient if he does not possess a complete understanding of a disease. [1] Accurate diagnosis of a disease is important before initiating any treatment, and any understanding of a disease’s manifestation is incomplete without understanding its ''nidana'' (etiology), ''poorvarupa'' (premonitory symptoms), ''linga'' (actual sign and symptoms), ''upashaya'' (pacifying factors) and ''samprapti'' (pathogenesis) – or the ''Nidana Panchaka'' (literally, the five components of ''nidana''). [2]  

A disease’s lifecycle starts with certain premonitory symptoms and ends with its complete manifestation, or ''samprapti''. Between these two stages of the disease, the body shows various sign and symptoms that could be observed by any knowledgeable physician, using the ''Nidana Panchaka'' . Naturally, any disease, if diagnosed very early, could be prevented from manifesting itself through a variety of interventions. [3] A proper understanding of the ''Nidana Panchaka'' helps the physician using various therapies, to establish an equilibrium among the patient’s ''doshas'', ''dhatus'', and ''mala'' – since it is the vitiation of these bodily features that cause a disease. A therapy is considered pure or correct (''vishuddha'') when it cures the disease without giving rise to another disease. [4] Curable diseases can progress to incurable if they are not properly treated. [5]

A disease’s lifecycle starts with certain premonitory symptoms and ends with its complete manifestation, or ''samprapti''. Between these two stages of the disease, the body shows various sign and symptoms that could be observed by any knowledgeable physician, using the ''Nidana Panchaka'' . Naturally, any disease, if diagnosed very early, could be prevented from manifesting itself through a variety of interventions. [3] A proper understanding of the ''Nidana Panchaka'' helps the physician using various therapies, to establish an equilibrium among the patient’s ''doshas'', ''dhatus'', and ''mala'' – since it is the vitiation of these bodily features that cause a disease. A therapy is considered pure or correct (''vishuddha'') when it cures the disease without giving rise to another disease. [4] Curable diseases can progress to incurable if they are not properly treated. [5]

Today, physicians use diagnostic tests and medical investigations to study a condition. These tests could be supplemented with tools like the ''Nidana Panchaka'' described here. For example, access to complete knowledge of dietary and lifestyle activities of a person, specific disease provoking factors, clinical history or health records of past diseases or conditions, and a thorough clinical examination of all bodily systems would help provide a complete view of a patient’s condition.   

Today, physicians use diagnostic tests and medical investigations to study a condition. These tests could be supplemented with tools like the ''Nidana Panchaka'' described here. For example, access to complete knowledge of dietary and lifestyle activities of a person, specific disease provoking factors, clinical history or health records of past diseases or conditions, and a thorough clinical examination of all bodily systems would help provide a complete view of a patient’s condition.   

Thus, the first part of the chapter deals with the ''Nidana Panchaka''. The second part, then, takes this important concept and applies it on the most generic of conditions afflicting patients – jwara. This also reveals how the Nidana Sthana section of the Charaka Samhita is structured – it starts with the generic or the foundational condition (that, in many cases, acts as a causative factor itself), and then moves on to discussing the vitiation of the dhatus that are causes of all somatic diseases – by the order of their importance (i.e., starting with rasa dhatus) – and ends with a study of vitiation of Rajas and Tamas (i.e., causes of mental diseases).  

 

Thus, the first part of the chapter deals with the ''Nidana Panchaka''. The second part, then, takes this important concept and applies it on the most generic of conditions afflicting patients – jwara. This also reveals how the [[Nidana Sthana]] section of the [[Charaka Samhita]] is structured – it starts with the generic or the foundational condition (that, in many cases, acts as a causative factor itself), and then moves on to discussing the vitiation of the dhatus that are causes of all somatic diseases – by the order of their importance (i.e., starting with rasa dhatus) – and ends with a study of vitiation of Rajas and Tamas (i.e., causes of mental diseases).  

It is important to note here that jwara is an independent ailment, per Ayurveda, but also a secondary condition of other diseases, and also an etiology responsible for various diseases. For example, jwara gives rise to raktapitta (haemorrhagic disease), which in turn causes jwara, and both cause shotha (phthisis). Thus, jwara is an etiology in this context, or a nidanarthakara. Sushruta describes jwara at first as a complication of a wound in an afflicted person because it is the chief among diseases and has emerged “from the fiery wrath of Lord Rudra”, per Vedic mythology. Explaining its nature, he says that it influences an individual particularly at the time of his birth and death. But in this chapter, jwara is described as an independent disease which acts upon vata, pitta, and kapha as an immediate etiological factor to cause fever. Besides this (as a cause), various indirect causes have also been described to explain the vitiation of each dosha, along with their pathogenesis and symptoms separately. However, it is important to note that while there could be any number or types of causes, amashaya (stomach?) is common to all types of jwara. Pathogenetic doshas combined with heat located in amashaya and accompanying the first dhatu created with the digestion of food (also known as rasa) obstructs the passage of rasa and sweda, causing them to spread all over the body in various ways raising the body temperature of a person. This rising temperature is the manifestation of fever.  

It is important to note here that jwara is an independent ailment, per Ayurveda, but also a secondary condition of other diseases, and also an etiology responsible for various diseases. For example, jwara gives rise to raktapitta (haemorrhagic disease), which in turn causes jwara, and both cause shotha (phthisis). Thus, jwara is an etiology in this context, or a nidanarthakara. Sushruta describes jwara at first as a complication of a wound in an afflicted person because it is the chief among diseases and has emerged “from the fiery wrath of Lord Rudra”, per Vedic mythology. Explaining its nature, he says that it influences an individual particularly at the time of his birth and death. But in this chapter, jwara is described as an independent disease which acts upon vata, pitta, and kapha as an immediate etiological factor to cause fever. Besides this (as a cause), various indirect causes have also been described to explain the vitiation of each dosha, along with their pathogenesis and symptoms separately. However, it is important to note that while there could be any number or types of causes, amashaya (stomach?) is common to all types of jwara. Pathogenetic doshas combined with heat located in amashaya and accompanying the first dhatu created with the digestion of food (also known as rasa) obstructs the passage of rasa and sweda, causing them to spread all over the body in various ways raising the body temperature of a person. This rising temperature is the manifestation of fever.  

Depending upon the etiological factors, Ayurveda prescribes one of two types of therapies – spiritual and rational. A specific rational treatment of jwara could involve the use of processed ghee (clarified butter) with suitable drugs in a chronic fever is to alleviate all the three doshas.  

Depending upon the etiological factors, Ayurveda prescribes one of two types of therapies – spiritual and rational. A specific rational treatment of jwara could involve the use of processed ghee (clarified butter) with suitable drugs in a chronic fever is to alleviate all the three doshas.

===Sanskrit text, transliteration and english translation===

===Sanskrit text, transliteration and english translation===