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==([[Nidana Sthana]] Chapter 1, Chapter on the Etiological Factors causing Fever)==

==[[Nidana Sthana]] Chapter 1, Jwara Nidana (Chapter on the diagnosis of Fever and other related diseases)==

=== Abstract ===

=== Abstract ===

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 [https://en.wikipedia.org/wiki/Ayurveda 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, [https://en.wikipedia.org/wiki/Ayurveda 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''.

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Vagbhata has not described ''vidhi samprapti''. He has described only five kinds of ''samprapti'' i.e. ''samkhya, vikalpa, pradhanya, bala'' and ''kala samprapti''. (A H Ni. 1/)</ref>Vagbhata, Ashtang Hridayam, Nidanasthana Adhyaya 1/9, Edited by Harishastri Paradkar Vaidya, Ninth Edition, Chaukhambha Orientalia, Varanasi, 2002, 443 </ref> [12]. ''Pradhanya samprapti'' indicates the primacy of a ''samprapti'' (A H Ni. 1/)<ref>Vagbhata, Ashtang Hridayam, Nidanasthana Adhyaya 1/10, Edited by Harishastri Paradkar Vaidya, Ninth Edition, Chaukhambha Orientalia, Varanasi, 2002, 443 </ref> When a ''dosha'' gets vitiated and becomes a causative factor of a disease, it does not necessarily mean that all its attributes also get vitiated. Vitiation of ''vata'' for example may mean aggravation of its coldness, lightness or ununctuousness.  

Vagbhata has not described ''vidhi samprapti''. He has described only five kinds of ''samprapti'' i.e. ''samkhya, vikalpa, pradhanya, bala'' and ''kala samprapti''. (A H Ni. 1/)</ref>Vagbhata, Ashtang Hridayam, Nidanasthana Adhyaya 1/9, Edited by Harishastri Paradkar Vaidya, Ninth Edition, Chaukhambha Orientalia, Varanasi, 2002, 443 </ref> [12]. ''Pradhanya samprapti'' indicates the primacy of a ''samprapti'' (A H Ni. 1/)<ref>Vagbhata, Ashtang Hridayam, Nidanasthana Adhyaya 1/10, Edited by Harishastri Paradkar Vaidya, Ninth Edition, Chaukhambha Orientalia, Varanasi, 2002, 443 </ref> When a ''dosha'' gets vitiated and becomes a causative factor of a disease, it does not necessarily mean that all its attributes also get vitiated. Vitiation of ''vata'' for example may mean aggravation of its coldness, lightness or ununctuousness.  

''Kala samprapti'' means the type that is governed by seasonal variations. Aggravation/ manifestation of ''shleshmika/kaphaja'' type of fever during winter season is the example of seasonal variation. Some [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] practitioners attribute an extreme form of manifestation to deeds in the patient’s past life, and define ''vidhi samprapti'' as an affliction attributed to such deeds. <ref>Chakrapani, Commentator, Charaka SamhitaNidansthana Adhyaya 1/11, Edited by Jadavaji Trikamji, Fifth Edition Chaukhambha Sanskrit Sansthana, Varanasi, 2001,196. </ref> The timing of disease manifestation shows variation in the ''samprapti'' or pathogenesis. This aspect of ''samprapti'' helps in clearly determining the specific characteristics of a disease.

''Kala samprapti'' means the type that is governed by seasonal variations. Aggravation/ manifestation of ''shleshmika/kaphaja'' type of fever during winter season is the example of seasonal variation. Some Ayurveda practitioners attribute an extreme form of manifestation to deeds in the patient’s past life, and define ''vidhi samprapti'' as an affliction attributed to such deeds. <ref>Chakrapani, Commentator, Charaka SamhitaNidansthana Adhyaya 1/11, Edited by Jadavaji Trikamji, Fifth Edition Chaukhambha Sanskrit Sansthana, Varanasi, 2001,196. </ref> The timing of disease manifestation shows variation in the ''samprapti'' or pathogenesis. This aspect of ''samprapti'' helps in clearly determining the specific characteristics of a disease.

Vagbhata describes that ''bala samprapti'' is important to assess the severity of disease. (A H Ni. 1/)<ref>Vagbhata, Ashtang Hridayam, Nidanasthana Adhyaya 1/11, Edited by Harishastri Paradkar Vaidya, Ninth Edition, Chaukhambha Orientalia, Varanasi, 2002, 443 </ref>[12-5]

Vagbhata describes that ''bala samprapti'' is important to assess the severity of disease. (A H Ni. 1/)<ref>Vagbhata, Ashtang Hridayam, Nidanasthana Adhyaya 1/11, Edited by Harishastri Paradkar Vaidya, Ninth Edition, Chaukhambha Orientalia, Varanasi, 2002, 443 </ref>[12-5]