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Jwara Chikitsa (view source)

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{{#seo:

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|title=Jwara Chikitsa

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|titlemode=append

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|keywords=Jwara roga, Santapa, pitta fever, ushma, heat regulation

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|description=Chikitsa Sthana Chapter 3. Management of Jwara

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}}

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<big>'''[[Chikitsa Sthana]] Chapter 3. Management of [[Jwara]]'''</big>

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=== Sanskrit text, Transliteration and English Translation ===

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अथातो ज्वरचिकित्सितं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

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athātō jwaracikitsitaṁ vyākhyāsyāmaḥ||1||

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iti ha smAha bhagavAnAtreyaH||2||

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</div></div>

We shall now explain the chapter on the treatment of ''jwara'' (different types of fever).

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==== Queries of Agnivesha ====

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विज्वरं ज्वरसन्देहं पर्यपृच्छत् पुनर्वसुम्|

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ज्वराधिकारे यद्वाच्यं तत् सौम्य! निखिलं शृणु||१०||

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vijwaraṁ jwarasandēhaṁ paryapr̥cchat punarvasum|

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jwaradhikAre yadvAcyaM tat saumya! nikhilaM shRuNu||10||

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</div></div>

Punarvasu, who was free from all types of diseases (''jwara'') and was having complete peace of mind, was sitting in a lonely place; where Agnivesha approached him and asked his queries about ''jwara'' with a modest ''namaskar'' (greeting, with hands folded).

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==== Synonyms of ''jwara'' ====

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ज्वरो विकारो रोगश्च व्याधिरातङ्क एव च|

एकोऽर्थो नामपर्यायैर्विविधैरभिधीयते||११||

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jvarō vikārō rōgaśca vyādhirātaṅka ēva ca|

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eko~artho nAmaparyAyairvividhairabhidhIyate||11||

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</div></div>

''Jwara, vikara, roga, vyadhi'' and ''atanka'' – these terms are synonymous and used to indicate this condition. [11]

==== ''Prakriti'' or nature of ''jwara'' ====

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तस्य प्रकृतिरुद्दिष्टा दोषाः शारीरमानसाः|

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इत्यस्य प्रकृतिः प्रोक्ता, ...|१४|

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tasya prakr̥tiruddiṣṭā dōṣāḥ śārīramānasāḥ|

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ityasya prakRutiH proktA, ...|14|

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</div></div>

The three physical ''doshas'' and the two ''manasika doshas'' are the natural factors responsible for ''jwara'' (''prakriti'') as ''jwara'' cannot originate in a person having the balance of these three ''dosha'' (''nirdosha'' – in the state of homeostasis). Therefore, these ''sharirika'' and ''manasika doshas'' are the prakriti of ''jwara''.

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==== ''Pravritti'' (origin of the disease) ====

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... प्रवृत्तिस्तु परिग्रहात्|

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जन्मादौ निधने च त्वमपचारान्तरेषु च||२५||

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... pravr̥ttistu parigrahāt|

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janmAdau nidhane ca tvamapacArAntareShu ca||25||

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</div></div>

The origin of ''jwara'' is because of the tendency for greed or attachment (''parigraha''). It has been described earlier in the [[Nidana Sthana]] that the origin of ''jwara'' resulted from the ferocious wrath of Rudra (Lord Shiva).

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

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सन्तापः सारुचिस्तृष्णा साङ्गमर्दो हृदि व्यथा|

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प्रकृतिश्च प्रवृत्तिश्च प्रभावश्च प्रदर्शितः|२७|

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santāpaḥ sārucistr̥ṣṇā sāṅgamardō hr̥di vyathā|

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prakRutishca pravRuttishca prabhAvashca pradarshitaH|27|

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</div></div>

''Santapa'' (feeling of heat or raised temperature), ''aruchi'' (anorexia), ''trishna'' (morbid thirst), ''angamarda'' (body ache), ''hrid vyatha'' (pain in the cardiac region) – these are the invariable manifestations of ''jwara''. At the time of birth and death, ''jwara'' is manifested in the form of tamas (''moha''- altered state of consciousness). In this way the ''prakriti'' (nature), ''pravritti'' (origin) and the ''prabhava'' (invariable manifestations) of ''jwara'' are described. [26-27]

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निदाने कारणान्यष्टौ पूर्वोक्तानि विभागशः||२७||

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nidānē kāraṇānyaṣṭau pūrvōktāni vibhāgaśaḥ||27||

nidAne kAraNAnyaShTau pUrvoktAni vibhAgashaH||27||

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</div></div>

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'' ====

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आलस्यं नयने सास्रे जृम्भणं गौरवं क्रमः|

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शीलवैकृतमल्पं च ज्वरलक्षणमग्रजम्||२९||

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ālasyaṁ nayanē sāsrē jr̥mbhaṇaṁ gauravaṁ kramaḥ|

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shIlavaikRutamalpaM ca jwaralakShaNamagrajam||29||

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</div></div>

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'' ====

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केवलं समनस्कं च ज्वराधिष्ठानमुच्यते|

शरीरं, बलकालस्तु निदाने सम्प्रदर्शितः||३०||

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kēvalaṁ samanaskaṁ ca jvarādhiṣṭhānamucyatē|

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sharIraM, balakAlastu nidAne sampradarshitaH||30||

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</div></div>

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 ====

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ज्वरप्रत्यात्मिकं लिङ्गं सन्तापो देहमानसः|

ज्वरेणाविशता भूतं न हि किञ्चिन्न तप्यते||३१||

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jwarapratyātmikaṁ liṅgaṁ santāpō dēhamānasaḥ|

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jvareNAvishatA bhUtaM na hi ki~jcinna tapyate||31||

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</div></div>

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 ====

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द्विविधो विधिभेदेन ज्वरः शारीरमानसः|

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भिन्नः कारणभेदेन पुनरष्टविधो ज्वरः||३५||

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dvividhō vidhibhēdēna jwaraḥ śārīramānasaḥ|

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bhinnaH kAraNabhedena punaraShTavidho jwaraH||35||

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</div></div>

''Jwara'' is classified into two types each on the basis of the following criteria –

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

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शारीरो जायते पूर्वं देहे, मनसि मानसः|

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इन्द्रियाणां च वैकृत्यं ज्ञेयं सन्तापलक्षणम्|३७|

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śārīrō jāyatē pūrvaṁ dēhē, manasi mānasaḥ|

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indriyANAM ca vaikRutyaM j~jeyaM santApalakShaNam|37|

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</div></div>

The ''sharira'' type of ''jwara'' first appears in the body and the ''manasa'' type, first appears in the mind. ''Vaichitya'' (mental instability), ''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 ====

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वातपित्तात्मकः शीतमुष्णं वातकफात्मकः||३७||

इच्छत्युभयमेतत्तु ज्वरो व्यामिश्रलक्षणः|३८|

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vātapittātmakaḥ śītamuṣṇaṁ vātakaphātmakaḥ||37||

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icchatyubhayametattu jvaro vyAmishralakShaNaH|38|

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</div></div>

A patient suffering from ''vatapittaja'' variety of ''jwara'' desires for cold things, while, a patient suffering from ''jwara'' caused by ''vata'' and ''kapha dosha'' 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'' ====

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योगवाहः परं वायुः संयोगादुभयार्थकृत्||३८||

दाहकृत्तेजसा युक्तः, शीतकृत् सोमसंश्रयात्|३९|

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yōgavāhaḥ paraṁ vāyuḥ saṁyōgādubhayārthakr̥t||38||

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dAhakRuttejasA yuktaH, shItakRut somasaMshrayAt|39|

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</div></div>

''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]

==== Features of internal and external ''jwara'' ====

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अन्तर्दाहोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||३९||

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बहिर्वेगस्य लिङ्गानि सुखसाध्यत्वमेव च||४१||

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antardāhō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||39||

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bahirvegasya li~ggAni sukhasAdhyatvameva ca||41||

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</div></div>

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 feces – are the clinical features of ''antarvegi jwara'' (internal manifestation of ''jwara'').

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

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प्राकृतः सुखसाध्यस्तु वसन्तशरदुद्भवः|

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हेतवो विविधास्तस्य निदाने सम्प्रदर्शिताः||४९||

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prākr̥taḥ sukhasādhyastu vasantaśaradudbhavaḥ|

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hetavo vividhAstasya nidAne sampradarshitAH||49||

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</div></div>

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

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==== Prognosis of ''jwara'' ====

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बलवत्स्वल्पदोषेषु ज्वरः साध्योऽनुपद्रवः|

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असाध्यो बलवान् यश्च केशसीमन्तकृज्ज्वरः|५३|

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balavatsvalpadōṣēṣu jwaraḥ sādhyō'nupadravaḥ|

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asAdhyo balavAn yashca keshasImantakRujjwaraH|53|

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</div></div>

===== ''Sadhya'' (curable) ''jwara'' =====

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

===== ''Santata jwara'' =====

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स्रोतोभिर्विसृता दोषा गुरवो रसवाहिभिः||५३||

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क्रियाक्रमविधौ युक्तः प्रायः प्रागपतर्पणैः|६१|

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srōtōbhirvisr̥tā dōṣā guravō rasavāhibhiḥ||53||

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kriyAkramavidhau yuktaH prAyaH prAgapatarpaNaiH|61|

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</div></div>

The aggravated ''dosha'' circulate through the channels carrying ''rasa'' (the first nutritional dhatu equivalent to plasma) and spread all over the body and gets stagnated, causes ''santata jwara''. This ''santata jwara'' is extremely difficult to treat and manifests its symptoms very quickly. In this type the patient either gets cured (on the pacification of ''dosha'') or killed (on the further aggravation of ''dosha'') on the 10th, 12th or 7th day.

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===== ''Satata jwara'' =====

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रक्तधात्वाश्रयः प्रायो दोषः सततकं ज्वरम्||६१||

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अहोरात्रे सततको द्वौ कालावनुवर्तते||६२||

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raktadhātvāśrayaḥ prāyō dōṣaḥ satatakaṁ jwaram||61||

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ahorAtre satatako dvau kAlAvanuvartate||62||

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</div></div>

The aggravated ''dosha'' when generally lodges in the ''rakta dhatu'', then they manifest with fever twice in 24 hours (Nycthemeron) depending on the time of ''dosha'' aggravation or subsidence. The ''dosha'' in this type of ''jwara'' can be counteracted. [61-62]

===== ''Anyedyushka jwara'' =====

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कालप्रकृतिदूष्याणां प्राप्यैवान्यतमाद्बलम्|

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सप्रत्यनीको जनयत्येककालमहर्निशि|

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kālaprakr̥tidūṣyāṇāṁ prāpyaivānyatamādbalam|

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sapratyanIko janayatyekakAlamaharnishi|

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</div></div>

Vitiated ''dosha'' produce ''anyedushka'' type of ''jwara'' with the support of any one factor amongst the ''kala'' (time), ''prakriti'' (physical constitution) and ''dushya'' (vitiated factors) leading to obstruction in ''medo vaha sira'' (the channel of circulation of ''medasa'' (fat)). It can be counteracted. This ''jwara'' occurs only once during day and night. [63-64]

===== ''Tritiyaka'' and ''chaturthaka jwara'' =====

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दोषोऽस्थिमज्जगः कुर्यात्तृतीयकचतुर्थकौ||६४||

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दिनद्वयं यो विश्रम्य प्रत्येति स चतुर्थकः||६७||

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dōṣō'sthimajjagaḥ kuryāttr̥tīyakacaturthakau||64||

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dinadvayaM yo vishramya pratyeti sa caturthakaH||67||

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</div></div>

When the ''dosha'' afflict the ''asthi dhatu'' (bone tissue) and ''majja dhatu'' (bone marrow), they cause the ''tritiyaka'' and ''chaturthaka jwara'' respectively.

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==== Cause of alterations in ''jwara'' episodes ====

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अधिशेते यथा भूमिं बीजं काले च रोहति|

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जङ्घाभ्यां श्लैष्मिकः पूर्वं शिरस्तोऽनिलसम्भवः||७२||

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adhiśētē yathā bhūmiṁ bījaṁ kālē ca rōhati|

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ja~gghAbhyAM shlaiShmikaH pUrvaM shirasto~anilasambhavaH||72||

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</div></div>

As a seed remains dormant in the soil and germinates at a favorable time, similarly the ''doshas'' remain in dormant condition in the ''dhatu'' and get aggravated at a favorable time. These ''dosha'' gain strength at an appropriate time and when the power of the inhibiting (disease preventing) factors has subsided, then the ''tritiyaka'' and ''chaturthaka jwara'' manifest.

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*Calf region is afflicted in the in the beginning by the vitiation of ''kapha''

*Head region is afflicted in the beginning by the vitiation of ''vata''. [70-72]

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विषमज्वर एवान्यश्चतुर्थकविपर्ययः|

त्रिविधो धातुरेकैको द्विधातुस्थः करोति यम्||७३||

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viṣamajwara ēvānyaścaturthakaviparyayaḥ|

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trividho dhAturekaiko dvidhAtusthaH karoti yam||73||

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</div></div>

''Chaturthaka viparyaya jwara'' is another variety of ''vishama jwara''. Each of the three ''dosha'' i.e. ''vata, pitta'' and ''kapha'' cause this disease by afflicting the two dhatu viz ''asthi'' (bone) and ''majja'' (bone marrow).[73]

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प्रायशः सन्निपातेन दृष्टः पञ्चविधो ज्वरः|

सन्निपाते तु यो भूयान् स दोषः परिकीर्तितः||७४||

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prāyaśaḥ sannipātēna dr̥ṣṭaḥ pañcavidhō jwaraḥ|

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sannipAte tu yo bhUyAn sa doShaH parikIrtitaH||74||

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</div></div>

These five types of ''jwara'' are mostly caused by ''sannipata'' (simultaneous vitiation of the three ''dosha''), however, the ''dosha'', which is predominant among the three ''doshas'' is generally attributed as the causative factors. [74]

==== ''Dhatugata jwara'' ====

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ऋत्वहोरात्रदोषाणां मनसश्च बलाबलात्|

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अस्थिमज्जगतः कृच्छ्रः शुक्रस्थो नैव सिद्ध्यति||८३||

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r̥tvahōrātradōṣāṇāṁ manasaśca balābalāt|

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asthimajjagataH kRucchraH shukrastho naiva siddhyati||83||

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</div></div>

Manifestation of ''jwara'' at a particular time or a change in the time of manifestation takes place due to following factors:

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==== Clinical features of ''jwara'' due to combination of two ''dosha'' ====

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हेतुभिर्लक्षणैश्चोक्तः पूर्वमष्टविधो ज्वरः|

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इत्येते द्वन्द्वजाः प्रोक्ताः ...|८९|

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hētubhirlakṣaṇaiścōktaḥ pūrvamaṣṭavidhō jwaraḥ|

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ityete dvandvajAH proktAH ...|89|

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</div></div>

Signs and symptoms of ''jwara'' by combination of ''vata'' and ''pitta'':

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==== ''Sannipataja jwara'' ====

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... सन्निपातज उच्यते||८९||

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चिरात् पाकश्च दोषाणां सन्निपातज्वराकृतिः|१०९|

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... sannipātaja ucyatē||89||

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cirAt pAkashca doShANAM sannipAtajwarakRutiH|109|

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</div></div>

Description of ''sannipataja jwara'' (caused by combined ''tridosha''):

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==== Prognosis of ''sannipata jwara'' ====

+

दोषे विबद्धे नष्टेऽग्नौ सर्वसम्पूर्णलक्षणः||१०९||

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संसर्गसन्निपातानां तया चोक्तं स्वलक्षणम्|१११|

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dōṣē vibaddhē naṣṭē'gnau sarvasampūrṇalakṣaṇaḥ||109||

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saMsargasannipAtAnAM tayA coktaM svalakShaNam|111|

+

</div></div>

If there is obstruction (or non – elimination) of the ''dosha'', the ''agnis'' are completely destroyed and if all the signs and symptoms are fully manifested, then ''sannipata jwara'' is incurable; otherwise it is treatable with difficulty.

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==== Classification of ''agantuja jwara'' ====

+

आगन्तुरष्टमो यस्तु स निर्दिष्टश्चतुर्विधः||१११||

अभिघाताभिषङ्गाभ्यामभिचाराभिशापतः|

+

āganturaṣṭamō yastu sa nirdiṣṭaścaturvidhaḥ||111||

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abhighAtAbhiSha~ggAbhyAmabhicArAbhishApataH|

+

</div></div>

The eighth type of ''jwara'' i.e. ''agantuja'' type (that caused due to external/exogenous factors) is of four types, viz: ''abhihataja, abhishangaja, abhicharaja'' and ''abhishapaja''.[111]

==== ''Abhighataja jwara'' (due to injury or trauma) ====

+

शस्त्रलोष्टकशाकाष्ठमुष्ट्यरत्नितलद्विजैः||११२||

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सव्यथाशोफवैवर्ण्यं करोति सरुजं ज्वरम्|११४|

+

śastralōṣṭakaśākāṣṭhamuṣṭyaratnitaladvijaiḥ||112||

Line 1,662: Line 1,758:

savyathAshophavaivarNyaM karoti sarujaM jvaram|114|

+

</div></div>

The ''jwara'' caused by the injury from weapons, stones, hunters, wood, fist, palm of the sole, teeth and such other things is called ''abhighataja''. In this type, vitiated ''vata'' affects predominantly ''rakta'' (blood) to resulting in ''jwara'' with discomfort, swelling, discoloration and pain.[112-114]

==== ''Abhishangaja, abhishapaja'' and ''abhicharaja jwara'' ====

+

कामशोकभयक्रोधैरभिषक्तस्य यो ज्वरः||११४||

Line 1,726: Line 1,824:

हेत्वौषधविशिष्टाश्च भवन्त्यागन्तवो ज्वराः|१२९|

+

kāmaśōkabhayakrōdhairabhiṣaktasya yō jvaraḥ||114||

Line 1,842: Line 1,941:

hētvauṣadhaviśiṣṭāśca bhavantyāgantavō jvarāḥ|129|

+

</div></div>

'''''Abhishangaja jwara''''': ''Jwara'' caused by the affliction of passion, grief, fear, anger and evil spirits including germs is called ''abhishangaja jwara''. ''Vata'' gets aggravated by passion, grief and fear, while pitta is aggravated by anger and all the three ''doshas'' are afflicted by ''bhootas'' (evil spirits or germs). Simultaneously, the signs and symptoms of the respective type of ''bhoota'' are described here. In the ''bhutadhikara'' section, the characteristic features of eight types of ''bhoota'' are described.

Line 1,875: Line 1,975:

==== General patho-physiology of ''jwara'' ====

+

संसृष्टाः सन्निपतिताः पृथग्वा कुपिता मलाः||१२९||

Line 1,887: Line 1,988:

भवत्यत्युष्णसर्वाङ्गो ज्वरितस्तेन चोच्यते|१३२|

+

saṁsr̥ṣṭāḥ sannipatitāḥ pr̥thagvā kupitā malāḥ||129||

Line 1,915: Line 2,017:

bhavatyatyuShNasarvA~ggo jvaritastena cocyate|132|

+

</div></div>

These aggravated ''dosha'' either alone or in the combination of two or three, spread along with the ''rasa dhatu'' (the first ''dhatu'' responsible for nourishment of the body) and displace the ''jatharagni'' from its own place. Supplemented by the ''dosha''’s own heat and the heat of the ''jatharagni'', the heat of the body gets accentuated and they are further aggravated by the blockage of the circulatory channels. It then pervades the entire body to produce excessive heat. Therefore, the temperature increases all over the body and this condition is called ''jwara''.[129-132]

==== Cause of lack of sweating ====

+

स्रोतसां सन्निरुद्धत्वात् स्वेदं ना नाधिगच्छति||१३२||

स्वस्थानात् प्रच्युते चाग्नौ प्रायशस्तरुणेज्वरे|१३३|

+

srōtasāṁ sanniruddhatvāt svēdaṁ nā nādhigacchati||132||

Line 1,931: Line 2,036:

svasthAnAt pracyute cAgnau prAyashastaruNejvare|133|

+

</div></div>

A person suffering from ''taruna jwara'' (the initial stage of ''jwara'') does not sweat because of the obstruction of the channels of circulation and the displacement of ''agni''. [132-133]

==== Clinical features of ''Ama Jwara'' (first stage of ''jwara'') ====

+

अरुचिश्चाविपाकश्च गुरुत्वमुदरस्य च||१३३||

Line 1,947: Line 2,054:

न विड् जीर्णा न च ग्लानिर्ज्वरस्यामस्य लक्षणम्|

+

aruciścāvipākaśca gurutvamudarasya ca||133||

Line 1,971: Line 2,079:

na viD jIrNA na ca glAnirjvarasyAmasya lakShaNam|

+

</div></div>

The ''ama jwara'' (first stage of ''jwara'') presents with the following clinical features –

Line 1,984: Line 2,093:

==== Clinical features of ''pachyamana jwara'' (second stage of ''jwara'') ====

+

ज्वरवेगोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः||१३६||

मलप्रवृत्तिरुत्क्लेशः पच्यमानस्य लक्षणम्|१३७|

+

jvaravēgō'dhikastr̥ṣṇā pralāpaḥ śvasanaṁ bhramaḥ||136||

Line 1,996: Line 2,107:

malapravRuttirutkleshaH pacyamAnasya lakShaNam|137|

+

</div></div>

The features of ''pachyamana jwara'' (second stage of fever) are as follows – high grade fever and excess thirst, delirium, dyspnea, giddiness and excess evacuation of wastes [136]

==== Clinical features of ''nirama jwara'' (third stage of ''jwara'') ====

+

क्षुत् क्षामता लघुत्वं च गात्राणां ज्वरमार्दवम्||१३७||

दोषप्रवृत्तिरष्टाहो निरामज्वरलक्षणम्|१३८|

+

kṣut kṣāmatā laghutvaṁ ca gātrāṇāṁ jvaramārdavam||137||

Line 2,012: Line 2,126:

doShapravRuttiraShTAho nirAmajvaralakShaNam|138|

+

</div></div>

Restoration of hunger, debility, lightness in the body, reduced fever, elimination of the ''dosha'' along with the waste products from the body – are all the clinical features of ''nirama jwara'' (condition when the patient’s body becomes free from the ''ama''). These features generally appear on the 8th day. [137-138]

==== Precaution at initial stage of ''jwara'' ====

+

नवज्वरे दिवास्वप्नस्नानाभ्यङ्गान्नमैथुनम्||१३८||

क्रोधप्रवातव्यायामान् कषायांश्च विवर्जयेत्|१३९|

+

navajvarē divāsvapnasnānābhyaṅgānnamaithunam||138||

Line 2,028: Line 2,145:

krodhapravAtavyAyAmAn kaShAyAMshca vivarjayet|139|

+

</div></div>

The patient, in the state of ''nava jwara'' (first stage fever) should avoid certain things as – daytime sleep, bath, massage, heavy to digest food, sexual intercourse, anger, direct exposure to wind, exercise, and ''kashaya'' (astringent foods). [138-139]

==== Contra-indications of ''langhana'' (fasting) ====

+

ज्वरे लङ्घनमेवादावुपदिष्टमृते ज्वरात्||१३९||

क्षयानिलभयक्रोधकामशोकश्रमोद्भवात् |१४०|

+

jvarē laṅghanamēvādāvupadiṣṭamr̥tē jvarāt||139||

Line 2,044: Line 2,164:

kShayAnilabhayakrodhakAmashokashramodbhavAt |140|

+

</div></div>

''Langhana'' or fasting is prescribed in the initial stage of ''jwara'' except those caused by ''kshaya'' (consumption), ''vata'' dominant ''jwara'', fear, anger, passion, grief and physical exertion.[139-140]

==== Benefits of ''langhana'' (fasting) in ''jwara'' ====

+

लङ्घनेन क्षयं नीते दोषे सन्धुक्षितेऽनले||१४०||

Line 2,056: Line 2,178:

बलाधिष्ठानमारोग्यं यदर्थोऽयं क्रियाक्रमः|१४२|

+

laṅghanēna kṣayaṁ nītē dōṣē sandhukṣitē'nalē||140||

Line 2,072: Line 2,195:

balAdjhiShThAnamArogyaM yadartho~ayaM kriyAkramaH|142|

+

</div></div>

''Langhana'' reduces the aggravated ''dosha'' and stimulates the ''agni'', as a result of which ''jwara'' subsides and the body becomes light and the person’s appetite is restored.

Line 2,078: Line 2,202:

==== Management principle of ''jwara'' ====

+

लङ्घनं स्वेदनं कालो यवाग्वस्तिक्तको रसः||१४२||

पाचनान्यविपक्वानां दोषाणां तरुणे ज्वरे|१४३|

+

laṅghanaṁ svēdanaṁ kālō yavāgvastiktakō rasaḥ||142||

Line 2,090: Line 2,216:

pAcanAnyavipakvAnAM doShANAM taruNe jvare|143|

+

</div></div>

''Langhana'' (fasting), ''swedana'' (fomentation), ''kala'' (waiting period of eight days), ''yavagu'' (medicated gruels) and ''tikta rasa'' drugs (drugs having bitter taste) and all digestive enhancers of ''avipakva dosha'' (untransformed) are prescribed in the ''taruna jwara'' (the initial stage of ''jwara'').[142]

==== Various drinks for management of thirst ====

+

तृष्यते सलिलं चोष्णं दद्याद्वातकफज्वरे ||१४३||

Line 2,102: Line 2,230:

स्रोतसां शोधनं बल्यं रुचिस्वेदकरं शिवम्|१४५|

+

tr̥ṣyatē salilaṁ cōṣṇaṁ dadyādvātakaphajvarē ||143||

Line 2,118: Line 2,247:

srotasAM shodhanaM balyaM rucisvedakaraM shivam|145|

+

</div></div>

If the patient of ''jwara'' feels thirsty, he should be given :

Line 2,128: Line 2,258:

==== ''Shadanga paniya'' ====

+

मुस्तपर्पटकोशीरचन्दनोदीच्यनागरैः||१४५||

शृतशीतं जलं दद्यात् पिपासाज्वरशान्तये|१४६|

+

mustaparpaṭakōśīracandanōdīcyanāgaraiḥ||145||

Line 2,140: Line 2,272:

shRutashItaM jalaM dadyAt pipAsAjvarashAntaye|146|

+

</div></div>

Patient should be given water cooled after boiling it with ''musta, parpataka, ushira, chandana, udichya'' and ''nagara'' for the alleviation of thirst and ''jwara''. [145]

==== Indication of ''vamana'' (therapeutic emesis) ====

+

कफप्रधानानुत्क्लिष्टान् दोषानामाशयस्थितान्||१४६||

बुद्ध्वा ज्वरकरान् काले वम्यानां वमनैर्हरेत्|१४७|

+

kaphapradhānānutkliṣṭān dōṣānāmāśayasthitān||146||

Line 2,156: Line 2,291:

buddhvA jvarakarAn kAle vamyAnAM vamanairharet|147|

+

</div></div>

If the ''jwara'' is predominantly caused by vitiated ''kapha dosha'', located in the ''amashaya'' (stomach) and is in a stage of ''utklesha'' (in a stage of being on the verge of coming out of its place), then it should be eliminated by the administration of emetics.

Line 2,162: Line 2,298:

==== Hazards of improper ''vamana'' (therapeutic emesis) ====

+

अनुपस्थितदोषाणां वमनं तरुणेज्वरे||१४७||

Line 2,170: Line 2,307:

दोषाः फलानामामानां स्वरसा इव सात्ययाः|१४९|

+

anupasthitadōṣāṇāṁ vamanaṁ taruṇējvarē||147||

Line 2,186: Line 2,324:

doShAH phalAnAmAmAnAM svarasA iva sAtyayAH|149|

+

</div></div>

If ''vamana'' (emesis) is administered to a ''jwara'' patient in whom the ''dosha'' have not attained the stage of ''utklesha'' (verge of coming out), then they may cause acute form of heart disease, dyspnea, ''anaha'' (obstruction to the movement of flatus and feces) and illusion. Attempting to take out the ''anupasthita dosha'' (unprepared to be eliminated) from the body of a person bring complications for the person and is just like attempting to take out juice from a raw fruit which creates complications (destroys the fruit). [147-149]

==== Post ''vamana'' protocol ====

+

वमितं लङ्घितं काले यवागूभिरुपाचरेत्||१४९||

Line 2,208: Line 2,348:

ज्वरघ्न्यो ज्वरसात्म्यत्वात्तस्मात् पेयाभिरादितः||१५३||

+

vamitaṁ laṅghitaṁ kālē yavāgūbhirupācarēt||149||

Line 2,244: Line 2,385:

jvaraghnyo jvarasAtmyatvAttasmAt peyAbhirAditaH||153||

+

</div></div>

The patient after being given emesis and kept on fasting should be administered ''yavagu'' (a gruel preparation) prepared by boiling with the drugs mentioned further, in appropriate time. Before administering ''yavagu'', the patient should be given ''manda'' (extremely thin gruel). This should be continued by the wise for either six days or till the ''jwara'' becomes mild.

Line 2,254: Line 2,396:

==== Contra-indications of ''yavagu'' ====

+

ज्वरानुपचरेद्धीमानृते मद्यसमुत्थितात्|

Line 2,260: Line 2,403:

ऊर्ध्वगे रक्तपित्ते च यवागूर्न हिता ज्वरे|१५५|

+

jvarānupacarēddhīmānr̥tē madyasamutthitāt|

Line 2,272: Line 2,416:

Urdhvage raktapitte ca yavAgUrna hitA jvare|155|

+

</div></div>

However, these gruels are contraindicated in the fevers caused by intake of alcohol, in alcoholism, for persons addicted to alcohol, in summer seasons, when there is predominance of ''pitta'' and ''kapha'' and in ''urdhwaga rakta–pitta'' (a disease characterized by bleeding from the different upper channels of the body).[154]

+

तत्र तर्पणमेवाग्रे प्रयोज्यं लाजसक्तुभिः||१५५||

ज्वरापहैः फलरसैर्युक्तं समधुशर्करम्|१५६|

+

tatra tarpaṇamēvāgrē prayōjyaṁ lājasaktubhiḥ||155||

Line 2,286: Line 2,433:

jvarApahaiH phalarasairyuktaM samadhusharkaram|156|

+

</div></div>

In cases where ''yavagu'' administration is prohibited, the physician should administer in the beginning ''tarpana'' (nutritional diet) prepared from ''laja saktu'' (powder of roasted grains) mixed with honey, sugar and fruit juices, which have ''jwara'' alleviating properties.[155]

==== Guidelines for diet, mouth cleansing and tooth brush ====

+

ततः सात्म्यबलापेक्षी भोजयेज्जीर्णतर्पणम्||१५६||

Line 2,306: Line 2,455:

मस्त्विक्षुरसमद्याद्यैर्यथाहारमवाप्नुयात्|१६०|

+

tataḥ sātmyabalāpēkṣī bhōjayējjīrṇatarpaṇam||156||

Line 2,338: Line 2,488:

mastvikShurasamadyAdyairyathAhAramavApnuyAt|160|

+

</div></div>

Depending upon the habituation (''satmya'') and the strength of the patient, after digestion of the ''tarpana'', patient is administered thin soup of ''mudga'' (green gram) or meat of wild animals. During food time, the patient’s teeth should be cleaned with the twig of plants, which should be such that their taste can counteract the taste of the patient’s mouth and is relishing to the patient. Such kind of cleaning of teeth makes the patient feel freshness in his mouth, develops appetite for food and drinks and becomes capable of appreciating the taste of food to be taken. The mouth should be cleaned several times with water after cleaning with twigs. Thereafter the patient should be given ''mastu'' (thin butter milk), sugarcane juice, alcoholic drinks etc. with suitable and appropriate diet.[156-159]

+

पाचनं शमनीयं वा कषायं पाययेद्भिषक्||१६०||

ज्वरितं षडहेऽतीते लघ्वन्नप्रतिभोजितम्|१६१|

+

pācanaṁ śamanīyaṁ vā kaṣāyaṁ pāyayēdbhiṣak||160||

Line 2,352: Line 2,505:

jvaritaM ShaDahe~atIte laghvannapratibhojitam|161|

+

</div></div>

The ''jwara'' patient, after six days and having been given light diet to eat, should be administered decoctions, which are either ''pachana'' (stimulant of digestion) or ''shamana'' (alleviator of ''doshas''). [160-161]

==== Contra-indications of ''kashaya'' (astringents) ====

+

स्तभ्यन्ते न विपच्यन्ते कुर्वन्ति विषमज्वरम्||१६१||

Line 2,364: Line 2,519:

यः कषायकषायः स्यात् स वर्ज्यस्तरुणज्वरे|१६३|

+

stabhyantē na vipacyantē kurvanti viṣamajvaram||161||

Line 2,380: Line 2,536:

yaH kaShAyakaShAyaH syAt sa varjyastaruNajvare|163|

+

</div></div>

If, decoctions of astringent drugs are administered to the patient in ''taruna jwara'' (first stage of ''jwara'') stage, then the ''doshas'' do not undergo ''paka'' (digested) and get adhered due to stickiness. This leads to the onset of ''vishama jwara'' (irregular fevers). The term ''kashaya'' has two meanings i.e. the decoction prepared by boiling the drugs and astringent taste. In the first stage of ''jwara'' (''taruna jwara''), the astringent tasted drugs are prohibited. [161-163]

==== ''Yusha'' (soup) indications ====

+

यूषैरम्लैरनम्लैर्वा जाङ्गलैर्वा रसैर्हितैः||१६३||

दशाहं यावदश्नीयाल्लघ्वन्नं ज्वरशान्तये|१६४|

+

yūṣairamlairanamlairvā jāṅgalairvā rasairhitaiḥ||163||

Line 2,396: Line 2,555:

dashAhaM yAvadashnIyAllaghvannaM jvarashAntaye|164|

+

</div></div>

The patient should be given light diet along with ''yusha'' (soup) prepared from vegetables and pulses and ''rasa'' (soup) of the meat of animals inhabiting arid regions, for the alleviation of ''jwara'', up to the tenth day. ''Amla'' (sour) things may or may not be added to these ''yusha''. [163-164]

==== Indications and contra-indications of ''ghrita'' ====

+

अत ऊर्ध्वं कफे मन्दे वातपित्तोत्तरे ज्वरे||१६४||

Line 2,412: Line 2,573:

बलं ह्यलं निग्रहाय दोषाणां, बलकृच्च तत् |१६७|

+

ata ūrdhvaṁ kaphē mandē vātapittōttarē jvarē||164||

Line 2,436: Line 2,598:

balaM hyalaM nigrahAya doShANAM, balakRucca tat |167|

+

</div></div>

Thereafter, in case of less aggravation of ''kapha dosha'' and excess aggravation of ''vata'' and ''pitta dosha'', and in whom the ''dosha'' have reached the ''pakva'' stage (having no ''ama ansha''), ghee should be given to the patients. It is like ''amrita'' (nectar) for them.

Line 2,444: Line 2,607:

==== Indication of milk ====

+

दाहतृष्णापरीतस्य वातपित्तोत्तरं ज्वरम्||१६७||

बद्धप्रच्युतदोषं वा निरामं पयसा जयेत्|१६८|

+

dāhatr̥ṣṇāparītasya vātapittōttaraṁ jvaram||167||

Line 2,456: Line 2,621:

baddhapracyutadoShaM vA nirAmaM payasA jayet|168|

+

</div></div>

A patient with the following conditions should be given milk in ''nirama'' stage in the body –

Line 2,463: Line 2,629:

==== Indication of ''virechana'' ====

+

क्रियाभिराभिः प्रशमं न प्रयाति यदा ज्वरः||१६८||

अक्षीणबलमांसाग्नेः शमयेत्तं विरेचनैः|१६९|

+

kriyābhirābhiḥ praśamaṁ na prayāti yadā jvaraḥ||168||

Line 2,475: Line 2,643:

akShINabalamAMsAgneH shamayettaM virecanaiH|169|

+

</div></div>

If the ''jwara'' does not subside by the therapies described before, then ''virechana'' (purgation) should be given for its alleviation provided, the patient is neither emaciated, weak, depleted of muscle tissue nor has reduced digestive power. [168-169]

==== Indications of ''niruha'' (enema with decoction) ====

+

ज्वरक्षीणस्य न हितं वमनं न विरेचनम्||१६९||

Line 2,491: Line 2,661:

स्रंसनं त्रीन्मलान् बस्तिर्हरेत् पक्वाशयस्थितान्|१७२|

+

jvarakṣīṇasya na hitaṁ vamanaṁ na virēcanam||169||

Line 2,515: Line 2,686:

sraMsanaM trInmalAn bastirharet pakvAshayasthitAn|172|

+

</div></div>

Neither ''vamana'' (emesis) nor ''virechana'' (purgation) is useful for patients emaciated by fever. It is thus desirable to remove their malas by the administration of milk or ''niruha'' (ununctuous type of medicated enema prepared by decoctions etc.)

Line 2,523: Line 2,695:

==== Indication of ''anuvasana'' (unctuous enema) ====

+

ज्वरे पुराणे सङ्क्षीणे कफपित्ते दृढाग्नये||१७२||

रूक्षबद्धपुरीषाय प्रदद्यादनुवासनम्|१७३|

+

jvarē purāṇē saṅkṣīṇē kaphapittē dr̥ḍhāgnayē||172||

Line 2,535: Line 2,709:

rUkShabaddhapurIShAya pradadyAdanuvAsanam|173|

+

</div></div>

In chronic types of fever (''jirna jwara'') ''anuvasana'' type of ''basti'' (medicated enema with oils) should be given in the following conditions –

Line 2,542: Line 2,717:

==== Indications of ''murdha-virechana'' (nasal errhines) ====

+

गौरवे शिरसः शूले विबद्धेष्विन्द्रियेषु च||१७३||

जीर्णज्वरे रुचिकरं कुर्यान्मूर्धविरेचनम्|१७४|

+

gauravē śirasaḥ śūlē vibaddhēṣvindriyēṣu ca||173||

Line 2,554: Line 2,731:

jIrNajvare rucikaraM kuryAnmUrdhavirecanam|174|

+

</div></div>

''Murdha virechana'' should be done in patients suffering from chronic type of fevers who have heaviness and pain in head, impaired sensoria. This develops relish for food and also the objects. [173-174]

==== Various external procedures ====

+

अभ्यङ्गांश्च प्रदेहांश्च परिषेकावगाहने||१७४||

Line 2,570: Line 2,749:

त्वङ्मात्रशेषा येषां च भवत्यागन्तुरन्वयः|१७७|

+

abhyaṅgāṁśca pradēhāṁśca pariṣēkāvagāhanē||174||

Line 2,594: Line 2,774:

tva~gmAtrasheShA yeShAM ca bhavatyAganturanvayaH|177|

+

</div></div>

''Abhyanga'' (massage), ''pradeha'' (unguentum), ''parisheka'' (sprinkling of water), and ''avagahana'' (bathing) should be done in patients of ''jirna jwara'' (chronic fevers) considering the types of ''jwara'' with their hot and cold types. By these measures the ''bahirmargagata'' (located in the external tissues) ''jwara'' gets alleviated instantaneously. There is a feeling of ease in the body along with the promotion of strength and complexion.

Line 2,602: Line 2,783:

==== Various dietary articles used in treatment ====

+

इति क्रियाक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१७७||

Line 2,610: Line 2,792:

यवाग्वोदनलाजार्थे ज्वरितानां ज्वरापहाः|१७९|

+

iti kriyākramaḥ siddhō jvaraghnaḥ samprakāśitaḥ||177||

Line 2,626: Line 2,809:

yavAgvodanalAjArthe jvaritAnAM jvarApahAH|179|

+

</div></div>

Proper line of treatment for the alleviation of ''jwara'' has been described above, the ingredients used for therapies in accordance to the above stated line of treatment has been described further.

Line 2,632: Line 2,816:

==== Ten types of ''yavagu'' (gruel) in ''jwara'' ====

+

लाजपेयां सुखजरां पिप्पलीनागरैः शृताम्||१७९||

Line 2,668: Line 2,853:

नागरामलकैः सिद्धां घृतभृष्टां ज्वरापहाम्|१८८|

+

lājapēyāṁ sukhajarāṁ pippalīnāgaraiḥ śr̥tām||179||

Line 2,740: Line 2,926:

nAgarAmalakaiH siddhAM ghRutabhRuShTAM jvarApahAm|188|

+

</div></div>

*The ''peya'' prepared with ''laja'' (fried paddy) and boiled with ''pippali'' and ''nagara'' is light to digest and should be given to the patient in the beginning of the ''jwara'' when the digestive power is reduced. However, it should be ascertained before administration that the patient is desirous for food before administration.

Line 2,753: Line 2,940:

==== Indications of soup ====

+

मुद्गान्मसूरांश्चणकान् कुलत्थान् समकुष्टकान्||१८८||

यूषार्थे यूषसात्म्यानां ज्वरितानां प्रदापयेत्|१८९|

+

mudgānmasūrāṁścaṇakān kulatthān samakuṣṭakān||188||

Line 2,765: Line 2,954:

yUShArthe yUShasAtmyAnAM jvaritAnAM pradApayet|189|

+

</div></div>

''Yusha'' is wholesome for some patients of ''jwara''. This ''yusha'' may be prepared from ''mudga, masura, chanaka, kulattha'' and ''makushtha''.[188-189]

==== Indications of vegetables ====

+

पटोलपत्रं सफलं कुलकं पापचेलिकम्||१८९||

कर्कोटकं कठिल्लं च विद्याच्छाकं ज्वरे हितम्|१९०|

+

paṭōlapatraṁ saphalaṁ kulakaṁ pāpacēlikam||189||

Line 2,781: Line 2,973:

karkoTakaM kaThillaM ca vidyAcchAkaM jvare hitam|190|

+

</div></div>

The leaves and fruits of ''patola, kulaka'' (''karvellaka''), ''papachelika'' (''patha''), ''karkotaka, kathilla'' (red variety of ''punarnava'') ''shakas'' are useful in the patients of ''jwara''. [189-190]

==== Indication of animal meat soups ====

+

लावान् कपिञ्जलानेणांश्चकोरानुपचक्रकान्||१९०||

Line 2,801: Line 2,995:

भिषङ्मात्राविकल्पज्ञो दद्यात्तानपि कालवित्|१९४|

+

lāvān kapiñjalānēṇāṁścakōrānupacakrakān||190||

Line 2,833: Line 3,028:

bhiSha~gmAtrAvikalpaj~jo [1] dadyAttAnapi kAlavit|194|

+

</div></div>

The soup prepared from ''lava, kapinjala'' (white variety of ''tittiri''), ''ena'' (''krishna sara''), ''chakora, upachakraka'' (a variety of ''chakora''), ''kuranga, kala puccha'' (a type of ''harina''), ''harina'' (coppery coloured dear), ''priashata'' (spotted deer) and ''shasha'' (rabbit) are alleviators of ''jwara'' and hence should be given to the patients of ''jwara'' for whom meat is wholesome. These meat soups may be made slightly sour or taken as such. The wise physician should administer these soups at appropriate time.

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==== ''Anupana''(beverages) ====

+

घर्माम्बु चानुपानार्थं तृषिताय प्रदापयेत्||१९४||

मद्यं वा मद्यसात्म्याय यथादोषं यथाबलम्|१९५|

+

gharmāmbu cānupānārthaṁ tr̥ṣitāya pradāpayēt||194||

Line 2,851: Line 3,049:

madyaM vA madyasAtmyAya yathAdoShaM yathAbalam|195|

+

</div></div>

Hot water should be given to drink to a thirsty person. Depending upon the ''doshas'' involved and the strength of the patient ''madya'' (wines) may be given to those patients for whom it is wholesome. [194-195]

==== Contra-indications in ''jwara'' ====

+

गुरूष्णस्निग्धमधुरान् कषायांश्च नवज्वरे||१९५||

Line 2,861: Line 3,061:

अन्नपानक्रमः सिद्धो ज्वरघ्नः सम्प्रकाशितः||१९६||

+

gurūṣṇasnigdhamadhurān kaṣāyāṁśca navajvarē||195||

Line 2,873: Line 3,074:

annapAnakramaH siddho jvaraghnaH samprakAshitaH||196||

+

</div></div>

Food ingredients, which are heavy to digest, hot in potency, with unctuous property, sweet and astringent taste should preferably be avoided in a patient suffering from ''nava jwara'' (the patient of first stage of ''jwara'') in order to facilitate the ''paka'' of the ''doshas''.

Line 2,879: Line 3,081:

==== Decoctions indicated in ''jwara'' ====

+

अत ऊर्ध्वं प्रवक्ष्यन्ते कषाया ज्वरनाशनाः|

Line 2,890: Line 3,093:

तृष्णारुचिप्रशमना मुखवैरस्यनाशनाः|२००|

+

ata ūrdhvaṁ pravakṣyantē kaṣāyā jvaranāśanāḥ|

Line 2,912: Line 3,116:

tRuShNAruciprashamanA mukhavairasyanAshanAH|200|

+

</div></div>

Now, we will describe the ''kashayas'' (decoctions), which alleviate ''jwara''. These are as follows:

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==== ''Kashaya'' in ''vishama jwara'' ====

+

कलिङ्गकाः पटोलस्य पत्रं कटुकरोहिणी||२००||

Line 2,936: Line 3,142:

सन्ततं सततान्येद्युस्तृतीयकचतुर्थकान्||२०३||

+

kaliṅgakāḥ paṭōlasya patraṁ kaṭukarōhiṇī||200||

Line 2,964: Line 3,171:

santataM satatAnyedyustRutIyakacaturthakAn||203||

+

</div></div>

The five types of ''jwara'' named the ''santata, satata, anyedyushka, tritiyaka'' and ''chaturthaka'' are quickly cured by the five types of decoctions made from drugs described below:

Line 2,972: Line 3,180:

#''Kiratatikta, amrita, chandana, vishva bheshaja''; and

#''Guduchi, amalaka'' and ''musta''. [200-203]

+

वत्सकारग्वधौ पाठां षड्ग्रन्थां कटुरोहिणीम्|

Line 2,986: Line 3,195:

पीत्वा निशिस्थितं जन्तुर्ज्वराच्छीघ्रं विमुच्यते|२०७|

+

vatsakāragvadhau pāṭhāṁ ṣaḍgranthāṁ kaṭurōhiṇīm|

Line 3,014: Line 3,224:

pItvA nishisthitaM janturjvarAcchIghraM vimucyate|207|

+

</div></div>

The decoction or ''shita kashaya'' of the following drugs should be taken by a person for curing ''jwara:''

Line 3,022: Line 3,233:

The ''shita kashaya'' of ''madhuka, musta, mrudvika, kashmarya, parushaka, trayamana, ushira, triphala,'' and ''katu rohini'', prepared by keeping overnight, immediately cures the ''jwara'' of living beings. [204-207]

+

जात्यामलकमुस्तानि तद्वद्धन्वयवासकम्||२०७||

Line 3,032: Line 3,244:

त्रिवृताशर्करायुक्तः पित्तश्लेष्मज्वरापहः||२०९||

+

jātyāmalakamustāni tadvaddhanvayavāsakam||207||

Line 3,052: Line 3,265:

trivRutAsharkarAyuktaH pittashleShmajvarApahaH||209||

+

</div></div>

The decoction of either ''jati, amalaka'' and ''musta'' or that of ''dhanavayavasakam'' along with ''guda'' (jaggery) should be given to the patient suffering from ''jwara'' where the ''doshas'' are in ''vibaddha'' state (adhered to ''dhatus'').

Line 3,058: Line 3,272:

==== Formulations used in ''sannipata jwara'' ====

+

बृहत्यौ वत्सकं मुस्तं देवदारु महौषधम्|

Line 3,078: Line 3,293:

कासादिषु च सर्वेषु दद्यात् सोपद्रवेषु च||२१४||

+

br̥hatyau vatsakaṁ mustaṁ dēvadāru mahauṣadham|

Line 3,118: Line 3,334:

kAsAdiShu ca sarveShu dadyAt sopadraveShu ca||214||

+

</div></div>

A decoction prepared from both the varities of ''bruhati, vatsaka, musta, devadaru, mahaushadha,'' and ''kolavalli'' cures ''sannipata jwara''. ''Shati, pushkaramula, vyaghri, shringi, duralabha, guduchi, nagara, patha, kirata, katurohini'' - all together are called by the name of ''shatyadi varga''. The decoction made from these drugs helps in curing ''sannipāta jwara'' along with ''kasa'' (coughs), ''hrid graham'' (a kind of heart disease), ''parshva arti'' (pain in the flanks), ''shvasa'' (breathlessness) and ''tandra'' (drowsiness).

Both the varieties of ''brihati, paushkar, bhaargi, shathi, shringī, duraalabha,'' seeds of ''vatsaka, patola'' and ''katu rohini'' – are together called the ''brihatyadi gana'' and the decoction made from it cures the ''sannipata jwara''. And is also useful in complications like ''kasa''. [210-214]

+

कषायाश्च यवाग्वश्च पिपासाज्वरनाशनाः|

निर्दिष्टा भेषजाध्याये भिषक्तानपि योजयेत्||२१५||

+

kaṣāyāśca yavāgvaśca pipāsājvaranāśanāḥ|

Line 3,134: Line 3,353:

nirdiShTA bheShajAdhyAye bhiShaktAnapi yojayet||215||

+

</div></div>

Different types of decoctions and gruels are also described in the first four chapters of [[Sutra Sthana]] which also cure ''pipasa'' (thirst) and ''jwara''. They may also be used by the physician for the treatment of ''jwara''. [215]

==== Advantage of ghee ====

+

ज्वराः कषायैर्वमनैर्लङ्घनैर्लघुभोजनैः|

Line 3,146: Line 3,367:

यः स्यादनुबलो धातुः स्नेहवध्यः स चानिलः||२१७||

+

jvarāḥ kaṣāyairvamanairlaṅghanairlaghubhōjanaiḥ|

Line 3,162: Line 3,384:

yaH syAdanubalo dhAtuH snehavadhyaH [1] sa cAnilaH||217||

+

</div></div>

If in a person of ununctuous disposition, jwara doesn’t get cured by the use of decoctions, emesis, fasting and by light diet, then ''jwara'' in such a person should be cured by the use of medicated ''ghrita'' (ghee). ''Jwara'' is manifested by ununctuous state of ''tejasa'' in such a person and a patient suffering from ''jwara'' further develops ununctuousness due to the action of this ''tejasa'' (''pitta''). The ''vata'' gets aggravated due to the action of this ''tejasa'' and it can be corrected by the use of some unctuous material like ''ghrita''. [216-217]

+

कषायाः सर्व एवैते सर्पिषा सह योजिताः|

प्रयोज्या ज्वरशान्त्यर्थमग्निसन्धुक्षणाः शिवाः||२१८||

+

kaṣāyāḥ sarva ēvaitē sarpiṣā saha yōjitāḥ|

Line 3,176: Line 3,401:

prayojyA jvarashAntyarthamagnisandhukShaNAH shivAH||218||

+

</div></div>

''Ghrita'' should be added to all those decoctions described above for the alleviation of ''jwara''. They stimulate the power of digestion and endow auspiciousness. [218]

==== Various medicated ghee formulations ====

−

+

पिप्पल्यश्चन्दनं मुस्तमुशीरं कटुरोहिणी|

Line 3,193: Line 3,419:

अंसाभितापमाग्निं च विषमं सन्नियच्छति||२२१||

+

pippalyaścandanaṁ mustamuśīraṁ kaṭurōhiṇī|

Line 3,217: Line 3,444:

aMsAbhitApamAgniM ca viShamaM sanniyacchati||221||

+

</div></div>

Medicated ''ghrita'' prepared by boiling with ''pipali, chandana, musta, katurohini, kalingaka, tamalaki'' (''bhumyamalaki''), ''sariva, ativisha, sthira, draksha, amalaka, bilva, trayamana'' and ''nidigdhika'' cure chronic types of ''jwara'' instantaneously. It also cures ''kshaya'' (consumption), ''kasa'' (coughs), ''shirahshula'' (headache), ''parshvashula'' (pain in the sides of chest), ''halimaka'' (a type of jaundice), ''ansabhitapa'' (burning sensation in the scapular region) and ''vishama agni'' (irregularity in the power of digestion). [219-221]

+

वासां गुडूचीं त्रिफलां त्रायमाणां यवासकम्|

Line 3,227: Line 3,456:

कल्कीकृतैश्च विपचेद्धृतं जीर्णज्वरापहम्||२२३||

+

vāsāṁ guḍūcīṁ triphalāṁ trāyamāṇāṁ yavāsakam|

Line 3,243: Line 3,473:

kalkIkRutaishca vipaceddhRutaM jIrNajvarApaham||223||

+

</div></div>

''Ghrita'' prepared from the decoction made by boiling ''vasa, guduchi, triphala, trayamana'' and ''yavasaka'', milk in double the quantity, paste of ''pippali, musta, mridvika, chandana, utpala'' and ''nagara'' cures chronic fevers.[222-223]

+

बलां श्वदंष्ट्रां बृहतीं कलसीं धावनीं स्थिराम्|

Line 3,257: Line 3,489:

क्षयकासशिरःशूलपार्श्वशूलांसतापनुत् ||२२६||

+

balāṁ śvadaṁṣṭrāṁ br̥hatīṁ kalasīṁ dhāvanīṁ sthirām|

Line 3,281: Line 3,514:

kShayakAsashiraHshUlapArshvashUlAMsatApanut ||226||

+

</div></div>

''Ghrita'' prepared from boiling the decoction of ''bala, shvadamstra, brihati, kalasi, dhavani, sthira, nimba, parpataka, musta, trayamana'' and ''duralabha''; paste of ''tamalaki, shati, draksha, pushkarmula, meda'' and ''amalakī'', ghee and milk; is an excellent medicine for the treatment of ''jwara''. It also cures ''kshaya'' (consumption), ''kasa'' (coughs), ''shirahshula'' (headache), ''parshvashula'' (pain in the sides of chest), ''halimaka'' (a type of jaundice), ''ansabhitapa'' (burning sensation in the scapular region. [224-226]

==== Formulations used in purification therapies ====

+

ज्वरिभ्यो बहुदोषेभ्य ऊर्ध्वं चाधश्च बुद्धिमान्|

Line 3,313: Line 3,548:

पयोऽनुपानमुष्णं वा पीत्वा द्राक्षारसं नरः||२३३||

+

jvaribhyō bahudōṣēbhya ūrdhvaṁ cādhaśca buddhimān|

Line 3,369: Line 3,605:

payo~anupAnamuShNaM vA pItvA drAkShArasaM naraH||233||

+

</div></div>

Elimination therapies (of ''doshas''), both in upward and downward routes should be administered at appropriate time, to a patient suffering from ''jwara'', having more aggravated ''doshas''. Details of these methods and the formulations used for them will be discussed in the [[Kalpa Sthana]].

Line 3,388: Line 3,625:

==== Formulations with medicated milk ====

+

कासाच्छ्वासाच्छिरःशूलात्पार्श्वशूलाच्चिरज्वरात्|

Line 3,412: Line 3,650:

पेयं तदुष्णं शीतं वा यथास्वं भेषजैः शृतम्||२३९||

+

kāsācchvāsācchiraḥśūlātpārśvaśūlāccirajvarāt|

Line 3,460: Line 3,699:

peyaM taduShNaM shItaM vA yathAsvaM bheShajaiH shRutam||239||

+

</div></div>

A patient suffering from ''chira jwara'' (chronic type of fevers), ''kasa, shvāsa, shirahshula'' and ''parshvashula'' gets cured by taking milk boiled with ''panchamula'' (''bilva'' and ''shyonaka, gambhari, patala'' and ''ganikarika'').

Line 3,476: Line 3,716:

==== Medicated enemas ====

+

प्रयोजयेज्ज्वरहरान्निरूहान् सानुवासनान्|

Line 3,532: Line 3,773:

सिद्धः स्नेहो ज्वरहरः स्नेहबस्तिः प्रशस्यते||२५३||

+

prayōjayējjvaraharānnirūhān sānuvāsanān|

Line 3,644: Line 3,886:

siddhaH sneho jvaraharaH snehabastiH prashasyate||253||

+

</div></div>

''Niruha'' and ''anuvasana'' types of ''bastis'' (medicated enemas) which will be described in the [[Siddhi Sthana]] should be administered when the ''doshas'' are lodged in the ''pakvashaya'', for the treatment of ''jwara''.

Line 3,662: Line 3,905:

==== Indications of ''shiro-virechana'' (nasal errhines) ====

+

यदुक्तं भेषजाध्याये विमाने रोगभेषजे|

Line 3,670: Line 3,914:

मात्राशितीये निर्दिष्टाः प्रयोज्यास्ता ज्वरेष्वपि||२५५||

+

yaduktaṁ bhēṣajādhyāyē vimānē rōgabhēṣajē|

Line 3,686: Line 3,931:

mAtrAshitIye nirdiShTAH prayojyAstA jvareShvapi||255||

+

</div></div>

Drugs for ''shirovirechana'' therapy (module of taking out the ''doshas'' from the ''uttamānga - shira'') are already described in the ''Bheshaja Chatushka'' of [[Sutra Sthana]] and [[Rogabhishagjitiya Vimana]] of [[Vimana Sthana]]. A physician well versed in these treatment modules should apply them for the treatment of ''jwara''.

Line 3,692: Line 3,938:

==== External applications ====

+

अभ्यङ्गांश्च प्रदेहांश्च परिषेकांश्च कारयेत्|

Line 3,700: Line 3,947:

दाहज्वरप्रशमनं दद्यादभ्यञ्जनं भिषक्||२५७||

+

abhyaṅgāṁśca pradēhāṁśca pariṣēkāṁśca kārayēt|

Line 3,716: Line 3,964:

dAhajvaraprashamanaM dadyAdabhya~jjanaM bhiShak||257||

+

</div></div>

''Abhyanga'' (massage), ''pradeha'' (unction) and ''parisheka'' (medicated bath) should be given to the patient, either hot or cold, according to the appropriateness of the two types of ''jwara'' of the patient.

Line 3,722: Line 3,971:

==== ''Chandanadya taila'' ====

+

अथ चन्दनाद्यं तैलमुपदेक्ष्यामः-

Line 3,737: Line 3,987:

मध्वारनालक्षीरदधिघृतसलिलसेकावगाहाश्च सद्यो दाहज्वरमपनयन्ति शीतस्पर्शत्वात्||२५९||

+

atha candanādyaṁ tailamupadēkṣyāmaḥ-

Line 3,767: Line 4,018:

madhvAranAlakShIradadhighRutasalilasekAvagAhAshca sadyo dAhajvaramapanayanti shItasparshatvAt||259||

+

</div></div>

Now, ''Chandanadya taila'' preparation will be described – ''chandana'' (red variety of ''chandana''), ''bhadrashri'' (white variety of ''chandana''), ''kalanusarya, kaiyaka, padma, padmaka, ushira, sariva, madhuka, nagapushpa, udichya, vanya, padma, utpala, nalina'' (a white variety of ''padma''), ''kumuda''; ''saugandhika, pundarika, shata patra, bis, mrinala, shaluka, shaivala, kasheruka, ananta, kusha, kasa, ikshu, darbha, shara, nala'' – root of ''shali, jambu, vetasa, vanira'' (a variety of ''vetasa'' which do not have fragrant root), ''gundra, kakubha, asana, ashvakarna'' (a variety of ''shala''), ''syandana'' (''nemi vriksha''), ''vatapotha'' (''palasha''), ''shala, tala, dava, tinisha'' (''vanjula''), ''khadira, kadara'' (''vitkhadira''), ''kadamba,'' fruit of ''kashmarya, sarja, plaksha, vata'' (the variety without any adventitious root), ''kapitana'' (popularly known as ''gandhamunda''), ''udumbara, ashvattha, nyagodhra, dhataki, durva, itkata, shringataka, manjishtha, jyotishmati'' (''kanganika''), seeds of ''pushkara, karunyachandana, badari, kovidara, kadali, samvartaka, ariṡṭa'' (a variety of ''neem'' growing in the hills), ''shataparva'' (''bibhitaka''), ''shita kumbhika'' (''kashtha patala''), ''shatavari, shriparni, shravani, mahashravani'' (''alambusha'' – having big fruits), ''rohini, seeta paki'' (''ganda durva''), ''odana paki'' (''neela bhendi''), ''kala'' (''kakoli''), ''bala, payasya, vidari, jeevaka, rishabhaka, meda, mahameda, madurasa, rishyaprokta'' (''riddhi''), ''trina shunya'' (''ketaki''), ''mocharasa, atarushaka, bakula, kutaja, patola, shalmali, narikela, kharjura, mridvika, priyala, priyangu, dhanvana, atmagupta, madhuka,'' and such other drugs which are cold in potency. Also, the drugs which have the same cooling effect can also be added to prepare this decoction, using double the quantity of water. The ''kalka'' (paste) of all the above mentioned drugs must also be taken. Oil mixed with the above stated decoction and paste should be boiled on mild fire till half the quantity is left.

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==== Guidelines for a patient with burning sensation ====

+

भवन्ति चात्र-

Line 3,807: Line 4,060:

वायवश्चन्द्रपादाश्च शीता दाहज्वरापहाः||२६६||

+

bhavanti cātra-

Line 3,867: Line 4,121:

vAyavashcandrapAdAshca shItA dAhajvarApahAH||266||

+

</div></div>

A patient of ''jwara'' suffering from burning sensation should reside in a house cooled by the leaves of ''puṡkara, padma, utpala, kadalī'' or ''kṡauma''. The house can also be cooled by cold water of sandalwood or the patient can also reside in a ''dhāra gṛha'' (a house cooled by running water either flowing from above or falling from the roof) or a house cooled by ice cool water. This gives comfort to the patient. His body should be touched with the pleasant touch of gold or conch shell or coral or jewels and pearls which are cooled by the sandalwood water. He should be made to wear the garlands made of ''nīlotpala'' or ''padma'' and fanned with the cold air from different types of fans which are cooled with sandalwood water.

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==== ''Agurvadya tailam'' ====

+

अथोष्णाभिप्रायिणां ज्वरितानामभ्यङ्गादीनुपक्रमानुपदेक्ष्यामः-अगुरुकुष्ठतगरपत्रनलदशैलेयध्यामकहरेणुकास्थौणेयकक्षेमकैलावराङ्गदलपुरतमालपत्रभूतीकरोहिषसरलशल्लकी-देवदार्वग्निमन्थबिल्वस्योनाककाश्मर्यपाटलापुनर्नवावृश्चीरकण्टकारीबृहतीशालपर्णीपृश्निपर्णीमाषपर्णीमुद्गपर्णीगोक्षुरकैरण्ड-शोभाञ्जनकवरुणार्कचिरबिल्वतिल्वकशटीपुष्करमूलगण्डीरोरुबूकपत्तूराक्षीवाश्मान्तकशिग्रुमातुलुङ्गपीलुकमूलकपर्णी-तिलपर्णीपीलुपर्णीमेषशृङ्गीहिंस्रादन्तशठैरावतकभल्लातकास्फोतकाण्डीरात्मजैकेषीकाकरञ्जधान्यकाजमोद-पृथ्वीकासुमुखसुरसकुठेरककालमालकपर्णासक्षवकफणिज्झकभूस्तृणशृङ्गवेरपिप्पलीसर्षपाश्वगन्धारास्नारुहारोहावचाबलातिबला-गुडूचीशतपुष्पाशीतवल्लीनाकुलीगन्धनाकुलीश्वेताज्योतिष्मतीचित्रकाध्यण्डाम्लचाङ्गेरी-तिलबदरकुलत्थमाषाणामेवंविधानामन्येषां चोष्णवीर्याणां यथालाभमौषधानां कषायं कारयेत्, तेन कषायेण तेषामेव चकल्केन सुरासौवीरकतुषोदकमैरेयमेदकदधिमण्डारनालकट्वरप्रतिविनीतेन तैलपात्रं विपाचयेत्|

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इत्यगुर्वाद्यं तैलम्

+

athōṣṇābhiprāyiṇāṁ jvaritānāmabhyaṅgādīnupakramānupadēkṣyāmaḥ-agurukuṣṭhatagarapatranaladaśailēyadhyāmakaharēṇukāsthauṇēyakakṣēmakailāvarāṅgadalapuratamālapatrabhūtīkarōhiṣasaralaśallakī-dēvadārvagnimanthabilvasyōnākakāśmaryapāṭalāpunarnavāvr̥ścīrakaṇṭakārībr̥hatīśālaparṇīpr̥śniparṇīmāṣaparṇīmudgaparṇīgōkṣurakairaṇḍa-śōbhāñjanakavaruṇārkacirabilvatilvakaśaṭīpuṣkaramūlagaṇḍīrōrubūkapattūrākṣīvāśmāntakaśigrumātuluṅgapīlukamūlakaparṇī-tilaparṇīpīluparṇīmēṣaśr̥ṅgīhiṁsrādantaśaṭhairāvatakabhallātakāsphōtakāṇḍīrātmajaikēṣīkākarañjadhānyakājamōda-pr̥thvīkāsumukhasurasakuṭhērakakālamālakaparṇāsakṣavakaphaṇijjhakabhūstr̥ṇaśr̥ṅgavērapippalīsarṣapāśvagandhārāsnāruhārōhāvacābalātibalā-guḍūcīśatapuṣpāśītavallīnākulīgandhanākulīśvētājyōtiṣmatīcitrakādhyaṇḍāmlacāṅgērī- tilabadarakulatthamāṣāṇāmēvaṁvidhānāmanyēṣāṁ cōṣṇavīryāṇāṁ yathālābhamauṣadhānāṁ kaṣāyaṁ kārayēt, tēna kaṣāyēṇa tēṣāmēva ca kalkēnasurāsauvīrakatuṣōdakamairēyamēdakadadhimaṇḍāranālakaṭvaraprativinītēna tailapātraṁ vipācayēt|

Line 3,895: Line 4,152:

ityagurvAdyaM tailam

+

</div></div>

Now, we will explain the therapies for patients of ''jwara'' for whom hot treatment is desirable –

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==== Indications of fomentation for alleviating cold ====

+

भवन्ति चात्र-

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शीतज्वरं जयन्त्याशु संसर्गबलयोजनात्||२७१||

+

bhavanti cātra-

Line 3,959: Line 4,219:

shItajvaraM jayantyAshu saMsargabalayojanAt||271||

+

</div></div>

Thirteen varities of ''sweda'' procedures have been described in the [[Swedadhyaya]] of [[Sutra Sthana]]. A physician who is well versed with the proper duration of ''sweda'' as suitable to the season and person should administer them for the treatment of ''shīta jwara''.

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====Contra-indications of ''langhana'' ====

+

वातजे श्रमजे चैव पुराणे क्षतजे ज्वरे|

लङ्घनं न हितं विद्याच्छमनैस्तानुपाचरेत्||२७२||

+

vātajē śramajē caiva purāṇē kṣatajē jvarē|

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la~gghanaM na hitaM vidyAcchamanaistAnupAcaret||272||

+

</div></div>

''Langhana'' (fasting) is not useful for patients suffering from ''jwara'' caused by aggravated ''vata'', by exhaustion, in chronic fevers, in fevers caused by ''kshata'' (external and internal injuries). Such patients should be treated by ''shamana'' therapy (alleviation therapy). [272]

==== Guidelines for improving ''agni'' (digestive strength) ====

+

विक्षिप्यामाशयोष्माणं यस्माद्गत्वा रसं नृणाम्|

Line 4,027: Line 4,292:

आदशाहमुपक्रम्य कषायाद्यैरुपाचरेत्|२८३|

+

vikṣipyāmāśayōṣmāṇaṁ yasmādgatvā rasaṁ nr̥ṇām|

Line 4,111: Line 4,377:

AdashAhamupakramya kaShAyAdyairupAcaret|283|

+

</div></div>

The aggravated ''doshas'' afflict the ''rasa dhatu'' and displace the ''agnī'' from the ''āmāshaya'', for causing ''jwara''. Thus, such patients have less of ''agni'' (digestive strength). Even if a rice pot is kept on burning fire with enough fuel, the rice will not get cooked if the fire is blown out by a strong wind. Similarly, in a patient of ''jwara'', the ''ūṡmā'' (digestive fire) is blown out of the ''paktī sthāna'' (place of digestion) and in this condition the consumed food is not digested properly. If the food is light, then also it gets digested with difficulty. Therefore, the line of treatment in ''jwara'' of ''langhana'' is useful for the preservation of the power of digestion.

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==== Guidelines for management in ''sannipata'' conditions ====

+

सामा ये ये च कफजाः कफपित्तज्वराश्च ये||२८३||

Line 4,137: Line 4,405:

कफस्थानानुपूर्व्या वा सन्निपातज्वरं जयेत्|२८७|

+

sāmā yē yē ca kaphajāḥ kaphapittajvarāśca yē||283||

Line 4,169: Line 4,438:

kaphasthAnAnupUrvyA vA sannipAtajvaraM jayet|287|

+

</div></div>

''Langhana'' and similar other therapies described in [[Langhanabrimhaniya Adhyaya]] of [[Sutra Sthana]] should be invariably administered in the following conditions:

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==== Management of ''karnamulika shotha'' (inflammatoion near the root of the ears) ====

+

सन्निपातज्वरस्यान्ते कर्णमूले सुदारूणः||२८७||

Line 4,190: Line 4,461:

प्रदेहैः कफपित्तघ्नैर्नावनैः कवलग्रहैः|२८९|

+

sannipātajvarasyāntē karṇamūlē sudārūṇaḥ||287||

Line 4,206: Line 4,478:

pradehaiH kaphapittaghnairnAvanaiH kavalagrahaiH|289|

+

</div></div>

A serious outcome of the ''sannipataja jwara'' is inflammation near the root of the ears which is a very serious condition and very few of such patients survive. Thus, efforts must be made immediately to cure it through therapeutic measures which alleviate ''kapha'' and ''pitta'' like blood letting, intake of ghee, ''pradeha'' (application of unction), ''navana'' (nasal instillation) and ''kavala graham'' (mouthful of liquid medication). [287-289]

==== Indications of blood letting ====

+

शीतोष्णस्निग्धरूक्षाद्यैर्ज्वरो यस्य न शाम्यति||२८९||

शाखानुसारी रक्तस्य सोऽवसेकात् प्रशाम्यति|२९०|

+

śītōṣṇasnigdharūkṣādyairjvarō yasya na śāmyati||289||

Line 4,222: Line 4,497:

shAkhAnusArI raktasya so~avasekAt prashAmyati|290|

+

</div></div>

When the ''jwara'' doesn’t get cured by either hot or cold or unctuous or ununctuous therapies etc., then it should be understood as ''śākhānusāri'' (that which is located in the peripheral tissues). Such type of fever gets cured by the administration of blood letting therapy. [289-290]

==== Indication of consumption of ghee ====

+

विसर्पेणाभिघातेन यश्च विस्फोटकैर्ज्वरः||२९०||

तत्रादौ सर्पिषः पानं कफपित्तोत्तरो न चेत्|२९१|

+

visarpēṇābhighātēna yaśca visphōṭakairjvaraḥ||290||

Line 4,238: Line 4,516:

tatrAdau sarpiShaH pAnaM kaphapittottaro na cet|291|

+

</div></div>

If ''jwara'' arises in a patient as a complication of ''visarpa'' (erysipelas like disease), ''abhighāta'' (injury) and ''visphoṭaka'' (eruptions in the body), the patient in such case should be given ghee to drink provided ''kapha'' and ''pitta dosha'' are not aggravated. [290-291]

==== Management of ''jeerna jwara'' (chronic stage) ====

+

दौर्बल्याद्देहधातूनां ज्वरो जीर्णोऽनुवर्तते||२९१||

बल्येः सम्बृंहणैस्तस्मादाहारैस्तमुपाचरेत्|२९२|

+

daurbalyāddēhadhātūnāṁ jvarō jīrṇō'nuvartatē||291||

Line 4,254: Line 4,535:

balyeH sambRuMhaNaistasmAdAhAraistamupAcaret|292|

+

</div></div>

The fever turns chronic if there is weakness in the tissues of the body. Hence such patients should be given foods which promote the strength and are nourishing. [291-292]

==== Management of ''dosha'' dominance in ''vishamajwara'' ====

+

कर्म साधारणं जह्यात्तृतीयकचतुर्थकौ ||२९२||

Line 4,274: Line 4,557:

कषायोष्णं च विषमे ज्वरे शस्तं कफोत्तरे|२९६|

+

karma sādhāraṇaṁ jahyāttr̥tīyakacaturthakau ||292||

Line 4,306: Line 4,590:

kaShAyoShNaM ca viShame jvare shastaM kaphottare|296|

+

</div></div>

The general line of treatment of ''jwaras'' should not be followed for the management of ''tṛtīyaka'' and ''chaturthaka jwara'' as these two types of fever are mostly associated with ''āgantu'' or extraneous factors as ''būtās'' or evil spirits including germs. When ''vāyu'' is predominantly aggravated in these two types of ''jwara'', then they should be cured by the administration of ghee, ''niruha'' and ''anuvāsana bastīs'' (medicated enemas), unctuous and hot diet and drinks. When the ''pitta dosha'' is dominant the patient should be given purgation therapy, medicated milk, ghee and articles which are bitter and cold. In state of ''kapha'' predominance, then the patient should be administered emetic therapy, ''pachana'' (therapy which promotes the digestion and metabolism), ununctuous diet and drinks, fasting and hot decoctions are useful. [292-296]

==== Guidelines and various formulations in ''vishama jwara'' ====

+

योगाः पराः प्रवक्ष्यन्ते विषमज्वरनाशनाः||२९६||

Line 4,366: Line 4,652:

धारणादगदानां च सेवनान्न भवेज्ज्वरः|३१०|

+

yōgāḥ parāḥ pravakṣyantē viṣamajvaranāśanāḥ||296||

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dhAraNAdagadAnAM ca sevanAnna bhavejjvaraH|310|

+

</div></div>

Formulations which are effective in curing ''jwara'' are being described. A wise physician should administer them, keeping in view their suitability for the type of ''dosha'' involved. These recipes are as follows –

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==== Spiritual therapy ====

+

सोमं सानुचरं देवं समातृगणमीश्वरम्||३१०||

Line 4,520: Line 4,809:

ज्वराद्विमुच्यते शीघ्रं साधूनां दर्शनेन च|

+

sōmaṁ sānucaraṁ dēvaṁ samātr̥gaṇamīśvaram||310||

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jvarAdvimucyate shIghraM sAdhUnAM darshanena ca|

+

</div></div>

Prayers should be offered to lord Ishvara along with Umā, their attendents and matṛs. This immediately cures ''viṡama jwara''.

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==== Management of ''jwara'' located in various ''dhatu'' ====

+

ज्वरे रसस्थे वमनमुपवासं च कारयेत्||३१५||

Line 4,576: Line 4,868:

अस्थिमज्जगते देया निरूहाः सानुवासनाः|३१७|

+

jvarādvimucyatē śīghraṁ sādhūnāṁ darśanēna ca|

Line 4,594: Line 4,887:

asthimajjagate deyA nirUhAH sAnuvAsanAH|317|

+

</div></div>

When the ''doshas'' causing ''jwara'' are located in –

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==== Management of ''abhicharaja'' and ''abhishangaja jwara'' ====

+

शापाभिचाराद्भूतानामभिषङ्गाच्च यो ज्वरः||३१७||

दैवव्यपाश्रयं तत्र सर्वमौषधमिष्यते|

+

śāpābhicārādbhūtānāmabhiṣaṅgācca yō jvaraḥ||317||

Line 4,614: Line 4,910:

daivavyapAshrayaM tatra sarvamauShadhamiShyate|

+

</div></div>

The ''jwara'' caused by ''shapa'' (curse), ''abhichara'' (tantric rituals with evil purpose), ''bhutabhishanga'' (affliction by micro organisms or evil spirits), ''daiva vyapashraya chikitsa'' (performance of spiritual therapies) is the most desired therapy. [317]

==== Management of ''abhighataja jwara'' ====

+

अभिघातज्वरो नश्येत् पानाभ्यङ्गेन सर्पिषः||३१८||

Line 4,626: Line 4,924:

क्षतानां व्रणितानां च क्षतव्रणचिकित्सया|

+

abhighātajvarō naśyēt pānābhyaṅgēna sarpiṣaḥ||318||

Line 4,642: Line 4,941:

kShatAnAM vraNitAnAM ca kShatavraNacikitsayA|

+

</div></div>

''Jwara'' caused by ''abhighāta'' (external injury) gets cured by the intake and massage of ghee, blood letting, in take of rice with wholesome meat soup. If such patients of ''abhighata jwara'', are suffering from ''anaha'' (gaseous distention of abdomen) and are accustomed to alcohol, then they should be given food with alcohol and meat soup. For the treatment of ''jwara'' caused by ''kshata'' (injury like cuts, stabs etc.) and ''vraṇa'' (ulcers) line of treatment suggested for ''kshata'' and ''vrana'' should be adopted. [318-320]

==== Management of ''agantuja jwara'' due to mental factors ====

+

आश्वासेनेष्टलाभेन वायोः प्रशमनेन च||३२०||

Line 4,662: Line 4,963:

तस्येष्टैस्तु विचित्रैश्च विषयैर्नाशयेत् स्मृतिम्|३२४|

+

āśvāsēnēṣṭalābhēna vāyōḥ praśamanēna ca||320||

Line 4,694: Line 4,996:

tasyeShTaistu vicitraishca viShayairnAshayet smRutim|324|

+

</div></div>

The ''jwara'' caused by ''kāma'' (passion), ''shoka'' (grief) and ''bhaya'' (fear) gets cured by the ''āshvāshana'' (assurance), ''ishṭa labha'' (providing the desired object), alleviation of ''vāyu'' and ''harshana'' (bringing excitement).

Line 4,704: Line 5,007:

==== Signs of remission of ''jwara'' ====

+

ज्वरप्रमोक्षे पुरुषः कूजन् वमति चेष्टते|

Line 4,724: Line 5,028:

तेषामदारुणो मोक्षो ज्वराणां चिरकारिणाम्||३२८||

+

jvarapramōkṣē puruṣaḥ kūjan vamati cēṣṭatē|

Line 4,764: Line 5,069:

teShAmadAruNo mokSho jvarANAM cirakAriNAm||328||

+

</div></div>

The clinical features manifested at the time of remission of (''sannipata jwara'') are – the patient produces ''kujana'' (rumbling) sound, vomiting, abnormal movements of the limbs (''cheshta''), heavy breathing or difficulty in breathing, discoloration, ''svinna anga'' (sweating), trembling (''vepate''), frequent fainting (''lihyate muhuḥ''), delirium, the body becoming very hot and cold at times, unconsciousness, more rise of temperature, angry appearance and forceful passage of liquid stools mixed with ''doshas'' with sound.

Line 4,772: Line 5,078:

==== Signs of completely cured ''jwara'' patient ====

+

विगतक्लमसन्तापमव्यथं विमलेन्द्रियम्|

युक्तं प्रकृतिसत्त्वेन विद्यात् पुरुषमज्वरम्||३२९||

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vigataklamasantāpamavyathaṁ vimalēndriyam|

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yuktaM prakRutisattvena vidyAt puruShamajvaram||329||

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</div></div>

Disappearance of ''klama'' (mental fatigue) and ''santapa'' (temperature), absence of pain, clarity of senses, gaining natural mental faculties – are all the signs and symptoms of a person who has become free from ''jwara''.[329]

==== Precautions after being cured from ''jwara'' ====

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सज्वरो ज्वरमुक्तश्च विदाहीनि गुरूणि च|

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ज्वरमुक्तो न सेवेत यावन्न बलवान् भवेत्||३३२||

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sajvarō jvaramuktaśca vidāhīni gurūṇi ca|

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jvaramukto na seveta yAvanna balavAn bhavet||332||

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</div></div>

A person suffering from ''jwara'' and the one who has become free from it should not indulge in and avoid the following - the intake of food and drinks which are ''vidahi'' (causing burning sensation), ''guru'' (heavy), ''asatmya'' (unwholesome) and ''viruddha'' (mutually contradictory); sexual intercourse, excessive exhaustion, bath and excessive walking. By observing these rules the fever gets alleviated and does not occur again.

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==== ''Punaravarti jwara'' (recurrent ''jwara'') ====

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असञ्जातबलो यस्तु ज्वरमुक्तो निषेवते|

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घ्नन्ति पीतानि चाभ्यासात् पुनरावर्तकं ज्वरम्||३४३||

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asañjātabalō yastu jvaramuktō niṣēvatē|

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ghnanti pItAni cAbhyAsAt punarAvartakaM jvaram||343||

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</div></div>

If a person, who has become free from ''jwara'', resorts to prohibited factors (as described before) before gaining strength, then the ''jwara'' reappears. If a person becomes free from ''jwara'' when the ''doshas'' have not been eliminated properly, then, even with mild irregularity in regimens (''apachara''), it reappears. As such patients have already suffered for a long time; hence there is weakness and loss of vitality in the tissues. If the fever reappears in them and then this certainly leads to their death.

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==== Guidelines for management ====

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तस्यां तस्यामवस्थायां ज्वरितानां विचक्षणः|

ज्वराक्रियाक्रमापेक्षी कुर्यात्तत्तच्चिकित्सितम्||३४४||

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tasyāṁ tasyāmavasthāyāṁ jvaritānāṁ vicakṣaṇaḥ|

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tasyAM tasyAmavasthAyAM jvaritAnAM vicakShaNaH|

jvarAkriyAkramApekShI kuryAttattaccikitsitam||344||

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</div></div>

The wise physician should treat the patient in different stages of ''jwara'', according to the line of treatment of ''jwara''. [344]

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रोगराट् सर्वभूतानामन्तकृद्दारुणो ज्वरः|

तस्माद्विशेषतस्तस्य यतेत प्रशमे भिषक्||३४५||

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rōgarāṭ sarvabhūtānāmantakr̥ddāruṇō jvaraḥ|

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rogarAT sarvabhUtAnAmantakRuddAruNo jvaraH|

tasmAdvisheShatastasya yateta prashame bhiShak||345||

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</div></div>

''Jwara'' is the king of diseases and it causes the death of all creatures and is of serious nature. Therefore, the physician should make special efforts for its treatment. [345]

==== Summary ====

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तत्र श्लोकः-

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यथाक्रमं यथाप्रश्नमुक्तं ज्वरचिकित्सितम्|

आत्रेयेणाग्निवेशाय भूतानां हितकाम्यया||३४६||

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tatra ślōkaḥ-

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yathAkramaM yathAprashnamuktaM jvaracikitsitam|

AtreyeNAgniveshAya bhUtAnAM hitakAmyayA||346||

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</div></div>

With a desire for the welfare of the living creatures, Atreya has furnished the replies to the queries of Agniveśa regarding the treatment of ''jwara''. [347]

Agnivesha

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