Changes

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]

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]

=== Tattva vimarsha ===

=== ''Tattva Vimarsha'' ===

· All diseases including jwara occur due to disequilibrium of dosha.  If the dosha are in equilibrium state, health is maintained and disease cannot occur.  

*All diseases including jwara occur due to disequilibrium of dosha.  If the dosha are in equilibrium state, health is maintained and disease cannot occur.  

· The origin of all diseases is because of the tendency for greed or attachment (parigraha).

*The origin of all diseases is because of the tendency for greed or attachment (parigraha).

¨ In order to know a disease, the diagnosis of sharira (physical) and manasa (mental); saumya (predominated by cold) and agneya (predominated by heat); antarvega (internal) and bahirvega (external); prakrita (according to seasons) and vaikrita (unseasonal); sadhya (curable) and asadhya (incurable) should be made and treated accordingly.  

*In order to know a disease, the diagnosis of sharira (physical) and manasa (mental); saumya (predominated by cold) and agneya (predominated by heat); antarvega (internal) and bahirvega (external); prakrita (according to seasons) and vaikrita (unseasonal); sadhya (curable) and asadhya (incurable) should be made and treated accordingly.  

¨ The psychic involvement in a disease shall be assessed on the basis of vaichitya (mental instability), arati (disliking for everything) and glani (feeling of weakness in the body).

*The psychic involvement in a disease shall be assessed on the basis of vaichitya (mental instability), arati (disliking for everything) and glani (feeling of weakness in the body).

¨ Dosha dominance can be assessed by the desire to take cold or hot things. In vata-pitta dominant diseases, there is desire for cold things and in vata-kapha dominant diseases, there is desire for hot things.     

*Dosha dominance can be assessed by the desire to take cold or hot things. In vata-pitta dominant diseases, there is desire for cold things and in vata-kapha dominant diseases, there is desire for hot things.     

¨ Seasonal variations in temperature, environment can adversely affect the dosha balance leading to diseases originated from naturally vitiated dosha.  

*Seasonal variations in temperature, environment can adversely affect the dosha balance leading to diseases originated from naturally vitiated dosha.  

¨ As a seed remains dormant in the soil and germinates at a favourable time, similarly the doshas remain in dormant condition in the dhatu and get aggravated at a favourable time. These dosha gain strength at an apropriate time and when the power of the inhibiting (disease preventing) factors subsides, then disease occurs.  

*As a seed remains dormant in the soil and germinates at a favourable time, similarly the doshas remain in dormant condition in the dhatu and get aggravated at a favourable time. These dosha gain strength at an apropriate time and when the power of the inhibiting (disease preventing) factors subsides, then disease occurs.  

¨ In the abhighataja jwara, caused by any injury, vitiated vata affects predominantly rakta (blood) to resulting in jwara with discomfort, swelling, discoloration and pain. This resembles with inflammation.  

*In the abhighataja jwara, caused by any injury, vitiated vata affects predominantly rakta (blood) to resulting in jwara with discomfort, swelling, discoloration and pain. This resembles with inflammation.  

¨ The exogenous jwara caused by external causes are at first independent, but later they get mixed up with the signs and symptoms of nija jwara (endogenous fevers).

*The exogenous jwara caused by external causes are at first independent, but later they get mixed up with the signs and symptoms of nija jwara (endogenous fevers).

¨ The processes of vitiated dosha spread all over body after combining with the rasa ( first dhatu of nutrition), its effect of displacement of agni (hampering metabolism), obstruction  of transport channels specifically sweat pores leading to increase in internal heat are important milestones in pathogenesis of jwara.  

*The processes of vitiated dosha spread all over body after combining with the rasa ( first dhatu of nutrition), its effect of displacement of agni (hampering metabolism), obstruction  of transport channels specifically sweat pores leading to increase in internal heat are important milestones in pathogenesis of jwara.  

¨ Langhana (fasting) reduces the aggravated dosha, stimulates the agni, and leads to lightness and restoration of appetite with alleviation of jwara .  

*Langhana (fasting) reduces the aggravated dosha, stimulates the agni, and leads to lightness and restoration of appetite with alleviation of jwara .  

¨ Langhana should be performed to the extent that it does not hamper the vitality or strength of the individual. The aim of all these measures is to regain the health which also depends on the physical, mental and spiritual strength.

*Langhana should be performed to the extent that it does not hamper the vitality or strength of the individual. The aim of all these measures is to regain the health which also depends on the physical, mental and spiritual strength.

¨ Any treatment shall always be performed after proper assessment of nature and state of dosha. Otherwise it leads to complications and adverse effects.

*Any treatment shall always be performed after proper assessment of nature and state of dosha. Otherwise it leads to complications and adverse effects.

¨ The purification treatments are done only in a state of utklishta dosha (on the verge of being expelled out). If the dosha are excessively vitiated, but not in utklishta, then pre-purification treatments like deepana, pachana, snehana are performed to bring the dosha to utlishta state.   

*The purification treatments are done only in a state of utklishta dosha (on the verge of being expelled out). If the dosha are excessively vitiated, but not in utklishta, then pre-purification treatments like deepana, pachana, snehana are performed to bring the dosha to utlishta state.   

¨ Langhana (fasting), swedana (fomentation to remove obstruction in sweat pores), kala (waiting period of eight days), yavagu (medicated gruels) and tikta rasa drugs (drugs having bitter taste) and all digestive enhancers of avipakwa dosha (untransformed) are prescribed in the initial stage of jwara.

*Langhana (fasting), swedana (fomentation to remove obstruction in sweat pores), kala (waiting period of eight days), yavagu (medicated gruels) and tikta rasa drugs (drugs having bitter taste) and all digestive enhancers of avipakwa dosha (untransformed) are prescribed in the initial stage of jwara.

¨ When vayu is predominantly aggravated in jwara, then patient should be treated by the administration of ghee, niruha and anuvasana bastis (medicated enemas), unctuous and hot diet and drinks.  

*When vayu is predominantly aggravated in jwara, then patient should be treated by the administration of ghee, niruha and anuvasana bastis (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.  

*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, the patient should be administered emetic therapy, pachana (therapy which promotes the digestion and metabolism), non-unctuous diet and drinks, fasting and hot decoctions are useful.  

*In state of kapha predominance, the patient should be administered emetic therapy, pachana (therapy which promotes the digestion and metabolism), non-unctuous diet and drinks, fasting and hot decoctions are useful.  

¨ When the doshas causing jwara are located in the rasa dhatu, then vamana and upavasa (emesis and fasting) should be done; in case of location in the rakta dhatu, seka and pradeha (pouring of hot medicated liquids and ointment application) should be done; in case of mamsa and the medas virechana and upavasa should be done; in the asthi and majja dhatus, niruha and anuvasana bastis should be given.  

*When the doshas causing jwara are located in the rasa dhatu, then vamana and upavasa (emesis and fasting) should be done; in case of location in the rakta dhatu, seka and pradeha (pouring of hot medicated liquids and ointment application) should be done; in case of mamsa and the medas virechana and upavasa should be done; in the asthi and majja dhatus, niruha and anuvasana bastis should be given.  

¨ 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.

*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.

¨ Jwara caused by abhighata (external injury) gets cured by the intake and massage of ghee, blood-letting, intake of rice with wholesome meat soup.   

*Jwara caused by abhighata (external injury) gets cured by the intake and massage of ghee, blood-letting, intake of rice with wholesome meat soup.   

¨ Mental factors like kama (passion), shoka (grief) and bhaya (fear) gets cured by the ashvasana (assurance), ishṭa labha (providing the desired object), alleviation of vayu and harshana (bringing excitement or pleasure).  

*Mental factors like kama (passion), shoka (grief) and bhaya (fear) gets cured by the ashvasana (assurance), ishṭa labha (providing the desired object), alleviation of vayu and harshana (bringing excitement or pleasure).  

¨ Krodha (anger) subsides by providing kamya artha (desired object), manojna artha (pleasing object), therapies for the alleviation of pitta and sadvakya (correct advice).  

*Krodha (anger) subsides by providing kamya artha (desired object), manojna artha (pleasing object), therapies for the alleviation of pitta and sadvakya (correct advice).  

¨ The jwara caused by krodha subsides by kama and that caused by kama gets cured by krodha. Jwara caused by bhaya (fear) and shoka (grief or sorrow) subsides by both kama and krodha.  

*The jwara caused by krodha subsides by kama and that caused by kama gets cured by krodha. Jwara caused by bhaya (fear) and shoka (grief or sorrow) subsides by both kama and krodha.  

¨ If a patient gets jwara just by thinking about it, then his mind should be diverted to desirable, different and surprising incidents (vishaya).

*If a patient gets jwara just by thinking about it, then his mind should be diverted to desirable, different and surprising incidents (vishaya).

¨ For prevention of re-occurrence of jwara and during its treatment, one should avoid the following: intake of food and drinks which are vidahi (causing burning sensation), guru (heavy), asatmya (unwholesome) and viruddha (mutually contradictory); sexual intercourse, excessive exhaustion, bath, excessive walking exercise, should be avoided by the person who has become free from jwara till he regains strength.

*For prevention of re-occurrence of jwara and during its treatment, one should avoid the following: intake of food and drinks which are vidahi (causing burning sensation), guru (heavy), asatmya (unwholesome) and viruddha (mutually contradictory); sexual intercourse, excessive exhaustion, bath, excessive walking exercise, should be avoided by the person who has become free from jwara till he regains strength.

¨ The remission of jwara depends upon strength of dosha. In acute stage, the remission occurs with difficulty because of severity of dosha. In chronic stage, the remission occurs without difficulty due to mild strength of dosha.  

*The remission of jwara depends upon strength of dosha. In acute stage, the remission occurs with difficulty because of severity of dosha. In chronic stage, the remission occurs without difficulty due to mild strength of dosha.  

¨ The signs of regaining health after remission of a disease are disappearance of klama (mental fatigue) and santapa (raised temperature/feeling of heat), absence of pain, clarity of senses and gaining natural mental faculties.  

*The signs of regaining health after remission of a disease are disappearance of klama (mental fatigue) and santapa (raised temperature/feeling of heat), absence of pain, clarity of senses and gaining natural mental faculties.  

¨ 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, who has become free from jwara, resorts to prohibited factors (as described before) before gaining strength, then the jwara reappears.

=== Vidhi vimarsha ===

=== Vidhi vimarsha ===