Sushruta Samhita Uttaratantra Chapter 39 Jvara Pratiṣedha (Treatment of Fever)

AIAPGET Points

–       JWARA has been described as ROGANEKA RAT – king of the group of diseases.

–       Jwara is born out of RUDRA KOPA AGNI.

–       Specific Purvarupas of Jwara – JRIMBHA in Vataja Jwara, NAYANAYOH DAHA in Pittaja Jwara and NA ANNABHINANDANA in Kaphaja Jwara. 

–       Special symptoms of ABHINYASA / HATAUJASA JWARA – नात्युष्णशीतोऽल्पसंज्ञो भ्रान्तप्रेक्षी हतस्वरः, स्वेदविण्मूत्रवर्जितः, पतितः शेते

–       Special symptoms of OJO NIRODHAJA Jwara – It is caused due to depletion of ojas due to aggravation of pitta and vata. Special symptoms include – Gatrastambha, SHAYANEPSU – desire to sleep always, API JAGRAT SWAPAN – gets into sleep and awakens often.

–       PARVA BHEDA is a feature of both Vata-Pittaja and Vata-Shleshmaja Jwara.

–       Vata is predominant in causation of Tritiyaka and Chaturthaka Jwara

–       Pitta is predominant in causation of Aupatyaka Jwara (fevers produced near hills and mountains) and Madyaja Jwara

–       Kapha is predominant in the causation of Pralepaka Jwara and Vatabalasaka Jwara.

–       भूताभिषङ्गादुद्वेगहास्यकम्पनरोदनम्।। – Symptoms of BHUTABHISHANGA JWARA are Udvega (great agitation), Hasya (laughing), Kampa (shaking, tremors) and Rodana (weeping). Ref – Su.Ut.39/80

–       SWACHCHA GHRTA should be administered in the Purvarupa stage of Jwara, especially in Vataja Jwara.

–       ANNAKALE Hita _________ Yatha Swam Pachanaih Krta. (Ans – PEYA – Su.Ut.39/109)

–       अतिप्रवर्तमानंचसाधयेदतिसारवत्।।(Su.Ut.39/122) – If malas are being eliminated in excess during the duration of fever, they should be treated similar to ATISARA – diarrhoea.

–       YAVAGU is not beneficial for those suffering from kaphaja and pittaja jwaras.

–       PLIHODARA UKTA GHRTA – is useful in curing Vishama Jwara i.e. SHATPALA GHRTA.

–       SUSHRUTA has described KALYANAKA GHRTA & MAHAKALYANAKA GHRTA in the chapter dealing with JWARA Chikitsa i.e. Uttara Tantra, chapter 39.

–       PANCHARASA PEYA – (Su.Ut.39/254, 255) – Prepared by adding boiled milk (shruta paya) with Sharkara, Pippali, Madhu and Sarpi and churning them well. Benefits – Kshata Kshina, Kshaya, Shwasa & Hrdroga.

–       Those suffering from VISHAMA JWARA should worship ISHANA (Lord Shiva) & AMBIKA (goddess Parvati), and also Brahmins and Cows.

–       ARAGVADHADI GANA KASHAYA (consumption) is beneficial in treatment of SHITA PURVA JWARA.

–       SHATADHAUTA GHRTA should be applied on the body of the person suffering from DAHAPURVA JWARA.

 

For More AIAPGET Points from this chapter and also for content and preparation, please join our SARATHI Program.

 

 The 37th chapter of Uttaratantra of Sushruta Samhita is named as Jvara Pratiṣedha Adhyaya. This chapter deals with the Treatment of Fever.  

अथतो  ज्वरप्रतिषेधं व्याख्यास्यामः ॥१॥
यथोवाच भगवान् धन्वन्तरि ः॥२॥

We will now expound Jvara pratişedha- treatment of fevers; as revealed by the venerable Dhañvañtari.

Susrutasya vijñapti – request of Suśruta

येनामृतमपां मध्यादुद्धृतं पूर्वजन्मनि ॥
यतोऽमतत्वं संप्राप्तस्रिदशास्रिदिवेश्वरात् ॥३॥
शिष्यास्तं देवमासीनं पप्रच्छुः सुश्रुतादयः ॥
व्रणस्योपद्रवाः प्रोक्ता व्रणिनामप्यतः परम् ॥४॥
समासाद् व्यासतश्चैव ब्रूहि नो भिषजांवर॥
उपद्रवेण जु ष्टस्य व्रणः कृच्छ्रेण सिध्यति ॥५॥
उपद्रवास्तु व्रणिनः कृच्छ्रसाध्याः प्रकीर्तिताः॥
प्रक्षीणबलमांसस्य शोषधातुपरिक्षयात् ॥६॥
तस्मादुपद्रवान् कृत्स्नान् ब्रूहि नः सचिकित्सितान् ॥
सर्वकायचिकित्सासु ये दृष्टाः परमर्षिणा ॥७॥

Adideva Dhanwantari had brought up the nectar from the middle of water (ocean of milk). Gods who had consumed this nectar had attained immortality. The same Dhanvantari was born as Divodasa and was considered as God. Sushruta and the other disciples approached Divodasa who was sitting calmly nearby and requested him as follows –

‘Dear sir, you are the best of all the physicians. So far, you have explained the features of wounds and also narrated their complications in brief. It has also been said that the wounds which develop complications would heal with difficulty. Such diseases are difficult to cure because of immense decrease of strength and muscles and also depletion of other tissues also. Hence dear sir, kindly instruct us in detail about such complications along with their treatment, as has been described by the great sages of the Kayachikitsa branch of Ayurveda’.

Jvara svabhava – nature of fever

तेषां तद्वचनं श्रृत्वा प्राब्रवीद्भिषजांबरः ॥
ज्वरमादौ प्रवक्ष्यामि स रोगानीकराट् स्मृतः ॥८॥
रुद्रकोपाग्रिसंभूतः सर्वभूतप्रतापनः ॥
तैस्तैर्नामभिरन्येषां सत्त्वानां परिकीर्त्यते ॥९॥
जन्मादौ निधने चैव प्रायो विश्ति देहिनम् ॥
अतः सर्वविकाराणामयं राज प्रकीर्तितः ॥१०॥
ऋते देवमनुष्येभ्यो नान्यो विषहते तु तम् ॥
कर्मणा लभते यस्माद्देत्वं मानुषादपि ॥११॥
पुनश्चैव च्युतः स्वर्गान्मानुष्यमनुवर्तते ॥
तस्मात्ते देवभावेन सहन्ते मानुषा ज्वरम् ॥१२॥
शोषाः सर्वे विपद्यन्ते तैर्यग्योना ज्वरार्दिताः ॥

The best of the physicians, Divodasa Dhanvantari heard this request of his disciples. He said, ‘I will first describe Jvara i.e. fever because it is the king of the group of diseases’.

Jvara – fever is born from the fire of Lord Rudra’s anger. It torments all living creatures. In the other species of living beings, Jvara is known by different names.

It is also known as the king of all diseases because it affects the living beings both at the beginning of life and also at the time of death.

Except Gods and men, no other living beings are able to escape from the harmful effects of fever. Therefore, the fever gains divinity by its feature of ‘affecting all’ and remains in heaven.

Again, it comes down from heaven and attacks human beings. So, considering jvara as divine, human beings tolerate it. All other animals are killed by the sufferings of fevers.

Jvara pradhana laksana – chief features of fever

स्वेदावरोधः सन्तापः  सर्वाङ्गग्रहणं तथा ॥१३॥
विकारा  युगपद्यस्मिन् ज्वरः स परिकीर्तितः ॥

The disease in which the below mentioned symptoms are present together, at the same time, is known as Jvara – fever –

–       obstruction or absence of sweating,

–       increased heat or body temperature and

–       pain (catching pain) all over the body

Vidha – kinds                                                                                                                                        

दोषैः पृथक् समस्तैश्च द्वन्द्वैरागन्तुरेव च ॥१४॥
अनेककारणोत्पन्नः  स्मृतस्त्वष्टविधो ज्वरः ॥

Jvara – fever is born from many causes. It is of eight kinds. They are –

–       one from each dosha separately (vataja, pittaja and kaphaja)

–       three types from combination of two doshas (vata-pittaja, vata-kaphaja and kapha-pittaja)

–       one sannipataja – caused due to combined aggravation of all three doshas together and

–       one agantu type – caused by extraneous cause

Sampräpti – pathogenesis

दोषाः प्रकुपिताः सेषु कालेषु स्वैः प्रकोपणैः ॥१५॥
व्याप्य देहमशेषेण ज्वरमापादयन्ति हि॥
दुष्टाः स्वहेतुभिर्दोषाः प्राप्यामाशयमूष्मणा॥१६॥
सहिता रसमागत्य रसस्वेदप्रवाहिणाम् ॥
स्रोतसां मार्गमावृत्य मन्दीकृत्य हुताशनम् ॥१७॥
निरस्य बहिरूष्माणं पक्तिस्थानाच्च केवलम् ॥
शरीरं समभिव्याप्य स्वकालेषु ज्वरागमम् ॥१८॥
जनयन्त्यथ वृद्धिं वा स्ववर्णं च त्वगादिषु ॥

Doshas get aggravated by their concerned doshas (dosha-specific causes) and time (specific time for dosha aggravation). These aggravated doshas spread throughout the body and give rise to fever.

Aggravated doshas reach the amashaya – stomach. Therein these doshas would combine with the usma i.e. heat of the digestive fire (jataragni). Following this, they invade rasa – the essence of food produced in the stomach following the digestion of food. They also block the channels of rasa (chyle) and sveda (sweat), weaken the anala – digestive fire and expel it from the places of digestion (seats where digestion of food takes place i.e. stomach and small intestine) out to the entire body. This would give rise to jvara – fever.

These doshas exhibit the symptoms of their increase and their related colours in the skin, eyes, nail, tongue, urine and faeces.

Añyakārana – other causes

मिथ्यातियुक्तैरपि च स्नेहाद्यैः कर्मभिर्नृणम् ॥१९॥
विविधादभिघाताच्च रोगोत्थानात् प्रपाकतः ॥
श्रमात् क्षयादजीर्णाच्च विषात्सात्म्यर्तुपर्ययात् ॥२०॥
ओषधीपुष्पगन्धाच्च शोकान्नक्षपीडया॥
अभीचाराभिशापाभ्यां मनोभूताभिशङ्कया॥२१॥
स्रीणामपप्रजातानां प्रजातानां तथाऽहितैः ॥
स्तन्यावतरणे चैव ज्वरो दोषैः प्रवर्तते ॥२२॥

Fever also arises (due to aggravation of doshas) by the below mentioned causes –

–       excess or improper administration of oleation therapy etc,

–       different kinds of injury, manifestation of other diseases (such as abscess, eruptions etc),

–       suppuration / ulceration,

–       exertion,

–       loss of tissues (like blood etc),

–       indigestion of food, poisons,

–       changes in habituations and natural features of the seasons,

–       inhalation of smell of plants and flowers,

–       sorrow,

–       bad effects of stars and planets,

–       effect of witchcraft / sorcery and wrath of gods etc;

–       possession (by evil spirits),

–       improper delivery in women,

–       improper conduct (in respect of food and activities) by women after delivery, and at the time of production of breast milk

Lakşanotpatti – development of symptoms

तैर्वेगवद्भिर्बुधा समुद्धान्तैर्विमार्गगै ः॥
विक्षिप्यमाणोऽन्तरग्रिर्भवत्याशु बहिश्चर ः ॥२३॥
रुणाद्धि चाप्यपांधातु यस्मत्तस्माज्ज्वरातुरः ॥
भवत्यत्युष्णगात्रश्च ज्वरितस्तेन चोच्यते ॥२४॥

The greatly aggravated powerful doshas move all over the body in wrong channels. While in this process, the doshas expel the agni – digestive fire and quickly cause obstruction of the channels of Ap or Jala Dhatu i.e. body water or tissue fluids. Hence, the body of the person suffering from jvara – fever becomes very hot i.e. there is great increase of body temperature. The person suffering from jvara – fever is called as Jvarita – ‘the one suffering from fever’.

Pūrvarüpa – prodromal symptoms

श्रमोऽरतिर्वित्वं वैरस्यं नयनल्पवः ॥
इच्छाद्वेषौ मुहुश्चापि शीतवातपादीषु ॥२५॥
जृम्भाऽङ्गमर्दो गुरुता रोमहर्षोऽरुचिस्तमः ॥
अप्रहर्षश्च शीतं च भवत्युत्पत्स्यति ज्वरे ॥२६॥
सामान्यतो, विशेषात्तु जृम्भाऽत्यर्थं समीरणात् ॥
पित्तान्नयनयोर्दाहः, कफान्नान्नाभिनन्दनम् ॥२७॥
सर्वलिङ्गसमवायः सर्वदोषप्रकोपजे ॥
द्वेयोर्द्वयोस्तु रूपेण संसृष्टं द्वन्द्वजं विदुः ॥२८॥

General prodromal symptoms – Below mentioned are the general symptoms of on-coming fever (fever which would manifest in future days) –

–       feeling of fatigue,

–       restlessness,

–       change of colour (of the skin etc),

–       bad taste in the mouth,

–       tears in the eyes,

–       like and dislike for cold and heat alternately often;

–       more of yawning,

–       malaise,

–       feeling of heaviness of the body,

–       horripilations,

–       loss of taste,

–       laziness,

–       absence of happiness and

–       feeling cold

Special symptoms due to vāta are more of yawns, that due to pitta is burning sensation in the eyes, and that due to kapha is dislike for food. Mixed symptoms are present in combination of doşhās in twos and all threes.

Rūpa – symptoms

Vataja Jwara

वेपथुर्विषमोवेगःकण्ठौष्ठपरिशोषणम्।।
निद्रानाशःक्षुतःस्तम्भोगात्राणांरौक्ष्यमेवच।।२९।।
शिरोहद्द्वात्ररुग्वक्रवैरस्यंबद्धविकता।।
जृम्भाऽऽध्मानंतथाशूलंभवत्यनिलजेज्वरे।।३०।।

The symptoms of vataja jvara (fever caused by vata) are –

–       shivering (rigors),

–       irregularity of onset,

–       profound dryness of the throat and lips,

–       loss of sleep,

–       absence of sneezing,

–       dryness of the body;

–       pain in the head, chest, and body;

–       bad taste in the mouth,

–       constipation,

–       more of yawning,

–       flatulence and

–       abdominal pain

Pittaja Jvara

वेगस्तीक्ष्णोऽतिसारश्चनिद्राल्पत्वंतथावमिः।।
कण्ठौष्ठमुखनासानांपाकःस्वेदश्चजायते।।३१।।
प्रलापःकटुतावक्रेमूर्च्छादाहोमदस्तृषा।।
पीतविण्मूत्रनेत्रत्वंपैत्तिकेभ्रमएवच।।३२।।

The symptoms of pittaja jvara (fever caused by pitta) are –

–       powerful bouts i.e. there is high temperature,

–       diarrhoea,

–       loss of sleep,

–       vomiting,

–       ulceration of throat, lips and nose,

–       excessive sweating,

–       delirium,

–       manifestation of bitter taste in the mouth,

–       fainting,

–       burning sensation,

–       toxaemia,

–       thirst,

–       faeces, urine and eyes become yellow in colour and

–       giddiness

Kaphaja Jwara

गौरवंशीतमुत्क्लेशोरोमहर्षोऽतिनिद्रता।।
स्त्रोतोरोधोरुगल्पत्वंप्रसेकोमधुरास्यता।।३३।।
नात्युष्णगात्रताछर्दिरङ्गसादोऽविपाकता।।
प्रतिश्यायोऽरुचिःकासःकफजेऽक्ष्णोश्चशुक्लता।।३४।।

The symptoms of kaphaja jvara (fever caused by kapha) are –

–       feeling of heaviness of the body,

–       nausea,

–       horripilation,

–       more of sleep,

–       obstruction of channels,

–       mild pain,

–       more of saliva,

–       sweet taste in the mouth,

–       body heat not very great (mild temperature),

–       vomiting,

–       debility of the body,

–       indigestion,

–       nasal catarrh (running in the nose),

–       loss of taste,

–       cough and

–       white colour of the eyes

Sāmāñya sannipātaja jvara – general toxic fevers

निद्रानाशोभ्रमःश्वासस्तन्द्रासुप्ताङ्गताऽरुचिः।।
तृष्णामोहोमदःस्तम्भोदाहःशीतंहृदिव्यथा ||३५||
पक्तिश्चिरेणदोषाणामुन्मादःश्यावदन्तता।।
रसनापरुषाकृष्णासन्धिमूर्धास्थिजारुजः।।३६।।
निर्भुग्रे कलुषे नेत्रे कर्णौ शब्दरुगन्वितौ ॥
प्रलापः स्रोतसां पाकः कूजनं चेतनाच्युति ः ॥३७॥
स्वेदमूत्रपुरीषाणामल्पशः सुचिरात् स्रुतिः ॥
सर्वजे सर्वलिङ्गानि विशेषं चात्र मे शृणु ॥३८॥

The symptoms of sāmāñya sannipātaja jvara (fever caused by all doshas combined together) are –

–       loss of sleep,

–       giddiness,

–       dyspnoea,

–       stupor,

–       loss of tactile sensation of the body,

–       loss of taste,

–       thirst,

–       delusion,

–       toxaemia,

–       rigidity,

–       feeling of burning sensation or cold,

–       discomfort in the (region of) heart,

–       slow ripening of the doşhas,

–       abnormal mind,

–       blue colour of the teeth (and gums),

–       tongue is rough and black,

–       pain in the joints, head, and bones;

–       eyes irregular and dirty,

–       noise and pain in the ears,

–       delirium,

–       ulcers in the orifices (nose, mouth, rectum etc),

–       cooing sound in the throat,

–       loss of consciousness,

–       elimination of sweat,

–       urine and faeces in small quantities and after long time

Viseşa sannipāta jvara – special toxic fevers

नात्युष्णशीतोऽल्पसंज्ञो भ्रान्तप्रेक्षी हतस्वरः ॥
खरजिह्वः शुष्ककण्ठः स्वेदविण्मूत्रवर्जितः ॥३९॥
सास्रो निर्भुग्रहृदयो भक्तद्वेवी हतप्रभः ॥
श्वसन्निपतितः शेते प्रलापोपद्रवायुतः ॥४०॥
तमभिन्यासमित्याहुर्हतौजसमथापरे ॥

Now hear its special kinds;

1. Abhinyāsa jvara-

The fever presenting with the below mentioned symptoms is called as Abhinyāsa jvara by few and as Hataujasa jvara by some others –

–       body neither very hot nor very cold (moderate increase of body temperature),

–       loss of consciousness,

–       debility,

–       unsteady eyes,

–       loss of voice,

–       coarse tongue,

–       dryness of the throat,

–       absence of sweat, faeces and urine;

–       eyes reddish and irregular,

–       discomfort in the chest,

–       aversion to food,

–       loss of complexion,

–       dyspnoea,

–       falling from the cot and lies on the floor,

–       suffers from irrelevant talk

सन्निपातज्वरं कृच्छ्रमसाध्यमपरे विदुः ॥४१॥
निद्रोपेतमाभिन्यासं क्षीणमेनं हतौजसम् ॥
संन्यस्तगात्रं संन्यासं विद्यात्सर्वात्मके ज्वरे ॥४२॥

Sannipāta jvara is difficult to cure. Some others say it is incurable. Among sannipāta jvaras,

–       abhinyāsa jvara – should be understood when the patient has more of sleep;

–       hataujasa – when there is loss / decrease of ojas (essence of tissues) and

–       sannāysa – when there is loss of conscious activity of the body

Ojonirodhaja jvara

ओजो विस्रंसते यस्य पित्तानिलसमुच्छ्रयात् ॥
स गात्रस्तम्भशीताभ्यां शयनेप्सुरचेतनः ॥४३॥
अपि जग्रत् स्वपन् जन्तुस्तन्द्रालुश्च प्रलापवान् ॥
संहृष्टरोमा स्रस्ताङ्गो मन्दसन्तापवेदनः॥४४॥
ओजोनिरोधनं तस्य जानीयात् कुशलो भिषक् ॥
सप्तमे दिवसे प्राप्ते दशमे द्वादशेऽपि वा ॥४५॥
पुनर्घोरतरो भूत्वा प्रशमं याति हन्ति वा ॥

An intelligent physician should understand that the person is suffering from Ojonirodhaja Jvara in the presence of below mentioned symptoms –

–       there is decrease of ojas due to aggravation of pitta and vata (this fever is caused due to aggravation of pitta and vata and consequent depletion of ojas)

–       rigidity of the body,

–       coldness,

–       desire to sleep always,

–       loss of consciousness,

–       gets into sleep and awakes often,

–       has stupor,

–       delirium,

–       horripilation,

–       weakness of the body parts,

–       mild increase of temperature and discomforts

This fever increases greatly on reaching the seventh, tenth or twelfth day either subsides or kills the patient.

Dvañdvaja jvara

द्विदोषोच्छ्रायलिङ्गास्तुद्वन्द्वजास्त्रिविधाःस्मृता॥४६॥

Dvañdvaja jvaras are three and have the symptoms of two aggravated doşhās together. 

तृष्णा मूर्छा भ्रमो दाहः स्वप्रनाशः शिरोरुजा ॥
कण्ठास्यशोषो वमथू रोमहर्षोऽरुचिस्तथा ॥४७॥
पर्वभेदश्च जृम्भा च वातपित्तज्वराकृतिः ॥
स्तैमित्यं पर्वणां भेदो निद्रा गौरवमेव च ॥४८॥
शिरोग्रहः प्रतिश्यायः कासः स्वेदप्रवर्तनम् ॥
सन्तापो मध्यवेगश्च वातश्र्लेष्मज्वराकृतिः ॥४१॥
लिप्तातिक्तास्यता तन्द्रा मोहः कासोऽरुचिस्तृषा॥
मुहुर्दाहो मुहुः शीतं श्र्लेष्मपित्तज्वराकृति ः ॥५०॥

Vata-Pittaja Jvara symptoms –

Below mentioned are the features of fever caused by combined vitiation of vata and pitta –

–       thirst,

–       fainting,

–       dizziness,

–       burning sensation,

–       loss of sleep,

–       headache,

–       dryness of throat and mouth,

–       vomiting,

–       horripilation,

–       loss of taste / anorexia,

–       joint pains and

–       excessive yawning

Vata-Slesmaja Jvara symptoms –

Below mentioned are the features of fever produced by combined vitiation of vata and kapha –

–       rigidity,

–       joint pains,

–       excessive sleep (sleepiness),

–       feeling of heaviness,

–       headache,

–       running nose,

–       cough,

–       sweating,

–       moderate heat in the body

Slesma-Pittaja Jvara symptoms –

Below mentioned are the features of fever caused by combined vitiation of kapha and pitta –

–       coating of mouth,

–       bitter taste in the mouth,

–       stupor,

–       delusion,

–       cough,

–       loss of thirst,

–       feeling of burning and coldness, alternatively, often

(जृम्भाध्मानमदोत्कम्पपर्वभेदपरिक्षयाः।।
तृट्प्रलापाभितापाःस्युर्ज्वरेमारुतपैत्तिके।।१।।
शूलकासकफोत्क्लेशशीतवेपथुपीनसाः : !
गौरवारुचिविष्टम्भावातश्लेष्मसमुद्भवे।।२।।
शीतदाहारुचिस्तम्भस्वेदमोहमदभ्रमाः।।
कासाङ्गसादहृल्लासाभवन्तिकफपैत्तिके।।३।।)

[Symptoms of Vata-Pittaja Jvara include – excessive yawning, flatulence, toxicity, joint pains, emaciation, thirst and delirium.

Symptoms of Vata-Slesmaja Jvara include – pain in the abdomen, cough, nausea, feeling of cold, rigors, rhinitis, feeling of heaviness, loss of taste and constipation.

Symptoms of Kapha-Pittaja Jvara include – feeling of cold or burning sensation, loss of taste, rigidity, sweating, delusion, toxicity, giddiness, cough, debility and nausea.]

Vişama jvara – intermittent fevers

कृशानांज्वरमुक्तानांमिथ्याहारविहारिणाम्।।
दोषःस्वल्पोऽपिसंवृद्धोदेहिनामनिलेरितः।।५१।
सततान्येद्युष्कत्र्याख्यचातुर्थान्सप्रलेपकान्।।
कफस्थानविभागेनयथासंख्यंकरोतिहि।।५२।।
अहोरात्रादहोरात्रात्स्थानात्स्थानंप्रपद्यते।।
ततश्चामाशयंप्राप्यदोषःकुर्याज्ज्वरंनृणाम्।।५३।।

The doshas, in spite of being less in the body, would get aggravated by stimulation of vata in the below mentioned persons –

–       those emaciated,

–       those who are relieved of fever recently and

–       those who are indulged in improper foods and activities

Such doshas give rise to Satata, Anyeduska, Tritiyaka, Caturthaka and Pralepaka types of Jvaras. These fevers arise from different seats of kapha respectively.

Doshas move from one place to the other in the course of a day or night. These doshas produce fever on reaching amasaya.

Notes –

Seats of Kapha are –

–        Amasaya – stomach,

–        Uras – chest / lungs,

–        Kantha – throat,

–        Siras – head and

–        Sandhi – joints of the body

Acharya Dalhana has established the relationship between doshas residing in seats of kapha and types of fevers produced by them.

Seat of Kapha wherein dosha is located / residing	Type of Jvara – fever manifested
Amasaya	Satata Jvara
Uras	Anyeduska Jvara
Kantha	Tritiyaka Jvara
Siras	Caturthaka Jvara
Sandhi	Pralepaka Jvara
All seats of Kapha	Santata Jvara

तथा प्रलेपको ज्ञेयः शोषिणां प्राणनाशनः ॥
दृश्चिकित्स्यतमो मन्दः सुकष्टो धातुशोषकृत् ॥५४॥

Features of Pralepaka Jvara –

–       fever seen in patients of sosa (rajayaksma) which destroys life (kills them),

–       very difficult to cure,

–       mild in nature and

–       produces decrease / loss of tissues

कफस्थानेषु  वा  दोषस्तिष्ठन्  द्वित्रिचतुर्षु वा ॥
विपर्ययाख्यान्  कुरुते विषमान् कृच्छ्रसाधनान् ॥५५॥

Viparyaya Jvara are fevers which are difficult to treat. These are irregular / intermittent fevers which occur when doshas remain in the seats of kapha. Fever occurs once in three or four days in these types of fevers.

परो हेतुः स्वभावो  वा  विषमे कैश्चिदीरितः ॥
आगन्तुश्चानुबन्धो  हि  प्रायशो  विषमज्वरे ॥५६॥

According to the opinion of some scholars, below mentioned are the causes of visama jvaras – intermittent fevers –

–       Parahetu – other chief causes or

–       Svabhava – natural tendency

In all kinds of visama jwaras, agantu i.e. an extraneous agent is generally a secondary cause (associated with the disease).

वाताधिकत्वात् प्रवदन्ति  तज्ज्ञास्तृतीयकं चापिचतुर्थकं  च ॥
औपत्यके मद्यसमुद्भवे  च हेतुं ज्वरे पित्तकृतं वदन्ति ॥५७॥
प्रलेपकं  वातबलासकं च  कफाधिकत्वेन  वदन्ति तज्ज्ञाः ॥
मूर्च्छानुबन्धा  विषमज्वरा ये  प्रायेण ते द्वन्द्वसमुत्थितास्तु ॥५८॥

According to th
e specialists, below mentioned dosha association is seen in different fever types –

Type of Jvara	Dosha Predominance (in causation)
Tritiyaka Jvara – tertian fever & Caturthaka Jvara – quartan fever	Vata
Aupatyaka jvara – fevers produced near hills and mountains and Madyaja Jvara – fever produced by drinking wine	Pitta
Pralepaka Jvara and Vatabalasaka Jvara	Kapha

 

Fainting is a secondary symptom in these intermittent fevers. They generally arise from aggravation of two doshas together.

Ďahasītādi jvara

त्वक्स्थौश्लेष्मानिलीशीतमादीजनयतोज्वरे।।
तयोःप्रशान्तयोःपित्तमन्तेदाहंकरोतिच।।५९ ||
करोत्यादौतथापित्तंत्वक्स्थंदाहमतीवच।।
प्रशान्तेकुरुतस्तस्मिश्छीतमन्तेचतावपि।।६।।
द्वावेतौदाहशीतादीज्वरौसंसर्गजौसमृतौ।।
दाहपूर्वस्तयोःकष्टःकृच्छ्रसाध्यश्चसस्मृतः।।६१।।

Sitapurva Jvara – When kapha and vata present in the skin get aggravated, they produce fever commencing with cold. When these subside, the pitta gets aggravated and produces a burning sensation.

Dahapurva Jvara – When pitta present in the skin gets aggravated, it first produces a severe burning sensation. Then it produces fever. When the fever subsides, kapha and vata produce a cold at the end.

Dahapurva and Sitapurva types of jvara are produced by combination of two doshas. Among them, Dahapurva Jvara is very difficult to treat.

प्रसक्तश्चाभिघातोत्यश्चेतनाप्रभवस्तुयः।।
रात्र्यह्रोःषट्सुकालेषुकीर्तितेषुयथापुरा।।६२।।
प्रसह्यविषमोऽभ्येतिमानवंबहुधाज्वरः।।

Below mentioned fevers are difficult to treat –

–       that which persists for long periods of time (chronic).

–       that produced by trauma and

–       that produced by disorders or imbalances of mind (fear, sorrow, grief etc.)

Visama Jvara appears by force, at six periods of a day and night as mentioned previously (sutra sthana – chapter 21). It troubles the person in many ways.

Note – the six periods of the day when visama jvara occurs are –

–       forenoon,

–       midday,

–       afternoon,

–       evening,

–       midnight and

–       early morning

Fevers may manifest in either one or more periods of a day or once or twice in any one given period or every day or other days.

सचापिविषमोदेहंनकदाचिद्विमुञ्चति।।६३।।
ग्लानिगौरवकार्येभ्यःसयस्मान्नप्रमुच्यते।।
वेगेतुसमतिक्रान्तेगतोऽयमितिलक्ष्यते।।६४।।
धात्वन्तरस्थोलीनत्वान्नसौक्ष्म्यादुपलभ्यते।।
अल्पदोषेन्धनःक्षीणःक्षीणेन्धनइवानलः।।६५।।

Visama Jvara will not completely leave the body at all. It would persist for long time periods. While running for a long time, these fevers produce exhaustion, heaviness and emaciation of the body. When the bouts subside in these fevers, it would appear as though the person is relieved of his fever.

Fever lurks inside the tissues in minute form (there is less quantity of doshas), just like a spark of fire ignited by little fuel.

दोषोऽल्पोऽहितसंभूतोज्वरोत्सृष्टस्यवापुनः।।
धातुमन्यतमंप्राप्यकरोतिविषमज्वरम्।।६६।।
सततंरसरक्तस्थःसोऽन्येद्युःपिशिताश्रितः।।
मेदोगतस्तृतीयेऽह्नित्वस्थिमज्जगतःपुनः।।६७।।
कुर्याच्चातुर्थकंघोरमन्तकंरोगसंकरम्।।
केचिद्भूताभिषङ्गोत्थंब्रुवतेविषमज्वरम्।।६८।।

Visama Jvara i.e. intermittent fevers are produced when little quantity of doshas which are aggravated by improper foods and activities invade any one of the dhatus.

These doshas reside in rasa and rakta dhatus and produce Satata Jvara.

The same doshas residing in mamsa dhatu produce Tritiyaka Jvara.

When the same doshas reside in asthi and majja dhatus, they produce Caturthaka Jvara. This fever is dreadful (fatal) and occurs in combination with other diseases.

According to some other authorities, Visama Jvaras are produced when the bhutas (evil spirits, bacteria, virus etc) invade the body.

Sañtata jvara

सप्ताहंवादशाहंवाद्वादशाहमथापिवा।।
सन्तत्यायोऽविसर्गीस्यात्सन्ततःसनिगद्यते।।६९।।
अहोरात्रेसततकोद्वौकालावनुवर्तते।।
अन्येद्युष्कस्त्वहोरात्रादेककालंप्रवर्तते।।७०।।
तृतीयकस्तृतीयेऽह्निचतुर्थेऽह्निचतुर्थकः।।

Type of Visama Jvara	Features
Santata Jvara	Fever continues for seven, ten or twelve days without giving any break (without remission)
Satataka Jvara	Fever occurs at any two times in a day
Anyedyuska Jvara	Fever occurs at any one time in a day
Tritiyaka Jvara	Fever appears on the third day
Caturthaka Jvara	Fever appears on the fourth day

वातेनोदीर्यमाणाश्चह्रीयमाणाश्चसर्वतः।।
एकद्विदोषामर्त्यानांतस्मिन्नेवोदितेऽहनि।।७१।।
वेलांतामेवकुर्वन्तिज्वरवेगेमुहुर्मुहुः।।
(वातेनोद्धयमानस्तुयथापूर्येतसागरः।।७२।।
वातेनोदीरितास्तद्वद्दोषाःकुर्वन्तिवैज्वरान्।।
यथावेगागमेवेलांछादयित्वामहोदधेः।।७३।।
वेगहानौतदेवाम्भस्तत्रैवान्तर्निलीयते।।
दोषवेगोदयेतद्वदुदीर्येतज्वरोऽस्यवै।।७४।।
वेगहानौप्रशाम्येतयथाऽम्भःसागरेतथा।।)

Either one or two aggravated doshas spread out throughout the body being propelled by vata. These doshas while spreading, themselves determine particular time for vegas i.e. bouts or commencement of fever on the specific (specified) day.

Fever arises from the doshas just like the ocean swells up by the force of the wind. When propelled by the wind, the waves rise up on the water of the sea. When the wind stops, the waves merge with the same sea water. Similarly, the doshas, at the height of their aggravation, produce fever when propelled by vata. On the other hand, when the aggravation subsides, there is remission (relief) of fever, just like the waves in the ocean.

Agañtu jvara – exogeneous fevers

विविधेनाभिघातेनज्वरोयःसंप्रवर्तते।।७५।।
यथादोषप्रकोपंतुतथामन्येततंज्वरम्।।
श्यावास्यताविषकृतेदाहातीसारहन्द्रहाः।।७६।।
अभक्तरुक्पिपासाचतोदोमूर्च्छाबलक्षयः।।
ओषधीगन्धजेमूर्च्छाशिरोरुक्वमथुःक्षवः।।७७।।
कामजेचित्तविभ्रंशस्तन्द्राऽऽलस्यमरोचकः।।
हृदयेवेदनाचास्यगात्रंचपरिशुष्यति।।७८।।
भयात्प्रलापःशोकाच्चभवेत्कोपाच्चवेपथुः।।
अभिचाराभिशापाभ्यांमोहस्तृष्णाचजायते।।७९।।
भूताभिषङ्गादुद्वेगहास्यकम्पनरोदनम्।।
श्रमक्षयाभिघातेभ्योदेहिनांकुपितोऽनिलः ||८०।।
पूरयित्वाऽखिलंदेहंज्वरमापादयेद्भृशम्।।
रोगाणांतुसमुत्थानाद्विदाहागन्तुतस्तथा।।८१।।
ज्वरोऽपरःसंभवतितैस्तैरन्यैश्चहेतुभिः।।
दोषाणांसतुलिङ्गानिकदाचिन्नातिवर्तते।।८२।।

Different kinds of trauma cause aggravation of doshas. These aggravated doshas cause fever. Such fevers should be recognized (diagnosed) by the symptoms of those doshas.

Symptoms of fever caused due to visa – poisons –

–       blue colour in the mouth (face),

–       burning sensation,

–       diarrhoea,

–       catching (gripping) pain in the region of the heart,

–       dislike for food,

–       thirst,

–       pricking pain,

–       fainting and

–       loss of strength

Symptoms of fever produced by smell of ousadhi (grass, flowering plants etc plants which produce pollen) –

–       fainting,

–       headache,

–       vomiting and

–       excessive sneezing

Symptoms of fever caused due to kama (lust, passion) –

–       disorders of mind,

–       stupor,

–       lassitude,

–       loss of appetite,

–       discomfort in the mind and

–       emaciation of the body

Symptoms of fever caused due to bhaya – fear and soka – sorrow – Delirium or irrelevant speech is the main symptom of fever caused due to fear and sorrow.

Symptoms of fever caused due to kopa – anger – Shaking or trembling of the body is the main symptom of fever caused by anger.

Symptoms of fever caused by abhichara i.e. sorcery / witchcraft and abhishapa i.e. curse – In these fevers, delusion and thirst will be manifested as predominant symptoms.

Symptoms of fever caused by Bhutabhisanga i.e. invasion by evil spirits (bacteria etc.) –

–        great agitation,

–        laughing,

–        shaking and

–        weeping

When vata gets aggravated by exertion, loss of tissues and trauma and occupies the whole body, it gives rise to fever.

Other causes of jvara –

–        due to (the effect of) other diseases,

–        ripening of doshas – leading to suppuration i.e. formation of pus,

–        external agencies and

–        other causes

Even these fevers do not exist without the symptoms of aggravated doshas i.e. even in these fevers we can see the manifestation of symptoms of dosha aggravation.

Dhatugata Jvara – fevers present in the tissues

गुरुता हृदयोत्क्लेशः सदनं छर्द्यरोचकौ ॥
रसस्थे तु ज्वरे लिङ्गं दैन्यं चास्योपजायते ॥८३॥
रक्तनिष्ठीवनं दाहं स्वेदश्छर्दनविभ्रमौ ॥
प्रलापः पिटिका तृष्णा रक्तप्राप्ते ज्वरे नृणाम् ॥८४॥
पीण्डिकोद्वेष्टनं तृष्णा सृष्टमूत्रपुरीषता ॥
ऊष्माऽन्तर्दाहविक्षेपौ ग्लानि, स्यान्मांसगे ज्वरे ॥८५॥
भृशं स्वेदस्तृषा मूर्च्छा प्रलापशछर्दिरेव च ॥
दौर्गन्ध्यारोचकौ ग्लानिर्मेदःस्थे चासहिष्णुता ॥८६॥
भेदोऽस्थां कूजनं श्वासो विरेकश्छर्दिरेव च ॥
विक्षेपणं च गात्राणामेतदस्थिगते ज्वरे ॥८७॥
तमः प्रवेशनं हिक्का कासः शैत्यं वमिस्तथा ॥
अन्तर्दहो महाश्वासो मर्मच्छेदश्च मज्जगे ॥
मरणं प्राप्रुयात्तत्र शुक्रस्थानगते ज्वरे ॥८८। ।
शोफसः स्तब्धता मोक्षः शुक्रस्य तु विशेषतः ॥
दग्ध्वेन्धनं यथा वह्निर्धातून् हत्वा यथा विषम् ॥८९॥
कृतकृत्यो व्रजेछ्छान्तिं देहं हत्वा तथा ज्वरः ॥

	Dhatu – tissue in which fever is located	Symptoms
	Rasa Dhatu	Heaviness in the region of the heart, Nausea, Debility, Vomiting, Loss of appetite / taste and Timidity
	Rakta Dhatu	Spitting of blood, Burning sensation, Sweating, Vomiting, Giddiness, Delirium, Eruptions, Rashes on the skin and Thirst
	Mamsa Dhatu	Twisting pain in the calves, Thirst, Excessive elimination of urine and faeces, Heat, Burning sensation inside the body and Shivering / shaking of the body
	Medo Dhatu	Profuse sweating, Thirst, Fainting, Delirium, Vomiting, Bad smell in the body, Loss of taste, Exhaustion and Restlessness
	Asthi Dhatu	Breaking pain in the bones, Contractions of body parts, Dyspnoea, Purgation, Vomiting and Convulsions
	Majja hatu	Person feels as if he is entering into darkness (unconsciousness), Hiccup, Cough, Feeling of cold, Vomiting, Burning sensation inside the body, Breathing is greatly increased and Cutting pain in vital organs / spots of the body
	Shukra Dhatu	Death, Loss of movement of the penis or erection of penis, Excessive elimination of semen

 

The fire would subside after consuming all the fuel. Also, the poison would subside after destroying all the tissues. Similarly, fevers subside after getting satisfied with (causing) death.

वातपित्तकफोत्थानांज्वराणांलक्षणंयथा।।९०।।
तथातेषांभिषग्ब्रूयाद्रसादिष्वपिबुद्धिमान्।।
समस्तैःसन्निपातेनधातुस्थमपिनिर्दिशेत्।।९१।।
द्वन्द्वजंद्वन्द्वजैरेवदोषैश्चापिवदेत्कृतम्।।

Just as (specific) symptoms appear in fevers caused by vāta, pitta and kapha, similarly, by seeing the symptoms of doshas manifesting in the rasa and other tissues, the intelligent physician should infer (recognize) the dosha involvement in the fevers located in these tissues also. Similarly when all doshas get aggravated in the tissues and cause fever, the physician should infer / recognize (or diagnose) sannipata (simultaneous aggravation of all three doshas) in the tissues. Same is the case when two doshas are simultaneously aggravated in the tissues to cause fever (the physician should infer samsarga – dual vitiation of doshas).

Gambhira jvara

गम्भीरस्तुज्वरोज्ञेयोह्यन्तर्दाहेनतृष्णया।।९२।।
आनद्धत्वेनचात्यर्थंश्वासकासोद्गमेनच।।

Gambhira Jvara is a fever which manifests with the below mentioned symptoms –

–       burning sensation inside the body,

–       thirst,

–       flatulence,

–       severe dyspnoea and

–       cough

Varjya rogi – rejectable patient

हतप्रभेन्द्रियंक्षीणमरोचकनिपीडितम्।।९३।।
गम्भीरतीक्ष्णवेगार्तंज्वरितंपरिवर्जयेत्।।

Patient of fever with the below mentioned symptoms should be rejected (not treated) –

–       the person who has lost his radiance (complexion) and sense organs (i.e. they are not functioning),

–       whose tissues have decreased (depleted),

–       who is suffering from loss of appetite / taste,

–       who has severe fever and

–       who has high bout of fever (great increase in temperature)

हीनमध्याधिकैदर्दोपैत्रिसप्तद्वादशाहिकः।।१४।।
ज्वरवेगोभवेत्तीवोयथापूर्वसुखक्रियः।।
कालोहोषयमश्चैवनियतिर्मृत्युरेवच।।१५।।
तस्मिन्व्यपगतेदेहाज्जन्मेहपुनरुच्यते।।
इतिज्वराःसमाख्याताःकर्मेदानीप्रवक्ष्यते।।१६।।6 

Mild, moderate and profound aggravation of doshas determine the severity of fever. Depending on these intensities of aggravation, the fever remains for three, seven and twelve days, in mild, moderate and profound aggravation of doshas respectively. In preceding order, the treatment of these fevers become easy.

Death is certain during these days because they are considered to be the days of yama (God of Death). After the fevers quit the body (get cured), it is considered as ‘rebirth’ of the person.

Thus, the features of different fevers were described. Further on, their treatment will be described.

Jvara cikitsā – treatment of fevers

ज्वरस्यपूर्वरूपेषुवर्तमानेषुबुद्धिमान्।।
पाययेतघृतंस्वच्छंततःसलभतेसुखम्।।९७।।
विधिर्मारुतजेष्वेष, पैत्तिकेषुविरेचनम्।।
मृदु, प्रच्छर्दनंतद्वत्कफजेषुविधीयते।।९८।।

Administration of Ghee – Pure ghee should be administered by an intelligent physician in the premonitory stage of the disease itself. Medicated ghee should not be administered. The patient obtains comfort by this. This should be done only in cases of vata jvara – fevers of vata origin.

In fevers of pitta origin – mild purgatives should be administered.

In fevers of kapha origin – mild emesis should be administered.

Lañghana – thinning therapies

सर्वद्विदोषजेषूक्तंयथादोषंविकल्पयेत्।।
अस्नेहनीयोऽशोध्यश्चसंयोज्योलङ्घनादिना।।९९।।
रूपप्राग्रूपयोर्विद्यान्नानात्वंवह्निधूमवत्।।
प्रव्यक्तरूपेषुहितमेकान्तेनापतर्पणम्।।१००।।

Treatment should be done appropriate to the doshas involved, in all the fevers arising from combination (combined aggravation) of two doshas.

Langhana (fasting and other therapies used for producing lightness of the body) should be adopted to treat all those patients who are unsuitable for snehana – oleation and shodhana – purificatory therapies.

There is not much difference in the treatment lines for premonitory stage and stage of manifestation of the disease. The difference is just like the difference between smoke and fire.

Apatarpana Chikitsa i.e. fasting or thinning therapies are most ideal to be administered when the disease has clearly manifested with all its symptoms.

आमाशयस्थेदोषेतुसोत्क्लेशेवमनंपरम्।।
आनन्द्धःस्तिमितैर्दोषैर्यावन्तंकालमातुरः।।१०१।।
कुर्यादनशनंतावत्ततःसंसर्गमाचरेत्।।

Vamana – Emesis therapy is the best one to be administered when the doshas are present in Amasaya – stomach and when nausea is present.

The patient should not take any food as long as the patient is having flatulence due to stagnation of doshas. He should follow the regimen of light liquid diet in this condition.

नलङ्घयेन्मारुतजेक्षयजेमानसेतथा।।१०२।।
अलक्याश्चापियेपूर्वद्विव्रणीयेप्रकीर्तिताः।।
अनवस्थितदोषाग्नेर्लङ्घनंदोषपाचनम्।।१०३।।
ज्वरघ्नंदीपनंकाङ्क्षारुचिलाघवकारकम्।।

Fasting should not be advised in the fevers of below mentioned kinds –

–       fevers produced by vata,

–       fevers produced by ksaya – decrease of tissues and

–       fevers produced by imbalances in manas (mind, mental disturbances or diseases causing fever) and also

–       for those unfit for fasting therapy (as described in Dvivraniya Cikitsa – chikitsa sthana, chapter 1)

Effects of Fasting therapy –

Fasting bestows the below mentioned benefits when the doshas and agni have moved out of their usual seats –

–       ripens the doshas,

–       relieves fever,

–       increases hunger,

–       increases desire for food and taste and

–       bestows feeling of lightness of the body

सृष्टमारुतविण्मूत्रंक्षुत्पिपासाऽसहंलघुम्।।१०४।।
प्रसन्नात्मेन्द्रियंक्षामंनरंविद्यात्सुलङ्गितम्।।

Signs of langhana properly done (indicating that the patient is properly thinned or made thin by proper fasting) –

–       patient eliminates flatus, faeces and urine,

–       intolerance towards hunger and thirst,

–       pleasantness of soul (mind) and sense organs and

–       thinness (person has become thin)

बलक्षयस्तृषाशोषस्तन्द्रानिद्राभ्रमक्लमाः।।१०५।।
उपद्रवाश्चश्वासाद्याःसंभवन्त्यतिलङ्घनात्।।

Features of excessively done langhana –

–       loss of strength,

–       excessive thirst,

–       dryness in the body,

–       stupor,

–       sleep,

–       giddiness,

–       exhaustion and

–       complications like dyspnoea etc.

Jalapāna – water drinking

दीपनंकफविच्छेदिपित्तवातानुलोमनम्।।१०६।।
कफवातज्वरार्तेभ्योहितमुष्णाम्बुतृद्धिदम्।।
तद्धिमार्दवकृदोषस्त्रोतसांशीतमन्यथा।।१०७।।
सेव्यमानेनतोयेनज्वर: शीतेनवर्धते।।

Below mentioned are the benefits of hot water when used for drinking –

–        increases hunger,

–        breaks kapha,

–        moves pitta and vata downwards,

–        beneficial in fevers produced by combined aggravation of kapha and vata,

–        relieves thirst and

–        softens the doshas and srotas

On the other hand, cold water has opposite qualities. Drinking cold water will increase the fever.

पित्तमद्यविषोत्थेषुशीतलंतिक्तकैःशृतम्।।१०८।।
गाङ्गेयनागरोशीरपर्पटोदीच्यचन्दनैः।।

Water boiled with bitter tasting herbs like Gangeya (musta), Nagara, Usira, Parpata, Udicya and Candana is beneficial in treating fevers caused by pitta, wine and poison.

Peyā

दीपनीपाचनीलध्वीज्वरार्तानांज्वरापहा।।१०९।।
अन्नकालेहितापेयायथास्वंपाचनैःकृता।।

At the time of meals, drinking peya i.e. thin gruels is beneficial.

Peya is –

–        carminative,

–        digestive,

–        easily digestive and

–        relieves fever

Peya boiled and prepared with digestive herbs is ideal.

Kaşāyopayoga – drinking decoctions

बहुदोषस्यमन्दाग्नेःसप्तरात्रात्परंज्वरे।।११०।।
लङ्घनाम्बुयवागूभिर्यदादोषोनपच्यते।।
तदातंमुखवैरस्यतृष्णारोचकनाशनैः।।१११।।
कषायैःपाचनैर्हृद्यैर्ज्वरघ्नैःसमुपाचरेत्।।

Conditions for administering Kashaya (decoctions) –

–        when doshas are greatly aggravated,

–        when the digestive fire is weak,

–        when fever persists even after seven days,

–        when doshas are not ripening even after seven days

–        when doshas are not ripening even with fasting, drinking hot water and consuming yavagu – thick gruel

Decoctions with below mentioned properties should be used –

–        those prepared from herbs which relieve bad taste in the mouth,

–        those prepared from herbs which relieve thirst and loss of appetite,

–        those prepared from herbs which are digestive,

–        those prepared from herbs which are good for heart and

–        those prepared from herbs which are anti-febrile

पञ्चमूलीकषायंतुपाचनंपवनज्वरे।।११२।।
सक्षौद्रंपैत्तिकेमुस्तकटुकेन्द्रयवैःकृतम्।।
पिप्पल्यादिकषायंतुकफजेपरिपाचनम्।।११३।
द्वन्द्वजेषुतुसंसृष्टंदद्यादथविवर्जयेत्।।

Dosha predominance in fever (fever caused by)	Useful decoction
Vata	Decoction of Mahat Pancamula added with honey
Pitta	Decoction of Musta, Katuka and indrayava
Kapha	Decoction of herbs belonging to Pippalyadi Gana group
Two doshas	Decoction prepared from suitable herbs which are best for both both doshas

पीताम्बुर्लङ्घितोभुक्तोऽजीर्णीक्षीणःपिपासितः।।११४।।
(तीक्ष्णेज्वरेगुरौदेहेविबद्वेषुमलेषुच।।
सामदोषंविजानीयाज्ज्वरंपक्कमतोऽन्यथा।

Contraindications for drinking Kashaya –

–       patients who have drunk water,

–       those who are fasting,

–       those who have just consumed food,

–       those having indigestion,

–       those emaciated and

–       those having thirst

Sāma- pakva doşa 

Symptoms of Sama Dosa Jvara (unripe fever or fever in which doshas are associated with ama or are unripe) are opposite of Symptoms of Pakva Dosa Jvara (ripe fever or fever in which doshas have ripened). They are –

–       high fever,

–       feeling of heaviness of the body,

–       non-elimination of wastes

मृदौज्वरेलघौदेहेप्रचलेषुमलेषुच।।
पक्कंदोषविजानीयाज्ज्वरेदेयंतदौषधम्।।११५।।

Signs and symptoms of Pakva Jwara (ripe fever) –

–       mild fever,

–       feeling of lightness of the body,

–       waste products are eliminated

In this condition, medicines shall be administered.

Ama jvara – features of unripe fever

दोषप्रकृतिवैकृत्यादेकेषांपक्कलक्षणम्।।
हृदयोद्वेष्टनंतन्द्रालालास्रुतिररोचकः।।११६।।
दोषाप्रवृत्तिरालस्यंविबन्धोबहुमूत्रता।।
गुरूदरत्वमस्वेदोनपक्तिःशकृतोऽरतिः।।११७।।
स्वापःस्तम्भोगुरुत्वंचगात्राणांवह्निमार्दवम्।।
मुखस्याशुद्धिरग्लानिःप्रसङ्गीबलवाश्र्वरः।।११८।।
लिङ्गैरेभिर्विजानीयाज्ज्वरमामंविचक्षणः।।

The symptoms of ripening appear due to change in normal qualities of the doshas (dosa prakriti) in some fevers.

Below mentioned are the symptoms of Ama Jvara (unripe fever) –

–        twisting pain in the region of heart,

–        stupor,

–        excessive salivation,

–        loss of appetite,

–        loss of taste,

–        non-movement of doshas,

–        lassitude,

–        constipation,

–        excessive urination,

–        heaviness in the abdomen,

–        absence of sweating,

–        improper formation of faeces (unripe faeces),

–        restlessness,

–        loss of tactile sensation,

–        rigidity and

–        feeling of heaviness of the body,

–        weakness of digestive fire,

–        impurity in the mouth,

–        less exhaustion,

–        fever is continuous and strong

Auşadha sevana

सप्तरात्रात्परंकेचिन्मन्यतेदेयमौषधम्।।११९।।
दशरात्रात्परंकेचिहातव्यमितिनिश्चिताः।।

According to some scholars, medicines should be given to the patients of fever after seven days. Some other scholars strongly opine that it should be given only after ten days.

पैत्तिकेवाज्वरेदेयमल्पकालसमुत्थिते।।१२०।।
अचिरज्वरितस्यापिदेयंस्याहोषपाकतः।।

In fevers of pitta origin, the doshas ripen quickly. Medicines can therefore be administered in these fevers though the fevers are of recent onset.

भेषजंह्यामदोषस्यभूयोज्वलयतिज्वरम्।।१२१।।
शोधनं, शमनीयंतुकरोतिविषमज्वरम्।।
च्यवमानंज्वरोत्क्लिष्टमुपेक्षेतमलंसदा।।१२२।।
अतिप्रवर्तमानंचसाधयेदतिसारवत्।। 

Fever gets increased if medicines are administered when the doshas are in an unripe (ama) state.

If purificatory and palliative medicines are administered when the doshas are in unripe stage, they give rise to visama jvara – intermittent fevers.

If the malas i.e. faeces (and excreta) are being eliminated during the duration of fever, it should be neglected and should not be stopped. If malas are being eliminated in excess, they should be treated similar to diarrhoea.

Sodhana cikitsa – purificatory therapies 

यदाकोष्ठानुगाःपक्काविबद्धाःस्त्रोतसांमलाः।।१२३।।
अचिरज्वरितस्यापितदादद्याद्विरेचनम्।।

Virechana i.e. purgation should be administered when the mala (doshas) are ripe but are stagnated in the channel of elimination. Purgation should be given though the fever is nascent.

पक्को ह्यानिर्हृतो देहे तिष्ठन महात्ययम् ॥१२४॥
विषमंवाज्वरंकुर्याद्वलव्यापदमेवच।।
तस्मान्निर्हरणंकार्यदोषाणांवमनादिभिः।।१२५।।

Doshas which have become ripe should be eliminated. If not eliminated, these doshas remain inside the body and give rise to great hazards, intermittent fevers and loss of strength. Hence emesis and other therapies should be administered to promptly remove the ripe doshas.

प्राकर्मवमनंचास्यकार्यमास्थापनंतथा।।
विरेचनंतथाकुर्याच्छिरसश्चविरेचनम्।।१२६।।

Firstly, vamana i.e. emesis should be administered.

Next, the other therapies i.e. asthapana basti – decoction enema, virechana – purgation and sirovirecana – purgation to the head should be done one after the other.

क्रमशःबलिनेदेयंवमनंश्लैष्मिकेज्वरे।।
पित्तप्रायेविरेकस्तुकार्यःप्रशिथिलाशये।।१२७।।
सरुजेऽनिलजेकार्यंसोदावर्तेनिरूहणम्।।
कटीपृष्ठग्रहार्तस्यदीप्ताग्नेरनुवासनम्।।१२८।।
शिरोगौरवशूलघ्नमिन्द्रियप्रतिबोधनम्।।
कफाभिपन्नेशिरसिकार्यंमूर्धविरेचनम्।।१२९।। 

In kaphaja jvara i.e. fever caused by kapha, vamana – emesis should be administered if the patient is strong.

In pittaja jvara i.e. fever caused by pitta, virechana – purgation should be administered if the patient is strong and the colon is loose.

In vataja jvara i.e. fever caused by vata, niruha vasti – decoction enema should be administered if the doshas are having upward movements inside the alimentary canal and accompanied by pain.

The patient should be administered with anuvasana basti – unctuous enema if he has catching pain in his waist and back and if the patient has keen digestive fire.

Murdha Virecana (siro virecana – purgation to the head, errhine) should be administered when there is accumulation of kapha in the head. It should be administered to relieve feelings of heaviness and pain in the head and also to stimulate the sense organs.

दुर्बलस्यसमाध्मातमुदरंसरुजंदिहेत्।।
दारुहैमवतीकुष्ठशताह्लाहिङ्गसैन्धवैः।।१३०।।
अम्लपिष्टैःसुखोष्णैश्चपवनेतूर्ध्वमागते।।
रुद्धमूत्रपूरीषायगुदेवर्तिनिधापयेत्।।१३१।।
पिप्पलीपिप्पलीमूलयवानीचव्यसाधिताम्।।
पाययेतयवागूंवामारुताद्यनुलोमिनीम्।।१३२।।

Paste of the below mentioned ingredients should be prepared by macerating them with sour juice –

–       Daru,

–       Haimavati,

–       Kustha,

–       Satahva,

–       Hingu and

–       Saindhava

This paste should be applied comfortably warm on the abdomen of the patient of fever who is debilitated, has flatulence and pain in the abdomen.

A wick or rectal suppository should be kept in the rectum when vata is moving upwards and there is obstruction to urine and faeces. Alternatively, yavagu i.e. thick gruel prepared with pippali, pippalimula, yavani and cavya should be given for drinking. This gruel will make for elimination of flatus etc.

Samana cikitsā – palliative therapies

शुद्धस्योभयतोयस्यज्वरःशान्तिंनगच्छति।।
सशेषदोषरूक्षस्यतस्यतंसर्पिषाजयेत्।।१३३।।

Sometimes, when the doshas remain inside the body and are dry, the fever will not subside even after administration of emesis and purgation so as to purify the doshas in both directions. In such cases, the doshas should be won over by administering ghee.

कृशंचैवाल्पदोषंचशमनीयैरुपाचरेत्।।
उपवासैर्बलस्थंतुज्वरेसन्तर्पणोत्थिते।।१३४।।
क्लिन्नांयवागूंमन्दाग्निंतृषार्तंपाययेन्नरम्।।
तृछर्दिदाहघर्मार्तंमद्यपंलाजतर्पणम्।।१३५।।
सक्षौद्रमम्भसापश्चाज्जीर्णेयूषरसौदनम्।।

The patient shall be treated with palliative treatments if the patient is emaciated and doshas are mild. On the other hand, the patient should be treated with fasting therapy if he is strong and if his fever is manifested due to over-nourishment.

The patient is given thin yavagu (gruel) to drink if the patient is having weak digestive fire and if he is suffering from thirst.

Laja Tarpana i.e. groats made from fried paddy added with honey and water should be given if –

–       the patient suffering from thirst,

–       vomiting,

–       burning sensation and heat and

–       if addicted to wine

After the tarpana gets digested, the patient should be given yusa i.e. soup of pulses and boiled rice along with soup of meat.

उपवासश्रमकृतेक्षीणेवाताधिकेज्वरे।।१३६।।
दीप्ताग्निंभोजयेत्प्राज्ञोनरंमांसरसौदनम्।।
मुद्द्रयूषौदनश्चापिहितःकफसमुत्थिते।।१३७।।

Boiled rice along with meat soup should be given to a patient –

–        who is weak / emaciated,

–        suffering from fever caused by fasting, exertion and predominance of vata and

–        having keen digestive fire

On the other hand, boiled rice along with green gram soup is beneficial to those suffering from fever caused by kapha.

In fever of pitta origin, the same green soup (prescribed in kapha fevers) should be added with sugar and served cold.

Yūşa prayoga

सएवसितयायुक्तःशीतःपित्तज्वरेहितः।।
दाडिमामलमुद्गानांयूषश्चानिलपैत्तिके।।१३८।।
हस्वमूलकयूषस्तुवातश्लेष्माधिकेहितः।।
पटोलनिम्बयूषस्तुपथ्यःपित्तकफात्मके।।१३९।।

Yusa – soup prepared with the below mentioned ingredients is beneficial in treating fevers caused by combined aggravation of vata and pitta –

–       Dadima,

–       Amalaka and

–       Mudga

Yusa prepared with Hrsva Mulaka is beneficial in treating fevers caused by combined aggravation of vata and kapha.

Yusa prepared with Patola and Nimba is beneficial in treating fevers caused by pitta and kapha aggravation.

दाहच्छर्दियुतंक्षामंनिरन्नंतृष्णयाऽर्दितम्।।
सिताक्षौद्रयुतंलाजतर्पणंपाययेतच।।१४०।।

Laja Tarpana added and mixed with sugar and honey should be given for drinking to the patients of fever having burning sensation, vomiting, emaciation and thirst. For these patients no other food should be given (other than laja tarpana).

कफपित्तपरीतस्यग्रीष्मेऽसृपित्तिनस्तथा।।
मद्यनित्यस्यनहितायवागूस्तमुपाचरेत्।।१४१।।
यूषैरम्लैरनम्लैर्वाजाङ्गलैश्चरसैर्हितैः।।

For patients having predominance of kapha and pitta, yavagu i.e. thick gruel is not beneficial.

Yusa i.e. soup prepared from pulses with or without addition of sour things should be prescribed in summer season, for those suffering from raktapitta and those who consume wine daily. Alternatively soup of meat of animals living in arid regions should be administered in the same conditions.

मद्यंपुराणंमन्दाग्नेर्यवान्नोपहितंहितम्।।१४२।।

For persons having weak digestive fire, old wine is beneficial along with boiled yava.

सव्योषंवितरेत्तक्रंकफारोचकपीडिते।।
कृशोऽल्पदोषोदीनश्चनरोजीर्णज्वरार्दितः।।१४३।।
विबद्धःसृष्टदोषश्चरूक्षःपित्तानिलज्वरी।।
पिपासार्तःसदाहोवापयसाससुखीभवेत्।।१४४।।
तदेवतरुणेपीतंविषवद्धन्तिमानवम्।।

For those suffering from kapha and loss of taste (appetite) buttermilk added with vyoşa should be given.

Drinking milk provides comfort to the patients of fever with below mentioned features –

–        those emaciated and timid,

–        having fever from long time,

–        in persons in whom the doshas are either obstructed or moving out,

–        those who are dry,

–        those suffering from fevers caused by combined aggravation of pitta and vata, or

–        those suffering from thirst or burning sensation

The same milk, when consumed, will kill the patient of nascent fever just like a poison.

Bhojana – partaking solid food 

सर्वज्यरेषुसुलघुमात्रावद्भोजनंहितम्।।१४५।।

It is beneficial to consume very light and digestible food, in limited quantities, in all kinds of fevers. Alternatively, hard-to-digest foods consumed in large quantities will increase the severity of fevers.

वेगापायेऽन्यथातद्धिज्वरवेगाभिवर्धनम्।।
ज्वरितोहितमश्नीयाद्यद्यप्यस्यारुचिर्भवेत्।।१४६।।
अन्नकालेह्यभुञ्जानःक्षीयतेम्रियतेऽथवा।।
सक्षीणःकृच्छ्रतांयातियात्यसाध्यत्वमेवच।।१४७।।
तस्माद्रक्षेद्वलंपुंसांबलेसतिहिजीवितम्।।

Even if the patient of fever has loss of taste, he should be eating suitable food. If he would not eat food at the time of meals, he would become either weak or may also die. Fever becomes difficult to cure or incurable in emaciated or weak persons. Therefore, the strength of the patient should be carefully protected. Only when there is strength, it is possible for the person to live.

गुर्वभिष्यन्द्यकालेचज्वरीनाद्यात्कथञ्चन।।१४८।।
नतुतस्याहितंभुक्तमायुषेवासुखायवा।।

Foods which are not light i.e. which are not easily digestible should never be consumed by patients of fever. Such foods would create more moisture inside the body of the patient. He should also not consume foods apart from the usual times of taking meals. Such foods are not beneficial to life or happiness.

संततंविषमंवाऽपिक्षीणस्यसुचिरोत्थितम्।।१४९।।
ज्वरंसंभोजनैःपथ्यैर्लघुभिःसमुपाचरेत्।।

Healthy and easily digestible foods should be given to the patient suffering from santata or visama jvara persisting for long periods and if he is very weak. Such foods can be given in a quantity as much as the patient desires to have.

मुद्रान्मसूरांचणकान्कुलत्थान्समकुष्ठकान्।।१५०।।
आहारकालेयूषार्थज्वरितायप्रदापयेत्।।

Patient of fever should be given Yusa – soup prepared from the below mentioned ingredients at the time of meals –

–       Mudga

–       Masura,

–       Canaka,

–       Kulattha and

–       Makusthaka

पटोलपत्रंवार्ताकंकठिल्लंपापचैलिकम्।।१५१।।
कर्कोटकंपर्पटकंगोजिह्वांबालमूलकम्।।
पत्रंगुडूच्याःशाकार्थेज्वरितानांप्रदापयेत्।।१५२।।

Below mentioned should be used as vegetables by patients of fever –

–       Patola patra,

–       Vartaka,

–       Kathilla,

–       Papacailika,

–       Karkotaka,

–       Parpataka,

–       Gojihva,

–       Balamulaka and

–       Guducipatra

लावान्कपिञ्जलानेणान्पृषताञ्छरमाञ्छशान्।।
कालपुच्छान्कुरङ्गांश्चतथैवमृगमातृकान्।।१५३।।
मांसार्थेमांससात्म्यानांज्वरितानांप्रदापयेत्।।

Meat of the below mentioned birds and animals may be given to patients of fever who are accustomed to meat consumption –

–       lava,

–       kapinjala,

–       ena,

–       prsata,

–       sarabha,

–       sara,

–       kalapuccha,

–       kuranga or

–       mrgamatrka

सारसक्रौञ्चशिखिनःकुक्कुटांस्तित्तिरां(री) स्तथा।।१५४।।
गुरूष्णत्वान्नशंसन्तिज्वरेकेचिच्चिकित्सकाः।।
ज्वरितानांप्रकोपंतुयदायातिसमीरणः।।१५५।।
तदैतेऽपिहिशस्यन्तेमात्राकालोपपादिताः।।

Below mentioned meats are not easily digestible and are also hot in potency and hence not advised by some physicians –

–       sarasa,

–       kraunca,

–       sikhi,

–       kukkuta and

–       tittiri

However, even these meats are said to be beneficial if used in suitable quantities, when vata becomes aggravated in patients of fever.

परिषेकान्प्रदेहांश्चस्नेहान्संशोधनानिच।।१५६।।
(स्नानाभ्यङ्गदिवास्वप्नशीतव्यायामयोषितः) ।।
कषायगुरुरूक्षाणिक्रोधादीनितथैवच।।१५७।।
सारवन्तिचभोज्यानिवर्जयेत्तरुणज्वरी।।
तथैवनवधान्यादिंवर्जयेच्चसमासतः।।१५८।।
अनवस्थितदोषाग्नेरेभिःसन्धुक्षितोज्वरः।।
गम्भीरतीक्ष्णवेगत्वंयात्यसाध्यत्वमेवच।।१५९।।

Patients suffering from fever of recent onset should avoid the below mentioned things –

–        pariseka – pouring water / medicated liquids on the body,

–        applying warm pastes,

–        oleation,

–        purificatory therapies,

–        bath,

–        anointing / doing massage with oil,

–        sleeping during day time,

–        cold comforts,

–        physical exercises,

–        copulation,

–        astringent foods,

–        foods which are not easily digestible,

–        dry foods,

–        anger and other mental emotions,

–        fatty foods,

–        foods which produce excessive moisture in the body and

–        freshly harvested foods

If the person consumes / gets exposed to the above said things, the doshas and agni would get displaced and begin to move. They increase the severity of the fever and make it incurable.

शीततोयदिवास्वप्रक्रोधव्यायामयोषितः।।
नसेवेतज्वरोत्सृष्टोयावत्रबलवान्भवेत्।।१६०।।
मुक्तस्यापिज्वरेणाशुदुर्बलस्याहितैर्ज्वरः।।
प्रत्यापन्नोदहेद्देहंशुष्कंवृक्षमिवानलः।।१६१।।
तस्मात्कार्यःपरीहारोज्वरमुक्तैर्विरिक्तवत्।।
यावन्नप्रकृतिस्थ: स्याद्दोषतःप्राणतस्तथा।।१६२।।

Until he regains strength and becomes strong once again, the person should not indulge in the below mentioned –

–        cold water,

–        day time sleeping,

–        anger,

–        physical exercises and

–        copulation

Just like the fire destroys a dried tree, the fever appears again and destroys the body of the person though he is relieved of fever because the person is weak, and indulged in unsuitable foods and activities.

Therefore, persons who are relieved of fever should be taken care of similar to a person who has had purgative therapy. This should be done until the doshas and prana i.e. strength have been restored to normal.

ज्वरेप्रमोहोभवतिस्वल्पैरप्यवचेष्टितैः।।
निषण्णंभोजयेत्तस्मान्मूत्रोच्चारौचकारयेत्।।१६३।।

Profound delusion / unconsciousness appears with even slight physical activities in patients of fever. Therefore the patient should be made to eat food while lying in the bed itself. He should also be made to eliminate urine and faeces while lying in the bed itself.

अरोचकेगात्रसादेवैवये॑ऽङ्गमलादिषु।।
शान्तज्वरोऽपिशोध्यःस्यादनुबन्धभयान्नरः।।१६४।।

Even after the fever subsides, if the person has loss of taste / appetite, weakness of the body, manifestation of abnormal colours in the body parts and excreta (urine and faeces), there will be a fear of onset of fever once again. Therefore, the patient should be administered with purificatory therapies in this condition.

नजातुस्नापयेत्प्राज्ञःसहसाज्वरकर्शितम्।।
तेनसंदूषितोह्यस्यपुनरेवभवेज्ज्वरः।।१६५।।

An intelligent physician should take caution that the person who has been debilitated by fever would never take a bath immediately. If he takes a bath, the doshas would become aggravated. This would lead to recurrence of fever.

चिकित्सेच्चज्वरान्सर्वान्निमित्तानांविपर्ययैः।।
श्रमक्षयाभिघातोत्थेमूलव्याधिमुपाचरेत्।।१६६।।
स्त्रीणामपप्रजातानांस्तन्यावतरणेचयः।।
तत्रसंशमनंकुर्याद्यथादोषंविधानवित्।।१६७।।

The physician should take care of removing all the causative factors of fever while treating all kinds of fevers. The primary cause should also be treated in fevers produced by exertion and trauma.

The physician who is well versed with ideal procedures should treat the below mentioned fevers with palliative therapies –

–        in fevers occurring in women who have had premature delivery (abortion, miscarriage or improper delivery etc) and

–        fever developing at the time of production of breast milk

Samana kaşāya – palliative decoctions

अतःसंशमनीयानिकषायाणिनिबोधमे।।
सर्वज्वरेषुदेयानियानिवैद्यैनजानता।।१६८।।

After this, the palliative decoctions which can be administered by the physicians in all kinds of fevers shall be explained by me. Listen to the same.

Vātajvara hara

पिप्पलीसारिवाद्राक्षाशतपुष्पाहरेणुभिः।।
कृतःकषायःसगुडोहन्याच्छ्रसनजंज्वरम्।।१६९।।

Decoction prepared from the below mentioned ingredients cures fever caused by vata –

–        Pippali,

–        Sariva,

–        Draksa,

–        Satapuspa and

–        Harenu

This decoction should be given mixed jaggery / treacle.

शृतंशीतकषायंवागुडूच्याःपेयमेवतु।।
बलादर्भश्वदंष्ट्राणांकषायंपादशेषितम्।।१७०।।
शर्कराघृतसंयुक्तंपिबेद्वातज्वरापहम्।।

Also, decoction or cold infusion prepared from Guduci may also be consumed by the patient.

Decoction prepared from the below mentioned herbs shall be reduced to one fourth –

–       Bala,

–       Darbha and

–       Svadamstra

This decoction should be added and mixed with sugar and ghee. Patients suffering from fever of vata origin should consume this decoction.

शतपुष्पावचाकुष्ठदेवदारुहरेणुकाः।।१७१।।
कुस्तुम्बुरूणिनलदंमुस्तंचैवाप्सुसाधयेत्।।
क्षौद्रेणसितयाचापियुक्तःक्वाथोऽनिलाधिके।।१७२।।

Decoction prepared from the below mentioned ingredients should be added and mixed with honey and sugar and served to the patient suffering from fever of vata origin –

–       Satapuspa,

–       Vaca,

–       Devadaru,

–       Harenuka,

–       Kustumburu,

–       Nalada and

–       Musta

द्राक्षागुडूचीकाश्मर्यत्रायमाणाःससारिवाः।।
निष्काथ्यसगुडंक्वाथंपिबेद्वातकृतेज्वरे।।१७३।।

Patients suffering from fevers of vata origin should consume the decoction prepared from the below mentioned herbs added with jaggery –

–       Draksa,

–       Guduci,

–       Kasmarya,

–       Trayamana and

–       Sariva

गुडूच्याःस्वरसोग्राह्यःशतावर्याश्चतत्समः।।
निहन्यात्सगुडःपीतःसद्योऽनिलकृतंज्वरम्।।१७४।।
घृताभ्यङ्गस्वेदलेपानवस्थासुचयोजयेत्।। 

Fresh juice of Guduci should be mixed with equal quantities of fresh juice of Satavari. In this, jaggery is mixed. This recipe cures fever caused by vata when consumed.

Below mentioned treatments should be done at different stages of vataja fever, as and when required –

–       drinking ghee,

–       anointing,

–       sudation and

–       applying poultices

Pittajvara hara

श्रीपर्णीचन्दनोशीरपरूषकमधूकजः।।१७५।।
शर्करामधुरोहन्तिकषायःपैत्तिकंज्वरम्।।

Decoction of below mentioned ingredients should be added with sugar and administered to patient suffering from fever caused by pitta –

–       Sriparni,

–       Candana,

–       Usira,

–       Parusaka and

–       Madhuka

पीतंपित्तज्वरंहन्यात्सारिवाद्यंसशर्करम्।।१७६।।
सयष्टीमधुकंहन्यात्तथैवोत्पलपूर्वकम्।।
शृतंशीतकषायंवासोत्पलंशर्करायुतम्।।१७७।। 

Decoction of herbs belonging to Sarivadi Gana group should be added and mixed with sugar. It cures fever caused by pitta when consumed.

Similarly, decoction of Utpaladi Gana group cures fever of pitta origin when administered, mixed with Yastimadhuka.

Also to cure fever of pitta origin, decoction or infusion of Utpaladi Gana group should be given, added with sugar.

गुडूचीपद्मरोध्राणांसारिवोत्पलयोस्तथा।।
शर्करामधुरःक्वाथःशीतःपित्तज्वरापहः।।१७८।।

Decoction of the below mentioned ingredients added with sugar and honey and consumed cold, cures pitta type of fevers –

–       Guduci,

–       Padma,

–       Rodhra,

–       Sariva and

–       Utpala

द्राक्षारग्वधयोश्चापिकाश्मर्यस्याथवापुनः।।
स्वादुतिक्तकषायाणांकषायैःशर्करायुतैः।।१७९।।
सुशीतैःशमयेत्तृष्णांप्रवृद्धांदाहमेवच।।
शीतंमधुयुतंतोयमाकण्ठाद्वापिपासितम्।।१८०।।
वामयेत्याययित्वातुतेनतृष्णाप्रशाम्यति।। 

Cold decoction of draksa and aragvadha or cold decoction of kasmarya, cold decoction of sweet and bitter group of herbs, added with sugar, served cold will effectively pacify severe thirst and burning sensation caused by pitta jvara.

When the patient is suffering from thirst, cold water added and mixed with honey should be given. The patient should be made to drink it up to his throat (full stomach or until saturation) and then made to vomit. This subsides thirst.

क्षीरैःक्षीरिकषायैश्चसुशीतैश्चन्दनायुतैः।।१८१।।
अन्तर्दाहविधातव्यमेभिश्चान्यैश्चशीतलैः।।

Below mentioned recipes should be administered if burning sensation is present inside the body –

–       decoction of trees having milky sap added with milk and candana should be served in cold state or

–       decoction of any other cold potency herb may also be given

पद्मकंमधुकंद्राक्षांपुण्डरीकमथोत्पलम्।।१८२।।
यवान्भृष्टानुशीराणिसमङ्गांकाश्मरीफलम्।।
निदध्यादप्सुचालोड्यनिशापर्युषितंततः।।१८३।।
क्षौद्रेणयुक्तंपिबतोज्वरदाहौप्रशाम्यतः।।

Powder of the below mentioned herbs should be prepared –

–       Padmaka,

–       Mmadhuka,

–       Draksa,

–       Pundarika,

–       Utpala,

–       Bhrsta Yava,

–       Usira,

–       Samanga and

–       Kasmari phala

This powder should be soaked in water at night. This water should be filtered next morning, added with honey and consumed. This recipe cures burning sensation and fever.

जिह्वातालुगलक्लोमशोषेमूर्ध्निचदापयेत्।।१८४।।
केशरंमातुलुङ्गस्यमधुसैन्धवसंयुतम्।।
शर्करादाडिमाभ्यांवाद्राक्षाखर्जूरयोस्तथा।।१८५।।
वैरस्येधारयेत्कल्कंगण्डूषंचतथाहितम्।। 

Cold paste of herbs may be kept on the head of the patient who has dryness of tongue, palate, throat and kloma.

Below mentioned recipes shall be used if the patient has loss of taste –

Paste of filaments of matulunga fruit added with the below said, may be kept in the mouth –

–       honey and saindhava lavana,

–       sugar and dadima or

–       draksa and kharjura

Alternatively gargling may be done.

Kaphajvara hara

सप्तच्छदंगुडूचींचनिम्बंस्फूर्जकमेवच।।१८६।।
क्वाथयित्वापिबेत्क्वाथंसक्षौद्रंकफजेज्वरे।।

Decoction of the below mentioned ingredients added with honey many be consumed by patients suffering from kaphaja jvara –

–       Saptacchada,

–       Guduci,

–       Nimba and

–       Sphurjaka

कटुत्रिकंनागपुष्पंहरिद्राकटुरोहिणी।।१८७।।
कौटजंचफलंहन्यात्सेव्यमानंकफज्वरम्।।

Decoction of the below mentioned herbs cures fever of kapha origin –

–       Katutrika,

–       Nagapuspa,

–       Haridra,

–       Katurohini and

–       Kutajaphala (Indrayava)

हरिडांचित्रकंनिम्बयुशीरातिविषेवचाम्।।१८८।।
कुष्ठमिन्द्रयवान्पूर्वीपटोलंचापिसाघितम्।।
पिबेन्परिचसंयुक्तंसक्षौद्रंकफजेज्वरे || १८९।।

Decoction should be prepared with the below mentioned ingredients –

–       Haridra,

–       Citraka,

–       Nimba,

–       Usira,

–       Ativisa,

–       Vaca,

–       Kustha,

–       Indrayava,

–       Murva and

–       Patola

This decoction should be added with powder of Marica – black pepper and honey. When consumed, this decoction cures fever of kapha origin.

सारिवातिविषाकुष्ठपुराख्यैःसदुरालभैः।।
युस्तेनचकृतःक्रायःपीतोहन्यात्कफज्वरम्।।१९०।।
मुस्तंवृक्षकबीजानित्रिफलाकटुरोहिणी ||
परुषकाणिचकाय: कफज्वरविनाशनः।।१९१।।

Decoction of below mentioned herbs cures fever produced by kapha when consumed –

–       Sariva,

–       Ativisa,

–       Kustha,

–       Pura,

–       Duralabha and

–       Musta

Decoction of the below mentioned ingredients when consumed cures fever caused by kapha –

–       Musta,

–       Seeds of Vrksaka – Indrayava,

–       Triphala,

–       Katurohini and

–       Parusaka

Kapha-vata jvarahara

राजवृक्षादिवर्गस्यकषायोमधुसंयुतः।।
कफवातज्वरंहन्याच्छीघ्रंकालेऽवचारितः।।१९२।।

Fevers produced by combined aggravation of kapha and vata will be cured if decoction of herbs belonging to Rajavrksadi Gana (Aragvadhadi Gana) group added with honey is consumed by the patient at proper time.

नागरंधान्यकंभार्गीमभयांसुरदारुच॥
वचपर्पटकंमुस्तंभूतीकमथकट्फलम् || १९३।।
निष्काथ्यकफवातोत्थेक्षौद्रहिङ्गुसमन्वितम्।।
दातव्यंश्वासकासघ्नंश्लेष्मोत्सेकेगलग्रहे।।१९४।।
हिक्कासुकण्ठश्वयर्थीशूलेहृदयपार्श्वजे।।

Decoction of below mentioned herbs may be consumed added with honey and hingu –

–       Nagara,

–       Dhanyaka,

–       Bharngi,

–       Abhaya,

–       Suradaru,

–       Vaca,

–       Parpataka,

–       Musta,

–       Bhutika and

–       Katphala

This decoction cures dyspnoea, cough, excess of kapha coming out, pain in throat, hiccup, swelling of the throat and pain in the region of heart and flanks.

Pittakaphajvara hara kashaya 

बलापटोलत्रिफलायष्ट्याह्वानांवृषस्यच।।१९५।।
क्वाथोमधुयुतःपीतोहन्तिपित्तकफज्वरम्।।
कटुकाविजयाद्राक्षामुस्तपर्पटकैःकृतः।।१९६।।
कषायोनाशयेत्प्रीतःश्लेष्मपित्तभवंज्वरम्।।
भार्गीवचापर्पटकधान्यहिङ्ग्वभयाघनैः।।१९७।।
काश्मर्यनागरैःक्वाथःसक्षौद्रःश्लेष्मपित्तजे।।
सशर्करामक्षमात्रांकटुकामुष्णवारिणा।।१९८।।
पीत्वाज्वरंजयेज्जन्तुःकफपित्तसमुद्भवम्।।

Decoction of below mentioned ingredients should be consumed added with honey –

–       Bala,

–       Patola,

–       Triphala,

–       Yashti and

–       Vrsa

This recipe cures fevers caused by combined aggravation of pitta and kapha.

Likewise, decoction of the below mentioned herbs too cures kapha-pitta type of fevers –

–       Katuka,

–       Vijaya (Haritaki),

–       Draksa,

–       Musta and

–       Parpataka

Decoction prepared from the below mentioned herbs added with honey is also beneficial for curing fevers of kapha-pitta origin, when consumed –

–       Bharngi,

–       Vaca,

–       Parpataka,

–       Dhanya,

–       Hingu,

–       Abhaya,

–       Ghana,

–       Kasmarya and

–       Nagara

One aksa i.e. 10 grams of Katuka is mixed with sugar and is consumed with hot water. This recipe cures fevers produced by kapha and pitta together.

Vātapitta jvara hara kashaya 

किराततिक्तममृतांद्राक्षामामलकंशटीम्।।१९९।।
निष्काथ्यवातपित्तोत्थेतंक्वाथंसगुडंपिबेत्।।
रास्नावृषोऽथत्रिफलाराजवृक्षफलैःसह।।२००।।
कषायःसाधितःपीतोवातपित्तज्वरंजयेत्।। 

Decoction of below mentioned ingredients should be added and mixed with jaggery (treacle) and consumed by persons suffering from fever produced by vata and pitta together –

–       Kiratatikta,

–       Amrta,

–       Draksa,

–       Amalaka and

–       Sati

Consumption of decoction prepared with the below mentioned herbs will also cure vata-pitta type of fevers –

–       Rasna,

–       Vrsa,

–       Triphala and

–       Rajavrksa (Aragvadha) phala

Sarvadoşa jvara hara

सर्वदोषसमुत्थेतुसंसृष्टानवचारयेत्।।२०१।।
यथादोषोच्छ्रयंचापिज्वरान्सर्वानुपाचरेत्।। 

Mixtures of appropriate herbs in accordance with the doshas should be administered in the treatment of fevers caused by aggravation of all doshas together. These fevers shall be treated in priority of aggravated doshas.

वृश्चीवबिल्ववर्षाभ्वःपयश्चोदकमेवच।।२०२।।
पचेत्क्षीरावशिष्टंतुतद्धिसर्वज्वरापहम्।।
उदकांशास्त्रयःक्षीरंशिंशपासारसंयुतम्।।२०३।।
तत्क्षीरशेषंक्वथितंपेयंसर्वज्वरापहम्।।

Below mentioned herbs are boiled with milk and water and reduced to the quantity of milk (all water should be evaporated leaving back only milk).

–       Vrścīva,

–       Bilva and

–       Varṣabhü

This Ksirapaka when consumed would cure the fevers produced by all the doshas.

Other recipe –

Three parts of water is boiled with one part of milk and pith of Simsipa tree (Simsipa sara). The preparation is reduced to the quantity of milk (as described in the above preparation). This recipe cures all kinds of fever when consumed.

नलवेतसयोर्मूलेमूर्वायांदेवदारुणि।।२०४।।
कषायंविधिवत्कृत्वापेयमेतज्ज्वरापहम्।।
हरिद्राभद्रमुस्तंचत्रिफलाकटुरोहिणी।।२०५।।
पिचुमन्दःपटोलीचदेवदारुनिदिग्धिका।।
एषांकषायःपीतस्तुसन्निपातज्वरंजयेत्।।२०६।।
अविपक्तिंप्रसेकंचशोफंकासमरोचकम्।।
त्रैफलोवाससर्पिष्कःक्वाथःपेयस्त्रिदोषजे।।२०७।।

All types of fevers can be cured by consuming the decoction of roots of Nala and Vetasa along with Murva and Devadaru, prepared in a stipulated manner.

Decoction of the below mentioned herbs when consumed cures Sannipata Jwara –

–       Haridra,

–       Bhadramusta,

–       Triphala,

–       Katurohini,

–       Picumanda,

–       Patoli,

–       Triphala,

–       Devadaru and

–       Nidigdika

Decoction of Triphala consumed after adding ghee to it will cure fevers caused by all three doshas. It will also cure improper digestion, excess salivation, oedema, cough and loss of taste (associated with jvara).

अनन्तांवालकंमुस्तांनागरंकटुरोहिणीम्।।
सुखाम्बुनाप्रागुदयात्पाययेताक्षसंमितम्।।२०८।।
एषसर्वज्वरान्हन्तिदीपयत्याशुचानलम्।। 

Powder of the below mentioned herbs should be prepared –

–       Ananta,

–       Valaka,

–       Musta,

–       Nagara and

–       Katurohini

This powder should be consumed in one karsa (10 gm) dose along with comfortable water before sunrise.

This recipe would cure all types of fevers and increase digestive fire / power.

द्रव्याणिदीपनीयानितथावैरेचनानिच।।२०९।।
एकशोवाद्विशोवाऽपिज्वरघ्नानिप्रयोजयेत्।।

Herbs which have carminative, purgative and anti-febrile properties / actions shall be used either singly or in combination, for the cure of fevers.

सर्पिमध्यभयातैललेहोऽयंसर्वजंज्वरम्।।२१०।।
शान्तिनयेनिवृच्चापिसक्षौद्राप्रबलंज्वरम्।।

A confection should be prepared with ghee, madya, Abhaya – Haritaki and oil (sesame oil) taken together. This recipe, when consumed, will cure all fevers. Similarly, even powerful fevers will get cured when Trivrt added with honey is consumed.

Vişamajvara cikitsa – treatment of intermittent fevers

ज्वरेतुविषमेकार्यमूर्ध्वंचाधश्चशोधनम्।।२११।।

Purification of the body in both upward and downward directions by administration of vamana and virecana respectively should be done.

घृतंप्लीहोदरोक्तंवानिहन्याद्विषमज्वरम्।।
गुडप्रगाढांत्रिफलांपिबेद्वाविषमादिंत: ।।२१२।।
गुडूचीनिम्बधात्रीणांकषायंवासमाक्षिकम्।। 

Vishama Jvara will be cured by consumption of medicated ghee mentioned in the treatment of Plihodara (Satpala Ghrta). Alternatively, the patient may also drink decoction of Triphala added with more quantity of jaggery. Decoction prepared with Guduci, Nimba and Dhatri, added with honey may also be consumed.

प्रातःप्रातःससर्पिष्कंरसोनमुपयोजयेत्।।२१३।।

Every day in the morning, Rasona may be consumed with ghee.

त्रिचतुर्भिःपिबेत्क्वाथंपञ्चभिर्वासमन्वितैः।।
मधुकस्यपटोलस्यरोहिण्यामुस्तकस्यच।।२१४।।
हरीतक्याश्चसर्वोऽयंत्रिविधोयोगइष्यते।।

Three recipes of decoction are prepared using three, four or five of the below mentioned herbs –

–       Madhuka,

–       Patola,

–       Katurohini,

–       Mustaka and

–       Haritaki

These decoctions cure Visama Jvara.

सर्पिःक्षीरसिताक्षौद्रमागधीर्वायथाबलम्।।२१५।।
दशमूलीकषायेणमागधीर्वाप्रयोजयेत्।।

Decoction of Dasamula is prepared. It is added with ghee, milk, sugar, honey and pippali. This may be consumed based on the strength of an individual.

Alternatively, decoction of Pippali added with ghee etc. may be consumed.

These two recipes cure Visama Jvara.

पिप्पलीवर्धमानंवापिबेत्क्षीररसाशनः।।२१६।।
ताम्रचूडस्यमांसेनपिबेद्वामद्यमुत्तमम्।।

The person may consume Vardhamana Pippali. While taking this recipe, he should consume only milk as part of his diet. Alternatively, he should drink good wine while consuming meat of cock.

Ghrta yoga – medicated ghee

कोलाग्निमन्थत्रिफलाक्वाथेदध्नाघृतंपचेत्।।२१७।।
तिल्वकावापमेतद्धिविषमज्वरनाशनम्।।

Medicated ghee is prepared by boiling ghee with decoction of kola (pañcakola), agnimañtha and triphala adding dadhi (curd) and paste of tilvaka while boiling. This ghee when consumed cures visamajvara.

पिप्पल्यतिविषाद्राक्षासारिवाबिल्वचन्दनैः।।२१८।।
कटुकेन्द्रयवोशीरसिंहीतामलकीघनैः।।
त्रायमाणास्थिराधात्रीविश्वभेषजचित्रकैः।।२१९।।
पक्कमेतैर्घृतंपीतंविजित्यविषमाग्निताम्।।
जीर्णज्वरशिरःशूलगुल्मोदरहलीमकान्।।२२०।।
क्षयकासंससंतापंपार्श्वशूलानपास्यति।।

Decoction of the below mentioned herbs should be prepared –

–       Pippali,

–       Ativisa,

–       Draksa,

–       Sariva,

–       Bilva,

–       Candana,

–       Katuka,

–       Indrayava,

–       Usira,

–       Simhi,

–       Tamalaki,

–       Ghana,

–       Trayamana,

–       Sthira,

–       Dhatri,

–       Visvabheshaja and

–       Citraka

Ghee should be cooked with this decoction and medicated ghee prepared.

When consumed, this ghee cures Visama Jvara associated with the below mentioned conditions –

–       Erratic digestive fire,

–       Chronic fever,

–       Headache,

–       Abdominal tumour,

–       Enlargement of abdomen,

–       Halimaka,

–       Consumptive cough,

–       Exhaustion by heat and

–       Pain in flanks

गुडूचीत्रिफलावासात्रायमाणायवासकैः।।२२१।।
क्वथितैर्विधिवत्पक्कमेतैःकल्कीकृतैःसमैः।।
द्राक्षामागधिकाम्भोदनागरोत्पलचन्दनैः।।२२२।।
पीतंसर्पिःक्षयश्वासकासजीर्णज्वरान्जयेत्।।

Decoction of the below mentioned ingredients is prepared –

–       Guduci,

–       Triphala,

–       Vasa,

–       Trayamana and

–       Yavaksara

This decoction is boiled once again with paste of the below mentioned herbs and ghee and medicated ghee prepared –

–       Draksa,

–       Magadhika,

–       Amboda,

–       Nagara,

–       Utpala and

–       Candana and

–       Ghee

Visama Jvara accompanied with wasting of body, dyspnoea, cough and chronic fever is cured by consumption of this ghee.

कलशीबृहतीद्राक्षात्रायन्तीनिम्बगोक्षुरैः
बलापर्पटकाम्भोदशालपर्णीयवासकैः।।२२३।।
पक्वमुत्क्कथितैःसर्पिःकल्कैरेभिःसमन्वितम्।।२२४।।
शटीतामलकीभार्गीमेदामलकपौष्करैः।।
क्षीरद्विगुणसंयुक्तंजीर्णज्वरमपोहति।।२२५।।
शिरःपार्श्वरुजाकासक्षयप्रशमनंपरम्।।

Decoction of the below mentioned herbs should be prepared –

–        Kalasi – Prsniparni,

–        Brhati,

–        Draksa,

–        Trayanti,

–        Nimba,

–        Goksura,

–        Bala Parpataka,

–        Amboda,

–        Salaparni and

–        Yavasaka

This decoction is one again boiled with paste of the below mentioned herbs and ghee and medicated ghee is prepared –

–        Sati,

–        Tamalaki,

–        Bharngi,

–        Meda,

–        Amalaka and

–       Pauskara and

–       Two parts of milk

When this medicated ghee is consumed, it cures chronic fevers. It is also the best recipe to mitigate pain of the flanks and head, cough and consumption.

पटोलीपर्पटारिष्टगुडूचीत्रिफलावृषैः।।२२६।।
कटुकाम्बुदभूनिम्यासयष्ट्याह्नचन्दनैः।।
दावशक्रयवोशीरत्रायमाणाकणोत्पलैः।।२२७।।
घात्रीभृङ्गरजोभीरुकाकमाचीरसैघृतम्।।
सिद्धमाश्वपचीकुष्ठज्वरशुक्रार्जुनव्रणान्।।२२८।।
हन्यान्नयनवदनश्रवणघ्राणजान्गदान्।।

Decoction of the below mentioned ingredients should be prepared –

–        Patoli,

–        Parpata,

–        Arista,

–        Guduci,

–        Triphala,

–        Vrsa,

–        Katuka,

–        Ambuda,

–        Bhunimba,

–        Yasa,

–        Yasti,

–        Candana,

–        Darvi,

–        Sakrayava – Indrayava,

–        Usira,

–        Trayamana,

–        Kana,

–        Utpala,

–        Dhatri,

–        Bhrngaraja,

–        Abhiru and

–        Kakamaci

Medicated ghee is prepared by cooking ghee with this decoction.

This recipe, when consumed, quickly cures the below mentioned conditions –

–        Cervical lymphadenitis,

–        Skin diseases,

–        Fever,

–        Ulcers of sclera and cornea,

–        Diseases of the eyes, mouth, ears and nose

Kalyāṇaka ghrta

विडङ्गत्रिफलामुस्तमञ्जिष्ठादाडिमोत्पलैः।।२२९।।
प्रियङ्ग्वेलैलवालूकचन्दनामरदारुभिः।।
बर्हिष्ठकुष्ठरजनीपर्णिनीसारिवाद्वयैः।।२३०।।
हरेणुकात्रिवृद्दन्तीवचातालीशकेसरैः।।
द्विक्षीरंविपचेत्सर्पिर्मालतीकुसुमैःसह।।२३१।।
जीर्णज्वरश्वासकासगुल्मोन्मादगरापहम्।।
एतत्कल्याणकंनामसर्पिर्माङ्गल्यमुत्तमम्।।२३२।।
अलक्ष्मीग्रहरक्षोग्निमान्द्यापस्मारपापनुत्।।
शस्यतेनष्टशुक्राणांवन्ध्यानांगर्भदंपरम्।।२३३।।
मेध्यंचक्षुष्यमायुष्यंरेतोमार्गविशोधनम्।।

Decoction of the below mentioned herbs is prepared –

–        Vidanga,

–        Triphala,

–        Musta,

–        Manjistha,

–        Dadima,

–        Utpala,

–        Priyangu,

–        Ela,

–        Elavaluka,

–        Candana,

–        Amaradaru,

–        Barhista – Valuka,

–        Kustha,

–        Rajani,

–        Two Parnis – Salaparni and Prsniparni,

–        Two Sarivas,

–        Harenu,

–        Trivrt,

–        Danti,

–        Vaca,

–        Talisa and

–        Kesara

Medicated ghee is prepared by boiling this decoction again with one part of ghee and two parts of milk and paste of Malati flowers.

This ghee is known as Kalyanaka Ghrta. When this ghee is consumed it bestows below mentioned benefits –

–   cures chronic fever, dyspnoea, cough, abdominal tumour and insanity,

–   is auspicious,

–   dispels inauspiciousness, evil spirits and sins,

–   cures dyspnoea and epilepsy,

–   beneficial for those who have loss of semen,

–   bestows pregnancy to barren women,

–   increases intelligence,

–   enhances eyesight,

–   enhances lifespan (longevity) and

–   purifies the channels of semen

Mahakalyanaka ghṛta

एतैरेवतथाद्रव्यैःसर्वगन्यैश्चसाधितम्।।२३४।।
कपिलायाघृतप्रस्थंसुवर्णमणिसंयुतम्।।
तत्क्षीरेणसहकध्यंप्रसाध्यकुसुमैरिमैः।।२३५।।
सुमनचम्पकाशोकशिरीषकुसुमैर्वृतम्।।
तथानलदपद्यानांकेशरैर्दाडिमस्यच।।२३६।।
तिथौप्रशस्तेनक्षत्रेसाधकस्यातुरस्यच।।
कृतंमनुष्यदेवायब्राह्मणैरभिमन्त्रितम्।।२३७।।
दत्तंसर्वज्वरान्हन्तिमहाकल्याणकंत्विदम्।।२३८।।
दर्शनस्पर्शनाभ्यांचसर्वरोगहरंशिवम्।।
अधृष्यःसर्वभूतानांवलीपलितवर्जितः।।२३९।।
अस्याभ्यासाद्धृतस्येहजीवेद्वर्षशतत्रयम्।।

Medicated ghee is prepared by cooking the below mentioned ingredients together –

–        decoction of the herbs mentioned so far,

–        sarvagandha – fragrant herbs,

–        ghee of a brown cow – 1 prastha (640 gms),

–        suvarna – gold and mani – gems and

–        paste of flowers such as sumana, campaka, asoka and sirisa,

–        filaments of flowers of nalada, padma and dadima

This ghee is prepared on a day and star constellations which are auspicious to both the physician and the patient. This recipe is known as Mahakalyanaka Ghrta.

This ghee is suitable for use by both Gods and men. It should be sanctified by holy hymns and should be given to the patient for consumption.

This ghee cures all kinds of fevers. It also cures all other diseases by its sight and touch. It is invincible by all living beings. People can live for three hundred years, free from wrinkles of skin and grey hairs by habitually using this ghee.

Pañcagavya ghṛta

गव्यंदधिचमूत्रंचक्षीरंसर्पिःशकृद्रसः।।२४०।।
समभागानिपाच्यानिकल्कांश्चैतान्समावपेत्।।
त्रिफलांचित्रकंमुस्तंहरिद्रातिविषेवचाम्।।२४१।।
विडङ्गंत्र्यूषणंचव्यंसुरदारुतथैवच।।
पञ्चगव्यमिदंपानाद्विषमज्वरनाशनम्।।२४२।।

Panca Gavya comprises five products derived from the cow. They are –

–       curds,

–       urine,

–       milk,

–       ghee and

–       juice of fresh dung

All five of these are taken in equal quantity and mixed together.

They are now cooked with the paste of the below mentioned herbs and ghee and medicated ghee is prepared –

–       Triphala,

–       Citraka,

–       Musta,

–       Haridra,

–       Ativisa,

–       Vaca,

–       Vidanga,

–       Trysana,

–       Cavya and

–       Suradaru

This preparation is known as Pancagavya Ghrta. When consumed, this ghee cures Visama Jvara.

पञ्चगव्यमृतेगर्भात्पाच्यमन्यद्वृषेणच।।
बलयाऽथपरंपाच्यंगुडूच्यातद्वदेवतु।।२४३।।
जीर्णज्वरेचशोफेचपाण्डुरोगेचपूजितम्।।
एतेनैवतुकल्पेनघृतंपञ्चाविकंपचेत्।।
पञ्चाजंपञ्चमहिषंचतुरुष्ट्रमथापिच।।२४४।।

One more different kind of Pancagavya Ghrta is prepared without addition of paste of Triphala etc. In fact it is prepared by adding the paste of Vrsa, Bala or Guduci. This ghee is beneficial in curing chronic fevers, dropsy and anemia.

In the same way, the below mentioned can be prepared –

–       pañcāvika ghṛta – with five products of sheep, 

–       pañcāaja – five products of goat,

–       pancamāhişa – five products of buffalo and

–       caturustra – four products of camel except juice of fresh dung

Triphalādi ghṛta 

त्रिफलोशीरशम्पाककटुकातिविषाघनैः।।
शतावरीसप्तपर्णगुडूचीरजनीद्वयैः।।२४५।।
चित्रकत्रिवृतामूर्वापटोलारिष्टवालकैः।।
किराततिक्तकवचाविशालापद्मकोत्पलैः।।२४६।।
सारिवाद्वययष्ट्याह्वचविकारक्तचन्दनैः।।
दुरालभापर्पटकत्रायमाणाटरूषकैः।।२४७।।
रास्नाकुङ्कुममञ्जिष्ठामागधीनागरैस्तथा।।
धात्रीफलरसैःसम्यग्द्विगुणैःसाधितंहविः || २४८।।
परिसर्पज्वरश्वासगुल्मकुष्ठनिवारणम्।।
पाण्डुप्लीहाग्निसादिभ्यएतदेवपरंहितम्।।२४९।।

Decoction of the below mentioned herbs is prepared –

–        Triphala,

–        Usira,

–        Sampaka,

–        Katuka,

–        Ativisa,

–        Ghana,

–        Satavari,

–        Saptaparna,

–        Guduci,

–        Two kinds of Rajani,

–        Citraka,

–        Trivrt,

–        Murva,

–        Patola,

–        Arista,

–        Valaka,

–        Kiratatikta,

–        Vaca,

–        Patola,

–        Visala,

–        Padmaka,

–        Utpala,

–        Two kinds of Sariva,

–        Yastyahva,

–        Cavika,

–        Rakta Candana,

–        Duralabha,

–        Parpataka,

–        Trayamana,

–        Atarusa,

–        Rasna,

–        Kumkuma,

–        Manjistha,

–        Magadhi and

–        Nagara

This decoction is added with equal quantity of juice of Dhatri phala and two parts of ghee and medicated ghee is cooked.

When consumed, this ghee cures erysipelas, fevers, dyspnoea, tumour of the abdomen and leprosy. It is said to be the best recipe for patients of anaemia, spleen disorders and dyspepsia.

Patoladi ghrta

पटोलकटुकादावनिम्बवासाफलत्रिकम्।।
दुरालभापर्पटकत्रायमाणाःपलोन्मिताः।।२५०।।
प्रस्थमामलकानांचक्वाथयेत्सलिलार्मणे।।
तेनपादावशेषेणघृतप्रस्थंविपाचयेत्।।२५१।।
कल्कैःकुटजभूनिम्बघनयष्ट्याह्नचन्दनैः।।
सपिप्पलीकैस्तत्सिद्धंचक्षुष्यंशुक्लयोर्हितम्।।२५२।।
घ्राणकर्णाक्षिवदनवर्त्मरोगव्रणापहम्।।
रक्तपित्तकफस्वेदक्लेदपूयोपशोषणम्।।२५३।।
कामलाज्वरवसर्पगण्डमालाहरंपरम्।।

 

Ingredients –

One pala (40 gm) each of the below mentioned herbs are taken –

–        Patola,

–        Katuka,

–        Darvi,

–        Nimba,

–        Vasa,

–        Triphala,

–        Duralabha,

–        Parpataka and

–        Trayamana

One prastha (640 grams) of decoction of amalaka

The above said are boiled in one armana (1 drona – 10.24kg) of water and the decoction is reduced to a quarter and filtered.

One prastha (640 gm) of ghee is added to it. Also, the paste of Kutaja, Bhunimba, Ghana, Yastyahva, Candana and Pippali are added to it and medicated ghee is prepared.

This ghee bestows the below mentioned benefits –

–       good for eyes,

–       cures diseases of the nose, ears, eyes, mouth and eyelids,

–       cures wounds and bleeding diseases,

–       dries kapha, sweat, moistness and pus,

–       cures jaundice, fever erysipelas and scrofula

Pañcasāra peya

शृतंपयःशर्कराचपिप्पल्योमधुसर्पिषी।।२५४।।
पञ्चसारमिदंपेयंमथितंविषमज्वरे।।क्षतक्षीणेक्षयेश्वासेहृद्रोगेचैतदिष्यते।।२५५।।

Pancasara Peya is prepared by adding boiled milk with sugar, pippali, honey and ghee and churned well.

Benefits – This drink is beneficial in curing the below mentioned conditions –

–        chest (lung) injuries,

–        consumption,

–        dyspnoea and

–        heart disease

Taila yogas- medicated oils

लाक्षाविश्वनिशामूर्वामञ्जिष्ठास्वर्जिकामयैः।।
षड्गुणेनचतक्रेणसिद्धंतैलंज्वरान्तकृत्।।२५६।। 

Decoction of the below mentioned is prepared –

–       Laksa,

–       Visa,

–       Nisa,

–       Murva,

–       Manjistha,

–       Svarjika,

–       Ksara,

–       Amaya – Kustha

Six parts of buttermilk are added to this decoction. Also, one part of sesame oil is added and medicated oil is prepared.

Benefits – Anointing this oil over the body of the patient will cure fevers.

क्षीरिवृक्षासनारिष्टजम्बूसप्तच्छदार्जुनैः।।
शिरीषखदिरास्फौटामृतवल्ल्याटरूषकैः।।२५७।।
कटुकापर्पटोशीरवचातेजोवतीघनैः।।
साधितंतैलमभ्यङ्गादाशुजीर्णज्वरापहम्।।२५८।।

Medicated oil is prepared with below mentioned ingredients –

–       ksiri vrksa – trees with milky sap (pancavalkala etc.)

–       asana,

–       arista,

–       jambu,

–       saptachada,

–       arjuna,

–       sirisa,

–       khadira,

–       asphota,

–       amrtavalli,

–       atarusaka,

–       katuka,

–       parpata,

–       usira,

–       vaca,

–       tejovati and

–       ghana

By anointing this oil on the body, it cures chronic fevers quickly.

निर्विषैर्भुजगैर्नागैर्विनीतैःकृततस्करैः।।
त्रासयेदागमेचैनंतदहर्भोजयेन्नच।।२५९।।
अत्यभिष्यन्दिगुरुभिर्वामयेद्वापुनःपुनः।।
मद्यंतीक्ष्णंपाययेतघृतंवाज्वरनाशनम्।।२६०।।
पुराणंवाघृतंकाममुदारंवाविरेचनम्।।
निरूहयेद्वामतिमान्सुस्विन्नंतदहर्नरम्।।२६१।।

Below mentioned things should be done to the patient of Visama Jvara on the day of fever –

–        threatened with non-poisonous snakes, tamed elephants and robbers,

–        should not be given any food on that day,

–        foods causing more secretion of moisture inside the body and which are not easily digestible should be given to the patient for eating and he should be made to vomit,

–        strong wines or medicated ghee which are anti-febrile should be given for drinking or

–        old ghee should be given for drinking in more quantity or

–        should be administered purgative recipe or

–        should be administered decoction enema after sudation

अजाव्योश्चर्मरोमाणिवचाकुष्ठंपलङ्कषा।।
निम्बपत्रंमधुयुतंधूपनंतस्यदापयेत् || २६२।।
बैडालंवाशकृद्योज्यंवेपमानस्यधूपनम्।।

The patient of visama jvara should be exposed to the fumes coming from

–       burnt leather and hairs of goat and sheep

–       burnt vaca, kustha, gugguulu and nimba patra added with honey or

–       burnt excreta of cat

Fumigation should be done with any one of the above said when the patient is shivering.

पिप्पलीसैन्धवंतैलंनेपालीचेक्षणाञ्जनम्।।२६३।।

Below mentioned ingredients mixed with oil may be applied as collyrium to the eyes of the patient –

–       Pippali,

–       Saindhava and

–       Nepali (Manassila)

उदरोक्तानिसपीषियान्युक्तानिपुरामया।।
कल्पोक्तंचाजितंसर्पिःसेव्यमानंज्वरंजयेत्।।२६४।।

Below mentioned medicated ghee recipes when consumed would cure Visama Jvara –

–       ghee formulae described by Acharya earlier, in the treatment of udara roga (chikitsa sthana – chapter 14) or

–       Ajita Ghrta (Ajita Agada) described in Kalpa Sthana – chapter 5

भूतविद्यासमुद्दिष्टैर्बन्धावेशनपूजनैः।।
जयेद्भूताभिषङ्गोत्थं

Below mentioned measures are used to treat fevers produced by Bhutabhisanga (invasion by evil spirits) –

–        bandha – binding / prevention,

–        avesana – driving out,

–        pujana – worship and

–        such other methods described in texts on Bhuta Vidya (sorcery, demonology etc.)

विज्ञानाद्यैश्चमानसम्।।२६५।।
श्रमक्षयोत्थेभुञ्जीतघृताभ्यक्तोरसौदनम्।।

When fevers are produced by mental emotions (mental upsets), they should be treated by explaining the knowledge of the same to the patient.

Patients suffering from fever caused by exertion and loss of tissues should be given good food added with ghee along with meat soup.

अभिशापाभिचारोत्थौज्वरौहोमादिनाजयेत्।।२६६।।
दानस्वस्त्ययनातिथ्यैरुत्पातग्रहपीडितम्।।

Fire sacrifice etc. should be conducted to cure the fever produced by curses and sorcery.

Fevers which are produced by bad effects of falling meteors, planets and stars should be cured by resorting to the measures like granting gifts, benedictory hymns and hospitality.

अभिघातज्वरेकुर्यात्क्रियामुष्णविवर्जिताम्।।२६७।।
कषायमधुरांस्निग्धांयथादोषमथापिवा।।

Below mentioned treatments should be done in fever caused by trauma –

–       no hot comforts should be given,

–       herbs predominantly having astringent and sweet taste should be administered,

–       unctuous measures and

–       treatments appropriate to the doshas should be done

ओषधीगन्धविषजौविषपित्तप्रसाधनैः।।२६८।।
जयेत्कषायंचहितंसर्वगन्धकृतंतथा।।
निम्बदारुकषायंवाहितंसौमनसंयथा।।२६९।।

Herbs and medicines which mitigate pitta and destroy poisons should be administered to treat fevers caused by the smell of pollen from plants and poisons. Decoction of herbs of Sarvagandha (like ela, tvak etc.) or decoction of nimba and devadaru are beneficial and should be administered for drinking.

यवान्त्रविकृतिःसर्पिर्मद्यंचविषमेहितम्।।
संपूजयेड्डिजान्गांश्चदेवमीशानमम्बिकाम्।।२७०।।

Foods prepared from products of yava, ghee and wine are beneficial and should be used to patients of Visama Jvara.

Patients of Visama Jvara should worship Brahmanas, cows, god Isana i.e. Siva and goddess Ambika – Parvati.

Sita pūrva jvara cikitsä- treatment of fever with rigors

कफवातोत्थयोश्चापिज्वरयोःशीतपीडितम्।।
दिह्यादुष्णेनवर्गेणपरश्चोष्णोविधिर्हितः।।२७१।।
सिञ्चेत्कोष्णैरारनालशुक्तगोमूत्रमस्तुभिः।।
दिह्यात्पलाशैःपिष्टैर्वासुरसार्जकशिप्रुजैः।।२७२।।
क्षारतैलेनवाऽभ्यङ्गःसशुक्तेनविधीयते।।
पानमारग्वधादेश्चक्वथितस्यविशेषतः।।२७३।।
अवगाहःसुखोष्णश्चवातघ्नक्वाथयोजितः।।
जित्वाशीतंक्रमैरेभिःसुखोष्णजलसेचितम्।।२७४।।
प्रवेश्यौर्णिककार्पासकौशेयाम्बरसंवृतम्।।
शाययेत्क्षामदेहंचकालागुरुविभूषितम्।।२७५।।
स्तनाढ्यारूपसंपन्नाःकुशलानवयौवनाः।।
भजेयुःप्रमदागात्रैःशीतदैन्यापहाःशुभाः।।२७६।।
शरच्छशाङ्कवदनानीलोत्पलविलोचनाः।।
स्फुरितभ्रूलताभङ्गललाटतटकम्पनाः।।२७७।।
प्रलम्बबिम्बप्रचलद्विम्बीफलनिभाधराः।।
कृशोदर्योऽतिविस्तीर्णजघनोद्बहनालसाः।।२७८।।
कुङ्कुमागुरुदिग्धाङ्गयोघनतुङ्गपयोधराः।।
सुगन्धिधूपितश्लक्ष्णस्त्रस्तांशुकविभूषणाः।।२७९।।
गाढमालिङ्गयेयुस्तंतरुंवनलताइव।।
प्रह्लादंचास्यविज्ञायताःस्त्रीरपनयेत्पुनः।।२८०।।
तासामङ्गपरिष्वङ्गनिवारितहिमज्वरम्।।
भोजयेद्धितमन्नंचयथासुखमवाप्नुयात्।।२८१।।

If the patient is suffering from a severe cold in fevers arising from combined aggravation of kapha and vata, the body of the patient should be applied with paste of herbs of a group of hot potency. Other warm comforts should also be adopted – such as sprinkling of whey or applying the paste of leaves of surasa, arjaka or sigru or anointing the body of the patient with ksara taila mixed with sukta.

The patient should consume decoction of herbs belonging to Aragvadhadi Gana group. He should also be immersed in the decoction of vata mitigating herbs made comfortably warm. These methods would subside the cold feeling. Once this has been achieved, he should be given a bath with warm water. Later he should be wrapped with cloth of woolen, cotton or silk and should be instructed to lie down in a chamber.

In the chamber, the women whose body has been anointed with paste of aguru, having full breasts, are beautiful, skilful and refreshingly youthful should be near the patient in order to relieve feeling of cold.

Women, whose face resembles that of the autumn moon, have eyes resembling nilotpala – blue lily flower, shaking eyebrows and forehead, having full lips resembling bimbiphala, thin abdomen, broad butts which are heavy to lift up.

The body of the women should have been anointed with paste of kumkuma and aguru, with hard and elevated breasts, wearing thin garments exposed to fragrant fumes. Such women should embrace the patient just like the creeper twines around the tree. The women should be withdrawn after determining that his (patient’s) cold fever adhering to his body has been fully relieved. The patient should be given suitable food and be made happy.

Dahapūrva jvara cikitsa – fever with burning sensation

दाहाभिभूतेतुविधिंकुर्याद्दाहविनाशनम्।।
मधुफाणितयुक्तेननिम्बपत्राम्भसाऽपिवा।।२८२।।
दाहज्वरार्तंमतिमान्वामयेत्क्षिप्रमेवच।।
शतधौतघृताभ्यक्तंदिह्याद्वायवसक्तुभिः ||२८३।।
कोलामलकसंयुक्तैःशुक्तधान्याम्लसंयुतैः।।
अम्लपिष्टैःसुशीतैश्चफेनिलापल्लवैस्तथा।।२८४।।
अम्लपिष्टैःसुशीतैर्वापलाशतरुजैर्दिहेत्।।
बदरीपल्लवोत्थेनफेनेनारिष्टकस्यच।।२८५।।
लिप्तेऽङ्गेदाहतृण्यूर्च्छाःप्रशाम्यन्तिचसर्वशः।।

Methods to relieve burning sensation should be adopted in fevers producing burning sensation (before the onset of fever). Vomiting should be administered by an intelligent physician quickly by giving the patient decoction of nimba patra added with honey and molasses.

The patient should be anointed with –

–        Satadhauta Ghrta – ghee washed many times in decoction of Pancavalkala or

–        Paste of flour of Yava mixed with Kola and Ammalaka or with

–        Sukta – vinegar and Dhanyamla – fermented gruel or with

–        Tender leaves of Phenila made cold or

–        Water with the froth obtained from tender leaves of badari and aristaka

Burning sensation, thirst and fainting will subside by application of these pastes on the body of the patient.

Prahladana taila

यवार्थकुडवंपिष्ट्वामञ्जिष्ठार्धपलंतथा।।२८६।।
अम्लप्रस्थशतोन्मिश्रंतैलप्रस्थंविपाचयेत्।।
एतत्प्रह्लादनंतैलंज्वरदाहविनाशनम्।।२८७।।

Paste of half kudava (80 gm) Yava and half pala (20 gm) of Manjistha is prepared. This paste is mixed with one hundred prastha (6400 ml) of fermented gruel, one prastha (640 ml) sesame oil is added and cooked and medicated oil is prepared. This is known as Prahladana Taila which means comforting oil. It cures fever accompanied with burning sensation.

न्यग्रोधादिर्गणोयस्तुकाकोल्यादिश्चयोगणः।।
उत्पलादिर्गणोयस्तुपिष्टैर्वातैःप्रलेपयेत्।।२८८।।
तत्कषायाम्लसंसिद्धाःस्नेहाश्चाभ्यञ्जनेहिताः।।
तेषांशीतकषायेवादाहार्तमवगाहयेत्।।२८९।।
दाहवेगेत्वतिक्रान्तेतस्मादुद्धृत्यमानवम्।।
परिषिच्याम्बुभिःशीतैःप्रलिम्पेच्चन्दनादिभिः।।२९०।।
ग्लानंवादीनमनसमाश्लिषेयुर्वराङ्गनाः।।
पेलवक्षौमसंवीताश्चन्दनार्द्रपयोधराः।।२९१।।
बिभ्रत्योऽब्जस्त्रजश्चित्रामणिरत्नविभूषिताः।।
भजेयुस्ताःस्तनैःशीतैःस्पृशन्त्योऽम्बुरुहैःसुखैः।।२९२।।
प्रह्लादंचास्यविज्ञायताःस्त्रीरपनयेत्पुनः।।
हितंचभोजयेदन्नंतथाऽऽप्नोतिसुखंमहत्।।२९३।।
पित्तज्वरोक्तंशमनंविरेकोऽन्यद्धितंचयत्।।

Paste of herbs belonging to one of the below mentioned group of herbs should be smeared over the body of the patient –

–        Nnyagrodhadi Gana,

–        Kakolyadi Gana or

–        Utpaladi Gana

For anointing, oil prepared with the decoction of the above mentioned group of herbs added with sour liquids is beneficial.

The cold infusion of the same group of herbs should be used for immersion (patient should be immersed in this infusion).

Once the severity of the burning sensation subsides, the patient should be instructed to come out and bathe in cold water again. He should also be anointed with a paste of candana etc.

Below mentioned treatments should be done if the patient is found exhausted and has depression of mind –

–        beautiful women wearing a thin dress of linen cloth, whose breasts have been smeared with paste of candana and is adorned with garlands of lotus flowers, gems and jewels should embrace the patient,

–        she should also touch the chest of the patient comfortably with cold lotus flowers

–        the women should be withdrawn after the physician knows that the patient is feeling comfortable after the above said treatments and

–        he should be administered food to the utmost satisfaction of the patient and

–       palliative measures and purgative recipes mentioned in the treatment of pittaja fevers or any other beneficial treatments may also be done

निर्हरत्पित्तमेवादौदोषेषुसमवायिषु।।२९४।।
दुर्निवारतरंतद्धिज्वरार्तानांविशेषतः।।

Pitta only should be eliminated first when the doshas are intimately combined in fevers. This is because pitta is the one which is very difficult to eliminate (among the doshas) in the patients of fever.

छर्दिमूर्च्छापिपासादीनविरोधाज्ज्वरस्यच।।२९५।।
उपद्रवाञ्जयेच्चापिप्रत्यनीकेनहेतुना।।

Complications such as vomiting, fainting, thirst etc. should be treated with –

–        therapies which are not opposite (not antagonistic) to the fever and

–        by adopting methods opposite to the cause of fever

Jvara upadrava cikitsä – treatment of secondary diseases

विशेषमपरंचात्रशृणूपद्रवनाशनम्।।२९६।।
मधुकंरजनीमुस्तंदाडिमंसाम्लवेतसम्।।
अञ्जनंतिन्तिडीकंचनलदंपत्रमुत्पलम्।।२९७।।
त्वचंव्याघ्रनखंचैवमातुलुङ्गरसोमधु।।
दिह्यादेभिर्ज्वरार्तस्यमधुशुक्तयुतैःशिरः।।२९८।।
शिरोभितापसंमोहवमिहिक्काप्रवेपथून्।।
प्रदेहोनाशयत्येषज्वरितानामुपद्रवान्।।२९९।।

Now, the treatments especially for the cure of complications shall be explained. Listen to the same.

Below mentioned ingredients are macerated in the juice of Matulunga –

–       Madhuka,

–       Rajani,

–       Musta,

–       Dadima,

–       Amlavetasa,

–       Anjana,

–       Tintidika,

–       Nalada,

–       Utpala patra,

–       Tvaca and

–       Vyaghranakha

This paste is added with honey and vinegar and should be applied on the head of the patient. This is highly effective in curing headache, delusion, vomiting, hiccup, shivering and complications.

मधूकमथहीबेरमुत्पलानिमधूलिकाम्।।३००।।
लीढ्वाचूर्णानिमधुनासर्पिषाचजयेद्वमिम्।।
कफप्रसेकासृक्पित्तहिक्काश्वासांश्चदारुणान्।।३०१।।

Powder of the below mentioned herbs shall be licked after mixing it with honey and ghee –

–       Madhuka,

–       Hribera,

–       Utpala and

–       Madhuka

This recipe cures vomiting and excess salivation, bleeding diseases, hiccups and severe cough.

लिहन् ज्वरार्तस्त्रिफलां पिप्पमी च समाक्षिकाम् ॥
कासे श्वासे च मधुना सर्पिषा  च भवेत् ॥३०२॥

The powder of Triphala and Pippali should be mixed with honey and ghee. It should be given to the patient of fever for licking. This recipe relieves cough and dyspnoea and the patient finds comfort.

विदारी  दाडिमं  लोध्रं  दधित्यं बीजपूरकम् ॥
एभिः प्रदिह्मान्मूर्धानं तृड्दाहार्तस्य देहिनः ॥३०३॥

Paste of the below mentioned is prepared –

–       Vidari,

–       Dadima,

–       Lodhra,

–       Dadhittha (Kapittha) and

–       Bijapuraka

This paste is applied on the head of the patient having fever.

It relieves thirst and burning sensation and the patient finds comfort.

दाडिमस्य  सितायाश्च द्राक्षामलकयोस्तथा॥
वैरस्ये धारयेत् कल्कं गण्डूवं व यथाहितम् ॥३०४॥
क्षीरेक्षुरसमाक्षीकसर्पिस्तैलोष्णवारिभिः ॥

Paste of Dadima, Draksa or Amalaka added with sugar should be held in the mouth when there is a bad smell in the mouth. Alternatively, Gadusa (holding liquids in the mouth) may be done with milk, sugarcane juice, honey, ghee, oil or warm water.

शून्ये मूर्ध्नि हितं नस्यं जीवनीयश्रृतं घृतम् ॥३०५॥

Nasya – nasal drops should be instilled using ghee boiled and prepared with herbs belonging to the Jivaniya Gana group, when there is feeling of emptiness of the head.

चूणितैरिस्रिफलाश्यामात्रिवृत्पिप्पलिसंयुतैः ॥
सक्षौद्रः शर्करायुक्तो विरेकस्तु प्रशस्येते ॥३०६॥
पक्के पित्तज्वरे रक्ते चोर्ध्वगे वेपथौ तथा ॥

Recipe prepared from the below mentioned ingredients is a best purgative –

–       Triphala,

–       Syama,

–       Trivrt and

–       Pippali

The above ingredients are powdered well and added with honey and sugar and administered to cause purgation.

It can be used as an effective purgative in ripe (advanced) fever of pitta origin, bleeding from upper routes (orifices) and convulsions (shivering).

कफवातो त्थयोरेवं स्नेहाभ्यङ्गैर्विशोधयेत् ॥३०७॥
हृतदोषो भ्रमार्तस्तु लिह्यात् क्षौद्रसिताभयाः ॥

In fever caused by combined vitiation of kapha and vata, the above said recipe shall be used for purification (purgation). Oleation and massage with oils can also be done to cure fever. Powder of Abhaya mixed with honey and sugar may be given for licking if the person is suffering from giddiness after elimination of the doshas.

वातघ्नमधुरैयोज्यानिरूहावातजेज्वरे।।३०८।।
अवेक्ष्यदोषंप्राणंचयथास्वंचानुवासनाः।।

Vata mitigating herbs and sweet tasting herbs may be used to prepare Niruha Basti – decoction enema and the same shall be administered in fever caused by vata. After considering the condition of doshas and strength of the patient, anuvasana basti – oil (unctuous) enema may also be given.

उत्पलादिकषायाद्याश्चन्दनोशीरसंयुताः।।३०९।।
शर्करामधुराःशीताःपित्तज्वरहरामताः।।
आम्रादीनांत्वचंशङ्खंचन्दनंमधुकोत्पले।।३१०।।
गैरिकाञ्जनमञ्जिष्ठामृणालान्यथपद्मकम्।।
लक्ष्णपिष्टंतुपयसाशर्करामधुसंयुतम्।।३११।।
सुपूतंशीतलंबस्तिदह्यमानायदापयेत्।।
ज्वरदाहापहंतेषुसिद्धंचैवानुवासनम्।।३१२।।

For fevers caused by pitta –

Below mentioned ingredients may be used to prepare decoction enema –

–       decoction of herbs belonging to Utpaladi Gana group,

–       Candana,

–       Usira

–       Sugar and

–       Honey

This decoction should be used cold as enema. It cures fever caused by pitta.

Decoction for enema is prepared with the below mentioned ingredients –

Paste of the below mentioned ingredients should be prepared with milk –

–        Barks of trees mentioned in Nyagrodhadi Gana group, commencing from Amra,

–        Sankha,

–        Candana,

–        Madhuka,

–        Utpala,

–        Gairika,

–        Anjana,

–        Manjistha,

–        Mrnala and

–        Padmaka

This paste is added with sugar and honey, mixed thoroughly and administered cold as enema.

This enema should be administered to the patient suffering from a burning sensation.

Anuvasa Basti prepared with the same ingredients also cure fever and burning sensation.

आरग्वधगणक्काथाःपिप्पल्यादिसमायुताः।।
सक्षौद्रमूत्रादेयाःस्युःकफज्वरविनाशनाः।।३१३।।

Enema is prepared with the below mentioned ingredients –

–       decoction of herbs belonging to Aragvadhadi Gana group added with,

–       paste of herbs belonging to Pippalyadi Gana group

–       honey and

–       cow’s urine

This enema recipe, when administered cures fevers of kapha origin.

कफघ्नैरेवसंसिद्धाद्रव्यैश्चाप्यनुवासनाः।।
संसर्गेसन्निपातेचसंसृष्टाबस्तयोहिताः।।३१४।।
संसृष्टैरेवसंसृष्टाद्रव्यैश्चाप्यनुवासनाः।।

Anuvasana Basti prepared with kapha mitigating herbs may also be given.

Decoctions prepared with a combination of herbs may be used as enema in fevers caused by combined aggravation of two doshas and three doshas. Likewise, anuvasana basti may also be prepared and used.

वातरोगापहाःसर्वेस्नेहायेसम्यगीरिताः।।३१५।।
विनातैलंतएवस्युर्योज्यामारुतजेज्वरे।।
निखिलेनोपयोज्याश्चतएवाभ्यञ्जनादिषु।।३१६।।

All kinds of fats which mitigate vata shall be used for anuvasana basti in fever caused by vata, except oil. On the other hand, all fats may be used for Abhyanga etc therapies.

पैत्तिकेमधुरैस्तिक्तैःसिद्धंसर्पिश्चपूज्यते।।
श्लैष्मिकेकटुतिक्तैश्च, संसृष्टानीतरेषुच।।३१७।।

For Anuvasana Vasti i.e. unctuous enema – ghee prepared with herbs predominantly of sweet and bitter taste is ideal in fevers caused by pitta.

Ghee prepared with pungent and bitter tasting herbs are ideal in fevers caused by sannipata i.e. combined aggravation of all three doshas.

For oil enema – ghee mixed with other fats is ideal.

हृतावशेषंपित्तंतुत्वक्स्थंजनयतिज्वरम्।।
पिबेदिक्षुरसंतत्रशीतंवाशर्करोदकम्।।३१८।।
शालिषष्टिकयोरन्नमश्नीयात्क्षीरसंप्लुतम्।।

Even after purgation if residue of pitta remains on the skin, it will once again produce fever. In this condition, the patient should be given sugarcane juice or cold sugar water for drinking. He may also eat rice or sastika sali rice well boiled and prepared with milk.

कफवातोत्थयोरेवस्वेदाभ्यङ्गौप्रयोजयेत्।।३१९।।

Sudation and anointing / massage with herbal oils should be adopted in fevers caused by kapha and vata together.

घृतंद्वादशरात्रात्तुदेयंसर्वज्वरेषुच।।
तेनान्तरेणाशयंस्वंगतादोषाभवन्तिहि।।३२०।।

Ghrta – medicated ghee may be given in all kinds of jvara after the elapse of twelve days. This is because all the doshas will have gone into their own seats by twelve days.

Jvara moksa lakşana – features of subsiding of fever-

धातून्प्रक्षोभयन्दोषोमोक्षकालेबलीयते।।
तेनव्याकुलचित्तस्तुम्रियमाणइवेहते।।३२१।।

The doshas become powerful and make the dhatus unsteady at the time of subsiding of fever. When this happens, the person suffers from abnormality (worried) of the mind and feels as though he is going to die.

 Jvara Mukha Laksana- features of relief of fever

लघुत्वं शिरसः स्वेदो मुखमापाण्डु  पाकि च ॥
क्षवथुश्चान्नकाङ्गा च  ज्वरमुक्तस्य लक्ष्यणम् ॥३२२॥

Below menti
oned are the features of a person being relieved from fever –

–   lightness of the head,

–   sweating,

–   white color / pallor of the face,

–   ulceration in the mouth,

–   commencement of sneezing and

–   desire to eat food

 Jvara Svadhava – nature of fever

शम्भुक्रोधोद्भवो घोरो बलवर्णाग्रिसादकः ॥
रोगराट् रोगसंघातो  ज्वर इत्युपदिश्यते ॥३२३॥
व्यापित्वात् सर्वसंस्पर्शात् कृच्छ्रत्वासन्तसं भावात् ॥
अन्तको ह्येष भूतानां ज्वर इत्युपदिशयते ॥३२४॥

Jvara is that which is –

–   born from the anger of Sambhu – Lord Mahesvara,

–   dreadful in nature,

–   mitigates strength, colour / complexion and digestive fire (digestive strength),

–   king of diseases and

–   group of many diseases

The disease is called as Jvara – the killer of living beings because –

–   of its wide spreading nature,

–   since it affects all living beings,

–   it is difficult to bear and difficult to cure and

–   it has chance of causing death

इति  श्रीसुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे ज्वरप्रतिषेधो नाम (प्रथमो ध्यायः, आदित्) एकोनचत्वारिशोऽध्यायः ॥३९॥

Thus ends the thirty ninth chapter by name Jwara Pratisedha in Uttara Sthana of Susruta Samhita.