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MODERN

FEVER

What is a fever?

normal body temperature can vary depending on both their age and the time of day. It can range between 36.5 and 38oC. A temperature higher than this is known as a fever.

A temperature of 38oC or more in a baby under 3 months of age, and 38.5oC or more in older infants and children,is considered high.

Fever is a natural process

Fever shows us that the body is working to fight infection. Fever is a natural response and in itself is not harmful. So it is not usually necessary to treat a fever.

What causes fever?

Fever is most often caused by a virus (such as colds and flu). Viral infections are more common than bacterial infections and do not need antibiotics as these medicines do not cure viruses. Most fevers will pass on their own. Less often, fevers are caused by a bacterial infection, and these are usually treated with antibiotics.Rarely, bacteria can cause infection of the urine, lungs (pneumonia), blood and brain (meningitis). 

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AYURVEDA

           This derivation explains that jwara induces tapa or pain in the body,organs & mind.(caraka)

A clinical condition where in –if sweda avrodha i.e. obstruction of sweating along with santapa(elevated body temperature) & sarvanga grahanam i.e. severe body ache are present it is specifically known as jwara.

Synonyms of Jwara:

The synonyms of Jwara are – Jwara (fever), Vikara (ailment), Roga (disease), Vyadhi (disease) and Atanka (fear inducing factor)

Nature of Jwara:

Factors which are responsible for the manifestation of Jwara, in brief are –

- the 3 physical Doshas – Vata, Pitta and Kapha and

- 2 Doshas of the mind namely – Rajas and Tamas

Living beings do not get afflicted with Jwara without the involvement of these Doshas.

Specific features of Jwara:

Kshaya – depletion of body tissues, weight loss,

Tamas – entering into internal darkness

Papma – manifestation of the sinful acts and

Mrutyu – death

Jwara Samprapti – Pathogenesis in general:

Nidana sevana+ mithya ahara vihara-> Tridosha prakopa-> Dosha sanchaya at amashaya-> Prakupita dosha+rasa dhatu sanyoga-> Prasara sarva sariara-> Bahrigaman kostagni -> Samadosha duara swedavaha shrotas avrodha-> Sampurna sarira ushana-> jwarotpatti

Jwara Pratyatmaka Linga: The signs and symptoms invariably associated with Jwara are Santapa Deha Manasa – The increase in the temperature of the body and mental unhappiness. There is no living being which is not afflicted by Jwara

Jwara Poorva Roopa –

The premonitory symptoms of Jvara (fever) are

- Mukha vairasyam – dyspepsia

- Guru gatratvam – heaviness in body

- Anannābhilāṣaḥ – loss of appetite

- Cakṣuṣorākulatvam – congestion in the eyes

- Aśrvāgamanaṃ – Lacrimation

- Nidrādhikyam – excessive sleep

- Aratiḥ – disliking for work

- Jrmbha – yawning

- Vināmaḥ – flexion

- Vepathuḥ – tremors

- Shrama – exhaustion

- Bhrama – giddiness

- Pralapa – delirium

- Jagarana – sleeplessness

- Roma harsha – horripilation

- Dantaharṣāḥ – setting on edge of teeth

- Sabda śīta vātātapa sahatvāsahatvam – wavering liking and disliking of sound , cold, wind and sun;

- Arochaka – anorexia

- Vipaka – indigestion

- Daurbalya – weakness

- Anga marda – malaise

- Sadanam – lassitude

- Alpa pranata – low-vitality

- Dīrghasūtratā – dilatory tendency

- Ālasyam – laziness

- Ucitasya karmaṇo hāniḥ – loss of regular functions

- Pratīpatā svakāryeṣu – aversion to work

- Gurūṇāṃ vākyeṣvabhyasūyā – disregard for instructions of preceptors (superiors) Mālyānulepanabhojana parikleśanaṃ – disliking for the use of garland, ointment and food

- Madhurebhyaśca bhakṣebhyaḥ pradveṣaḥ – aversion to sweet food, liking four sour, saline and pungent food.

- All these premonitory symptoms appear before the onset of hyperpyrexia. Some of these symptoms also continue to exist during the period of hyperpyrexia

Different Stages of Fever and Symptoms-

A. Samajvara/Nava lakshana-

(First stage of fever) Sama means with ama Jvara. It is the first stage of fever.

1.Anorexia, indigestion, heaviness in stomach, drowsiness, and lazyness.

2.There is no remission of temperature

3.Acute attack

4.Doshés are not

5.Salivation, nausea absence of hunger and tastelessness

6. Rigidity, numbness and haviness.

7. Excessive urination.

8. The stools are not formed properly.

9. No glani or emaciation.

B . Pachyamima Jvara

(SECOND STAGE OF FEVER)- It is the second stage excessive fever, thirst delirium dyspnoea, giddiness and elimination of feces. These are the signs and symptoms of 'Pacyamnaa Jvara.

C . Nirama Jvara Lakshana

Appearence of the, appetite, lightness, reduction in temperature, elimination of dosas, These are the signs and symptoms of 'Nirama jvara' which commonly appear on the 8th day.

Different Conditions of Jvara (Fever) and Their Approch-

1. Nava Jvara up to 3 days

2. Taruna Jvara 4 to 7 days

3. Madhya Jvara 7 to 12 days

4. Puréna Jvara 12 to 21 days

5. Jirna Jvara Afte 21 days onwards

Bad prognosis:(JWARA ARISTA LAKSHANA)-

Acute fever (Teekshna Jwara) associated with

Pralapa – delirium,

Bhrama – Giddiness and

Shwasa – difficulty in breathing, asthma causes death of the patient on the seventh, tenth or twelfth days.

If deep seated (Gambhira) and strong fever occurs in a weak and in an emaciated patient, and continues for several nights (Dairgha Ratrika), then it is incurable. In such diseases; the hairs of the head fall apart to produce a straight line (Kesha Semanta Krut).

JVARA MOKSHA-

Disappearence of klama (mental fatigue) and santépa (temperature), absence of pain, clarity of senses, restoration of natural mental faculty, are the important signs and symptoms of a person who has become free from Jvara.

JVARA MUKTA LAKSHANA-

1. Svedégamana (sweating)

2. Lightness of body

3. Itching sensation in head

4. Mukhapéka (stomatitis)

5. Kshavathu (sneezing)

6. Desire for food these are the signs of Jvara mukta i.e. disappearence of fever.

Jwara Chikitsa Sutra – Line of treatment:

During the stage of Purvarupa (premonitory symptoms) or in the primary stage of Jvara (fever), intake of Laghvashana (light food) or Apartarpanam (fasting) is useful because Amashaya (stomach including small intestine) is the site of the origin of this disease. Thereafter, depending upon the Dosha involved and the therapeutic property, the patient is administered

Kashaya – decoction

Pana – drink

Abhyanga – unction

Sneha – oleation (therapy)

Sveda – fomentation

Pradeha – ointment

Parisheka – bath

Anulepana – application of pasted medicine

Vamana – emesis

Virechana – purgation

Asthapana type of enema

Shamana – alleviation therapy

Nasya karma – inhalation

Dhupana -smoking

Anjana – collyrium and

Kshira bhojana – milk preparations

Use of ghee in fever:

In all the types of chronic fever, intake of ghee is beneficial. This ghee may however, be prepared by boiling with such drugs as would help alleviating the particular Dosha(s) involved. Vata is alleviated by ghee due to the latter’s unctuousness, Kapha due to the method of preparation (with drugs like those having pungent and bitter taste, which alleviate Kapha) and Pitta and hyperpyrexia due to coldness, thus, as water is useful for things burnt with fire, so also ghee is beneficial in all types of chronic fever (because it acts both against disease as well as the Doshas involved). Thus it is said: – as people spray water over a house set on fire, so also ghee is used a view to alleviate chronic jvara. Vata is alleviated due to latter’s ununctuousness, Pitta due to coldness and even Kapha which has identical properties (with ghee) due to suitable method of preparation. No other fact so carries the properties of drugs with which it is processed as ghee, hence ghee is considered to the fat par excellence.

The 8 factors responsible for the causation of fever is human beings are

(A) NIJA (ENDOGENOUS)

1. Vata

2. Pitta

3. Kapha

4. Vata pitta

5. Vata-kapha

6. Pitta kapha

7. Vata pitta kapha and

(B) AGANTUJA JWARA(EXOGENOUS)

8. Aagantuja – Extrinsic factors

A. Abhighataja – due to external injury

B. Abhishangaja – due to excess lust, anger, grief, poison, etc

C. Abhicharaja – Due to evil tantric rituals

D. Abhishapaja – due to Shapa (curse) of elderly

(a) In Gandhaja jwara,due to inhalation of smell

(b) In Kamaja jwara, due to lust excessive

(c) In Shoka Abhishangaja Jwara, due to grief, crying spells are seen.

(d) In Bhaya Jwara, due to fever, excess tiredness is seen

(e) In Krodhaja Jwara, Pitta symptoms such as redness of face is seen.

(f) In Bhuta Jwara – due to evil spirits /microbes, varied symptoms are

observed.

(g) In Visha Jwara  

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CHIKITSA  SIDDHANTA

1. Navajvar –

Tajya – sanana, abhyanga, maithuna, krodha, kasaya rasa sevana

1. Langhan- laghu ahar vihar,purn langhan na karaye

2. Svedana- rajai,kambal

3. Kal pratiksha- 6 din aamvastha rahti h,fir medicine de

a. Yadi aam pachan ho jaye to saman kasaya prayog kare-

AMRITASTAK KVATHA

b. Yadi pachan na ho to pachak kasaya ka prayog kare-

PANCHKOL KVATHA

4. Tikta Rasa Se Sanskarit Yavagu Sevana(Aam Pachan Hetu)

5. Trishna/Jvar Adhikya- shadang paniya sevana

6. Utklesa avastha- vaman karaye

7. Mukha/nasa se rakta srav jvar k samay ho to- tarpan chikitsa & raktapitta chikitsa kare

8. Ghrita sevan(rukshata rokane hetu)

9. Dugdhapana- daha/trishna/vata-pitta dosha avastha)

10. Atisara avastha- aja dugdha 

ADARSHA CHIKTSA PATRA

1. Tribhuvan kirti rasa-250 mg + Amrita satva-250 mg + Godanti-250mg ( 2 times with madhu )

2. Sudarshan curna-2gm  (  2 times with koshna water )

3. Amritarista- 20ml ( 2 times with 20ml water )

4. Panartha- shadanga paniya or lavanga sadhit koshna jala

5. (Daurbalya)

Drakshavaleha-20gm  ( 2 times with milk )

SPECIAL CONDITION CHIKTSA

A. (USEFULL IN ANY TYPE OF JVAR)*******

Svarnbasant malti rasa-60mg + Sarvajvarhar loha-250mg + Siddhamakar dhavaj-60mg + Giloy-250mg 

B. (PRATISHAYA WITH FEVER)

Vyosadi vati (4-6 vati cushnarth) 

C. YAKRUT VRADDHI

1. Yakrutplihari loha-250mg + Sothari loha-250mg + Yavakshar-250mg (2 times with madhu)  

1. Yakrutapalihari loha-250mg + Mulak kshar-250mg + Rohitak loha-250mg (2 times with madhu)  

2. Rohitkarista-20ml + Bhunimbadi kvatha-20ml /Kumaryasava-20ml  (2 times with 40ml water)  

3. Arogyavardhani vati-2 vati (2 times with water) 

D.(PRALAP)

1. Yogendra rasa-125mg + Brahmi vati-2vati + Mukta bhasma-250mg ( 2 times with madhu) 

1. Brihat kasturi bhairav rasa-500mg + Sanjeevani vati-250mg + Godanti-500mg ( 2 times with lavangodaka )

2.Hemgarbh pottali rasa / Yogendra rasa

E. (NIDRANASHA)

1. Asvagandha ghan vati/ Brahmi vati / Sarpagandha ghan vati -2 vati ( 2 times with ushnodaka )

F. (HRID DAURBALYA)

1. Vishveshver rasa-250mg + Siddha makardhuaj-250mg + Soubhagya vati-250mg ( 4 times with madhu)  

G. (ATISARA)

1. Sanjeevani vati-250mg + Anand bhairav rasa-250mg + Ramban rasa-250mg +

Bilva curna-2gm  ( 3 times with madhu )

2. Kutjarista- 20ml ( 2 times with 20ml water )

H.(ANTRAGATA RAKTASRAV)

1. Raktpittakulkandan rasa-250mg + Bol parpati-250mg + Karpuara rasa-125mg +

Nagkesar curna-2gm (  3 times with madhu )

2. Chandanadi kvatha-20ml  ( 2 times with 20ml jala )

I. (RAKTSTHIVAN)

1. Raktpittantak yoga-250mg + Svarn gairik-250mg + Praval pisti-250mg (2-3 times with madhu )

J (JVAROTTAR DOURBALYA)

1. Navayas loha-250mg + Guduchi satva-250mg + Sitopaladi curna-2gm +

Satavari curna-2gm ( 2 times with madhu )

2. Yavani sadav curna-2gm  ( 2 times with ushnodaka )

3. Arogyavardhani vati-2vati   ( 3 times with water )

4. Draksharista/ Ashvagandharista-20ml  ( 2 times with 20ml jala )

5. Chayvanprasha avleha-20gm (  2 times with milk )

6. Haritaki curna-3gm  (  before sleep with ushnodaka )

7. Abhayanga with chandanadi or lakshadi taila 

K. (DAHA)

Shatdhot ghrita abhyanga 

L. (TRISHNADHIKYA)

1. Praval pisti-500mg + Amrita ghana satva-250mg   (  2 times with jala )

CLINICAL PANCHKARMA

   1. VIRECHANA- If jver not subside then give virechana  (main chiktsa karna of pitta)

A.  Abhyanter sneha pana with Panchtikta ghrita

B. Virechana kalp-

Amaltas Guda + Nisoth-> Mridu virechana

C. If virechan is not possible then give mriduvirechana  

Erand taila 20ml + dugdha -> morning empty stiomach 

2. NIRUHA BASTI-

after Dugdhapana 

give niruha basti with Patoladi kvatha or shadangpaniya dravyo 

3. ANUVASANA BASTI-  in Jeerna jvar give dasamula anuvasana basti

4. NASYA- in  Jeera jvar  

PATHYA-APATHYA

PATHYA-

- Purana Sali, Mudga, Masoor, Parval, Karela, Sahijan, Choulai, Gaduchi, Jeevanti, Makoya, Manukka, Anar, Laghu Ahar, Yavagu, Peya, Vilepi, Yava, Lajamanda, Daliya

APATHYA-

- Guru, vidahi, vistambhi, dushita jala sevana, ankurita anna, tilkuta, sweet, chole, lassi, chana dal

- Vegadharana, vyayama, divasvapna, sanana, adhyasana

NISHEDHJA-

- Nava jvar me divasvapna, snana, abhyanga, maithuna, krodha, dhimi hava  

RASODHI/BHASMA/PISTI-(120-250MG WITH MADHU/USHNODAKA)

- Tribhuvan kirti rasa-(hingula,vatsanabh,trikatu,tankan)

- Hinguleshver rasa-(vatsanabh,pippali,hungula)

- Swarnbasant malti rasa-(swarna,muktapisti,hingula,maricha)

- Kasturi bhairav rasa-(javitri,jayphala,marich,pippali,kasturi)

- Mritunjaya rasa-(vatsanabh,hingula,gandhak,tankan,pippali,marich)

- Jwar keshri rasa-(parad,gandhak,triphala,trikatu,vatsanabh,jayphaala)

- Jwar sanhar rasa-(rasasindura,trikatu,kuth,mustak,tankan,katuki)

- Godanti bhasma-(godanti)***********

- Shringa bhasma-(mrigshringa)

- Jaharmora pisti-(jaharmohra)

- Laxmivilas rasa-(swarn,rajat,abhrak,tamra,nagabhasma)

- Praval pisti

- Kaphaketu rasa-(vatsanabh,tankan,sankh,pippali)

VATI-(250-500MG WITH USHNA JALA)

- Sanjeevani vati-(vidang,nagar,pippali,abhaya,vibhitaki,vacha,guduchi,bhallataka,visha)*******

- Shoubhagya vati-(rasasindura,dvikshar,trilavan,loha,trikatu,triphala)*******

- Sansamani vati-(guduchi)********

- Vishatindukadi vati-(kuchala,mustak,parpat,triphala)***********

- Jayavati-(suddha visha,trikatu,motha,haridra,nimbapatra,bidanga)

- Amrita satva-(guduchi)

- Karanjadi vati-(karanj beej,parpat,atish,guduchi,patol,kutki)

CURNA-(3-6GM WITH MADHU/USHNODAKA)

- Sudarshan curna-(triphala,trimada,atish,chirayata)********

- Panchkol curna-(pippali,pippalimula,chavya,chitrak,sunthi)********

- Sitophaladi curna-(dalchini,ela,pippali,vanshlochan,mishri)*******

- Talisadi curna-(talisa,marich,sunthi,pippali,vanshlochan,mishri)*******

- Lavangadi curna-(lavanga,sheetal chini,khas,sveta chandana,tagar,bhringraja,motha)********

- Drakshadi curna-(draksha,harad,mustak,kutki,amaltas,parpat)

KAVATH/ASAV/ARISHTA-(20-40ML WITH SAMABHAG WATER)

- Patol panchak kwatha-(patol,saptaparna,guduchi,nimba tvak,vasa)********

- Dravyadi kwatha-(devdaru,parpat,bharangi,motha,vacha,dhaniya)

- Bharangyadi kvatha-(bharngi,vasa,parpat,mustak)

- Guduchyadi kvatha-(guduchi,dhanyak,padmakhya,nimbachal,raktchandan)******

- Amritarista-(guduchi)*********

GHRITA(20-30ML WITH USHNODAKA)

- Panchtikta ghrita-(patol,saptaparna,nimba,vasa,guduchi)******

- Amritadhya ghrita-9guduchi,mulethi,draksha)*********

- Shatpalak ghrita-(pippali,pippali mula, chavya,chitrak,sunthi,saindhav)

- Chandanadi ghrita-(svetachandan,vasa,karanj)

AVLEHA-(20-30 GM WITH DUGDHA)

- Drakshavaleha-(draksha,madhur varga aushadhiya)*******

- Chyavanprash-(amla,trikatu,jeevaniyagana)*******