1

NIDANA

All 3 Doshas in the body get aggravated all at a time- because of the combination of the etiological factors or due to the following :

- Vishamashana – irregular dieting

- Anashana -fasting sudden change in the food habit without following the proper procedure prescribed for it, seasonal vagaries,

- inhalation of substance having unwholesome smell,intake of poisonous water, habitation near poisonous (artificial) material or mountain,

- improper administration of oleation , fomentation, Emesis, Purgation, Asthapana, and Anuvasana types of enema and errhines, giving improper diet after the administration of Panchakarma therapy,

- improper child delivery and resorting, to the aggravated Doshas manifest Jvaras due to the simultaneous vitiation of 2 Doshas or all 3 doshas. 

2

SYMPTOMS & TRETMENT

(1) Vatalvana sannipata jwara-

- Langhanam (Fasting or 1i ght diet according to condition)

- Svedana (Sudation)

- Nasya (Inhalation etc.)

- Nishtivana (Expectoration)

- Avalehya (Linctus to dispel the cough) and

- Anjana (Application of some medicine to the eyes)

These measures should be initiated as per the need of particular case. In 'Vatolvana sannipz‘lta jvara' 'Brihat kasturi bhairava rasa' is very efficacious, it maintains the volume of the pulse and subsides delirium, and combats hyper-pyrexia (tivarajvara vega) and prevent toxaemia, and gives strength.

Dose-One pill (60 mg) with anupana of honey thrice a day all other drugs indicated in 'Jvara' are also useful in this condition.

(2) Pittolvana Sannipata Jvara-

Temperature should be brought down by external and internal measures as described earlier.

'Shadanga paniya" is good for thirst and fever.

Parushakadi and chandanadi kvatha are recommended.

Brihat-kasturi bhairavi rasa with juice of Brahmi as anupana.

Dose-One pills with 20 ml of Chandanadi kvatha, thrice a day is a good schedule.

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(3) Kapholvana Sannipata Jvara-

There is hyper-pyrexia with special symptoms like ”Gadgata Vakya" i.e. stammering, sweet taste in mouth and drowsiness (tandra).

It is also known as "Kampan" sannipitajvara.

Treatment-Brihatyadi kvatha is the specific medicine for Kapholvana sannipata jvara. It is prepared from both varities of Kantakari, pushkaramt‘lla, Bharangi, Karehura, Karkataka, dhamasa (Fagonia arabica), Nirmalibi'ja, patola patra and Katuki.

"Sannipéta-bhairava rasa" is a specific medicine in this condition. One pill thrice with anupana of Brihatyadi kvatha is a promising prescription.

(4) Vita Pittolvana Sannipiita Jvara-

There is giddiness, thirst, burning sensation, heaviness in the body, severe head-ache, are the special features in addition to hyper-pyrexia. It is also called as ‘Babhru' or babravastha sannipata jvara.

Kasyapa added 'angarmarda’ (body aches) and ’Talososha’~ lakshanas to this fever symptomology.

(5) Vata Kaphalvana Sannipata Jvar-

Brihatpanchamaula Kvatha is specific

(6) Pitta Kapholvana Sannipata Jvara-

Parpatadi Kvatha is specific

(7) Tridosholvana Sannipata Jvara-

Yogaraja Kvatha is the specific Kvatha.

Apart from these seven types of sannipata jvaras, there are other sannipata fevers like--

(8) Hina Vata-pitta Madhya Sleshmadhika Sannipata Jvara-It is also known as Vaidarika sannipata jvara.

(9) Hina Vata-madhyama Kapha, Pittadhika Sannipata, also known as 'Yamya sannipata jvara'.

(10) Hina Pitta-madhyama Kapha, Vétadhika Sannipata-Also known as 'Krakacha' sannipata jvara.

(11) Hina Pitta-véta madhya, Kaphadhikya-It is also known as 'Karkataka’ sannipata jvara.

(12) Hina Kapha, Pitta-madhyama, Viitadhika sannipata-Also known as 'Sammohaka sannipata jvara.

(13) Hina Kapha, Vata-madhyama, Pittiidhika Sannipata-Also known as pilaka sannipata jvara.

All these sannipatas are due to permutation and computation of doshas involved in them. They manifest their symptoms

according to the said permutation and computation. The signs and symptoms are indicative of dosha’is involved in samprapti of jvara.

The Sannipata condition can be due to (25) different combinations, out of which (13) types described above are due to aggravated doshas, while (12) types are due to doshas below normal (dosha kshaya).

As doshas below normal quantity do not produce any disease, hence those are not considered here.  

3

Cikitsa Sutra : Line of Treatment for sannipataj jwar 

(1) For treating Sannipata jvaras, where three aggravated doshés are "hina" (less aggravation), madhyama-medium aggravation and adhika-maximum aggravation.

The less aggravated dosa should be increared and the one, which is aggravated maximum, should be reduced. This means that dosa which is maximum increased, should be removed by sodhana cikitsa (purification therapy) and the one, which is little increased should be pacified with Shamana cikitsa.

(2) Some other feels that attention should be paid to that dosa which is increased in maximum. At this time even if other doshas gets increased, one should ignore the same, e.g. in pitta predominant Sannipata jvara, it is the duty of the physician to treat the Esna, (hot) and 'tiksna' (penetrating) qualities of pitta dosa first for reducing the shooting temperature by cold procedures, even if those measure caused increase of Vita and Kapha doshas.

(3) Sama sannipéta jvara means where in all doshés have increased equally. Charaka advised.the following line of treatment that is Always treat Kapha dosha and Kapha sites first, as zima is produced in the amasaya (stomach) (Ca. Ci. 3/285)

While Sushruta has different opinion. he suggested to treat pitta first because in samprapti (pathogenesis) of jvara. pitta doshaplays a key role.

(4) However in other sannipftta jvarés. vain must be treated first.

(5) It has been stated in Bhela, that in "Sannipéta jvara, treatment should be done in the first instance to correct éma and kapha.

After the alleviation of Kapha, steps shoudl be taken to correct Pitta and Véyu".

Drug Therapy (Rasa aushadhi)

(1) Unmatta rasa250 mg thrice a day with adraka (ginger) rasa.

(2) Kanakasundara rasa is Jvaragna i.e. antipyritic, contains gold, copper, abraka (mica), Nébhi and Kajjali and it is processed in lemon juice. It should be prescribed in dose of 100 mg 2 to 3 times a day.

(3) Trinnetra Rasa150 mg twice a day.

(4) Pancha Vakra Rasa150 mg thrice a day.

(5) Sannipéta Bhairava Rasa50 mg twice a day.

(6) Brihat-kastiiri Bhairava Rasa50 mg thricea day.

(7) Hema-Garbha Potli60 mg twice a day.

(8) Laxmi Vilés Rasa125 mg to 250 mg twice a day.

Karnamiilika Sotha and its Treatment (Parotitis)

Inflamation near the root of the ear as a sequele of Sannipéta jvara is a serious condition. Hence it should be treated immedietly, with therapeutic measures which alleviate Kapha and Pitta, like "Raktamoksana" (i.e. blood letting),

Pradeha (application), Névana (inhalation therapy) and

Kavala graha (Therapy in which drugs are kept in the mouth)

Lepas like Kulatlfidi lepam, Gairikiidi lepam should be applied. If neccessery, surgical intravention should be undertaken with proper antibiotic cover and analgesics, etc.  

4

CHIKITSA- 

1. LANGHANA

A. Vata pradhan sannipataja- 3 din

B. Pitta pradhan sannipataja- 5 din

C. Kapha pradhan sannipataja- 10 din

2. SVEDANA-

A. Baluka svedana- sandhi sthana ruksha svedanartha

B. Saindhava sveda- saindhav lavan

C. Snigdha sveda- saindhav lavan + ghrita vaksha pradesha

3. NASYA-

A. Trikatu curna pradhamana nasya

B. Katphal tvak curna pradhamana nasya

C. Svasa kuthar rasa nasya

4. ANJANA-

Trinda / murcha avastha me sirishaanjana prayoga in netra 

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)

- Naradiya laxmivilas rasa-(parad,gandhak,karpura,jayphala,javitri,vidhara)

- Makardhuaj-(parad,svarna varka)

- Brihat vata chintamani rasa-(svarna,ropya,abhrak,parad,loha,praval,mukta)

- Shringrabha rasa-(abhrak,javitri,triphala,trikatu)

- Krishna chaturmukh rasa-(parad,gandhak,loha,tamra,abhrak)

- Brahmi vati-(brahmi,svarnasindura,vanga,abhrak,shilajatu)

- Hemgarbha pottali rasa-(parad,gandhak,tamra,svarna)

- Sarpagandha ghana vati-(sarpagandha)

- Suchika bharan rasa-(visha,parad)

- Anadbhairav rasa-(visha,trikatu,gandhak,tankan)

- Svasakuthar rasa-(parad,gandhak,visha,tankan,manashila,trikatu)

- Sutshekhar rasa-(svarna,tamra,trikatu,dhattura beeja)

- Praval pisti

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)

- Trikatu curna(sonth,maricha,pippali)

- Sudarshan curna

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

- Dasamula kwatha-(brihat,panchmula(kasa,swasa,parshva shoola)

- Chaturdashang kvatha-(dasamula,chirayata,mustak,guduchi,sunthi)

- Asthangdasang kwatha-(dasamula,karcura,pushkarmula,yavasa,karkatshringi,bharangi,indrayava,patol,kutki)

- Parpatidi kwatha-(parpat,raktchandan,netrabala,sunthi)

- Brihtyadi kvatha-(brihati,kantkari,pushkarmula,bharangi,karcura,yavasa)

- Amritastak kwatha-(guduchi,indrayava,nimbachal,patol,kutki,sonth,raktchandan,mustak)

(aruchi,vamana,daha)