Introduction:
Jvara affect body, senses, and mind also diminishes the intelligence, strength, complexion and enthusiasm of the sufferer and produces exhaustion, exertion and aversion to food. It should be treated considering its type, Avasthaa, causative factors and involved Dosha.
Contraindications:
Aahaara: Guru Anna, Kashaaya Rasa
Vihaara: Divaasvaapa, Snaana, Abhyanga, Maithuna, Krodha, Pravaata, Vyaayaama.
Kashaaya Rasa, Guru, Ushn`a should be avoided.
Saamanya Chikitsaa:
Nava Jvara :
Following treatment modalities should be suggested according to Avasthaa, Rugn`a Bala.
- Langhana
- Svedana
- Kaala
- Yavaagoo
- Tikta Rasa
- Kashaayapaana
- Langhana
Langhana is the first treatment in Nava Jvara, however Langhana should be advised considering Rugn`a Bala. Depleted Agni is not even capable to digest the medicine, hence, first Langhana should be advised.
Langhana types:
o Upavaasa or Anas`hana type of Langhana is expected generally.
o Vamana for Kaphapradhaana Avasthaa.
o Charaka has described 10 types of Langhana.
- Vamana
- Virechana
- Basti
- Nasya
- Paachana
- Annavarjana
- Udakavarjana
- Vyaayaama
- Aatapasevana
- Maarutasevana
o Hemaadri has added Raktamokshan`a and Deepana thus mentioned 12 types.
o Langhana is indicated for seven days. While Haarita suggests one, three or seven days Langhana according to Dosha.
Effect of Langhana
Jvara is characterized by Aamas`hayastha Dosha, Agnidaurbalya, Saamataa and Srotovibandha. Langhana is best treatment in this condition. Effects of Langhana are as follows:
- Doshakshaya
- Agnivardhana
- Laghutva
- Kshudhaa Vardhana
- Jvaranaas`ha
- Ruchi
- Aamapaachana
- Bala (Utsaaha) Vardhana
- Ojovriddhi
Contraindications of Langhana:
Though Langhana is primary treatment of Jvara, it is contraindicated in following Jvara types.
- Kshayaja Jvara
Dhaatukshayaja Jvara
Raajyakshmaajanya Jvara
- Vaataja Jvara
- Bhayaja Jvara
- Krodhaja Jvara
- Kaamaja Jvara
- S`hramaja Jvara
Vamana in Nava Jvara
Indications:
- Kaphapraadhaanya
- Utklisht`a Dosha
- Aamaas`hayasthita Dosha
- Vaamya Rugn`a
- Svedana
Svedana is indicated in Vaata Kaphaja Avasthaa. Effects of Svedana are:
- Srotos`hodhaka
- Laaghavakara
- Svedakara
Indications of Svedana:
- Vaata Kaphaja Jvara
- Kaphaja Jvara
- Vaataja Jvara
- S`heetapoorvaka Jvara
- Kaala
For Doshapaachana and Agnivardhana, period of 8 days is required. This period should be decided as per signs and symptoms of Agni, Saamataa, Dosha Vriddhi etc. Diet or any other drug is indicated after this period.
- Yavaagoo
After Vamana (Langhita Rugn`a) Paacahna Dravya siddha Yavaagoo should be given as diet. E.g. Pippalee Naagara Siddha Yavaagoo.
Aahaara of Jvara Rugn`a should be started with Man`d`a, Peyaa and then Yavaagoo. This should be given for Six days or up to Doshapaaka (Jvaramaardava).
Effects of Yavaagoo:
Yavaagoo is Laghu, Drava, Sara, Ushn`a. it is indicated for following reasons.
o Agnivardhana
o Vaatanulomaka
o Mootraanulomaka
o Pureeshanulomala
o Doshaanulomaka
o Svedana
o Aamapaachana
o Praan`a Dhaaran`a (Bala)
Contraindications of Yavagoo
Due to Ushn`a Gun`a Yavagoo is contraindicated in following diseases.
o Madyaja Jvara
o Madaatyayajanya Jvara
o Madyanitya Rugn`a
o Gresshma Ritu
o Pitta Kaphaja Jvara
o Oordhvaga Raktapitta
Indication of Tarpan`a:
In above conditions or Vyaadhi, Tarpan`a is indicated. This Tarpan`a should be made up of Jvaraghna Phalarasa (fruit juices) with Laajaa, Saktu, Madhu, S`harkaraa.
- Tikta Rasa:
For Aamapaachana, Agnideepana Tikta Rasa should be used. Kvaatha etc. formulations should be prepared from Tikta Rasa drugs.
- Kashaayapaana:
Though Kashaayapaana is indicated after Langhana, (6 – 8 days) Doshaavasthaa should be assessed first.
Aamaavasthaa Paachana Kashaaya
Pakvaavasthaa S`hamana Kashaaya
Kashaaya Rasa formulations are contraindicated in Nava Jvara. Kashaaya Rasa formulations can cause Doshastambhana and may lead to Vishamajvara. Along withKashaaya Rasa, Guru, Ushn`a, Snigdha, Madhura formulations should also avoided.
General flow of Nava Jvara Chikitsaa is as follows:
Jeern`a Jvara Chikitsaa:
Considering status of Dhaatu; Snehana, Ghritapaana, Balya, Brimhan`a Aahaara is indicated in Jeern`a Jvara. Snehana should be administered inform of Anuvaasana Basti, Nasya, Ghritapaana.
Indications of Ghritapaana:
o Niraama Dosha
o Jeern`a Jvara
o Ksheen`a (Manda) Kapha
o Vaata Pitta Vriddhi
Contraindications of Ghritapaana:
Though Ghritapaana is indicated in Jeern`a Jvara, Kaphaja Jvara and Alanghita Rugn`a are contraindicated.
Ghritapaana: Mode of action.
o Nirdrava (Rooksha) Pittas`hamana
o Vaatas`hamana
o Ksheen`a Kaphavardhana
Indications of Ksheerapaana:
o Daaha + Trishn`aa
o Baddha Dosha: Gavya Ksheera (Cow milk): Acts as Pravartaka i.e. Promoting elimination of Mala.
o Chyuta Dosha
o Chhaaga Ksheera (Goat milk): Acts as Samgraahaka
Indications of Anuvaasana:
o Pakvas`hayagata Dosha
o Ksheen`a Kapha Pitta
o Rooksha Rugn`a
o Baddha Purisha
o Niraama Jvara
Indications of Nasya:
o Jeern`a Jvara
o S`hirogaurava
o S`hirahs`hoola
o Indriya Jaad`ya
Raktadusht`ee Nidaana and Chikitsaa:
Jvara, which does not respond to S`heeta Ushn`a, Snigdha Rooksha Chikitsaa, should be considered as S`haakhaanusaari Jvara. It indicates that Dosha are situated inRaktadhaatu. Raktamokshan`a is indicated in this stage.
Sannipaata Jvara Chikitsaa
Though Sannipaata Jvara has Tridoshavriddhi, Considering individual Dosha levels (tara – tamatva) Chikitsaa to be planned.
Basic aim of Sannipaata Jvara Chikitsaa is to maintain balance of Dosha. In this case two possibilities exist:
- Samaana Vriddhi (Vaatavriddhatama, Pittavriddhatama, Kaphavriddhatama)
Kaphasthaana S`huddhi (Vamana etc.) is indicated first.
- Vishama Vriddhi(13 combinations of Sannipaata)
Alleviate (Kshapan`a) Vriddha Dosha.
Aggravate (Vardhana) Ksheen`a Dosha.
Vishamajvara Chikitsaa:
o Yuktivyapaas`hraya:
Vaatapradhaana: Snehabasti, Snigdha, Ushn`a Anna Paana
Pittapradhaana: Virechana, Siddha Ghrita, Tikta, S`heeta Anna Paana.
Kaphapradhaana: Vamana, Paachana, Rooksha, Kashaaya Anna Paana
o Daivavyapaas`hraya:
Man`idhaaran`a, Agadadhaaran`a Mangala, Somapoojana, Purushasookta Pat`han`a, Brahmaa Ashvinau -Indra -Himaachala -Gangaa -Marutgan`a poojana.
o Satvaavajaya:
Maanasavikaara Chikitsaa
Karun`aa, Dayaa, and Maana shuddhikara bhaava are effective in all types of Jvara.
Aagantuja Jvara Chikitsaa:
- Abhis`haapaja Jvara
- Abhichaaraja Jvara Daivavyapaas`hraya Chikitsaa
- Bhootaabhishangaja Jvara
- Abhighaataja Jvara: Abhyanga, Ghritapaana, Raktamokshan`a, Madya, Maamsarasa
- Kshataja Jvara, Vran`aja Jvara: Vran`a Chikitsaa.
- Kaamaja, S`hokaja, Bhayaja Jvara: Aas`hvaasana, Harshan`a, Pittaghna Chikitsaa
- Krodhaja Jvara: Sadvaakya, Kaama
- Kaamaja Jvara: Krodha
Diet in Jvara:
After Yavaagoopaana, Yoosha or Maamsarasa should be given for 10 days. This diet can be specified as:
- Kaphapraadhaanya, Balavaana Agni Yoosha
- Vaatapraadhaanya, Durbala Agni Maamsarasa.
- Mandaagni, Alasaatmya Rugn`a Use of Amla Rasa.
Pathya:
Rasa – Tikta
Gun`a – Laghu
S`hooka – Puraan`a Tan`d`ula, Godhuma, Raktas`h`aalee, Shas`hti`ka S`haalee
S`haaka – Tan`d`ulakeeya, Vaastuka, Baala Moolaka, Parpat`ka, Gud`oochee, Kaalas`haaka, Nimba, Maat`ha, Kaaravellaka, Chukra, Vaartaaka, Peelu, Punarnavaa, Paat`haa, Marisha, Jeevantee, Ambasht`hakee, Vandhyaa Karkot`ee
S`himbee – Mudga, Kulattha, Chan`aka, Makusht`a
Maamsa – Laavaa, Kapinjala, Harin`a, Prishat, Kaalapuchchha, S`harabha, S`has`ha, Kuranga, Mriga, Kukkut`a
Dugdha – Godugdha, Ghrita
Phala – Daad`ima, Aamalakee, Parushaka, Mridvikaa
Kritaanna – Mudga, Masoora, Chan`aka, Kulattha, Yava Krit Yoosha, Rakta S`haalee Peyaa, Laajaa Man`d`a, Madhura Takra Yukta Khad`a Yoosha, Jvara Naashaka Aushadha Kvaatha Siddha Bhakta, Peyaa, Nisneha S`haaka
Other – Gud`a, Suraa, Khan`d`a S`harkaraa, S`hun`t`hee, Jeeraka, Saindhava, Pippalee
Apathya:
Rasa – Amla, Kashaaya
Gun`a/ Karma –Vidaahee, Guru, Abhishyandi, Rooksha
S`haaka – Patra S`haaka
Maamsa – Tod`ee Matsya
Phala – Kshudra Panasa, Kalingad`am
Other – Asaatmya Bhojana, Viruddhaanna, Kshaara, Nava Dhaanya, Paisht`ika Padaartha, Taambula, Pin`yaaka, Vegadhaaran`a, Danta Kaasht`ha, Shrama, Vaata Sevana