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Ashtanga samgrahaJVARA CHIKITSA - Treatment of fever - Ashtanga Samgraha Chikitsa Sthana Chapter...

JVARA CHIKITSA – Treatment of fever – Ashtanga Samgraha Chikitsa Sthana Chapter 1

अथातो ज्वरचिकित्सितं व्याख्यास्यामः । इतिह स्माहुरात्रेयादयो महर्षयः ।। १ ।।

Further on, we will now expound Jvara chikitsa – treatment of fevers; thus said Atreya and other great sages. (1)

Jvara Chikitsa – Fever Ayurvedic Treatment

Langhana – fasting

आमाशयस्थो हत्वाग्निं सामो मार्गान् पिधाय यत् । विदधाति ज्वरं दोषस्तस्मात् कुर्वीत्लङ्घनम् || २ ||

प्राग्रूपेषु ज्वरादौ वा बलं यत्नेन पालयन् । बलाधिष्ठानमारोग्यमारोग्यार्थः क्रियाकम्रः ॥ ३ ॥

The doshas getting localised in the amasaya (stomach and small intestine) destroy the agni (fire / digestive activity) present there in, get mixed with Ama (inadequately processed food materials) obstruct the channels (of rasa- the first circulating dhatu) and produce Jvara (fever ). Hence the patient should resort to langhana ( fasting ) either at its prodromal stage or at its commencement, taking care to maintain his strength. Health depends on strength and (the aim of) remedial measures ( treatment ) is restoration of health. ( 2-3)

लङ्घनैः क्षपिते दोषे दीप्तेऽ ग्रौ लाघवे सति । स्वास्थ्यं क्षुत्तृड्रुचिः पक्तिर्बलमोजश्च जायते ॥४॥

When, by fasting the doshas become mitigated, agni (digestive activity becomes intense and the body feels light, then develop health, hunger, thirst, desire for food, digestion, strength and vigour. (4)

Vamana – emesis

तत्रोत्कृष्टेसमुत्क्लिष्टेकफप्राये चले मले। सहल्लासप्रसेकान्नद्वेषकासविषूचि ॥५॥

सद्योभुक्तस्य सञ्जाते ज्वरे सामे विशेषतः । वमनं वमनार्हस्य शस्तं कुर्यात्तदन्यथा |॥ ६ ॥

श्वासातीसारसम्मोहहृद्रोगविषमज्वरान् ॥ ७ ॥

When the doshas, of which kapha is predominant are greatly aggravated (increased), get dislodged from their normal seats and begin to circulate all over the body accompanied with nausea, excess of salivation, aversion to food, cough and pricking pain; and also in fevers which commence soon after meals, expecially in sama jvara (fever having symptoms of ama accumulation) administration of vamana (emesis therapy) is ideal for those who are fit for it. In other conditions, it (emesis) will produce dyspnoea, diarrhoea, delusion, diseases of the heart and irreregular (intermittant) fevers. ( 5-7)

पिप्पलीभिर्युतां गालां कलिङ्गैर्मधुकेन वा । पीत्वोष्णतोयेन वमेन्मध्वम्बु लवणाम्बु वा ॥ ८ ॥

पटोलनिम्बकर्कोटवेत्रपत्रजलानि वा । पेयां मण्डंरसं चेक्षोर्मद्यं कल्पोदितानि वा ॥ ॥ ९ ॥ वमनानिप्रयुञ्जीत बलकालविभागवित् ।

Gala (madana phala) along with pippali, kalinga and madhuka should be used along with hot water for producing vomiting or honey water or salt water may be used; Or juice of leaves of pa nimba, karkota or vertra, may be used; or peya (thin gruel) manda (supernatent fluid of gruel), juice of sugaracane or wines described in Kalpa sthana (chapter 1) may be used. (8-9)

Vamana (emesis therapy) be administered considering the strength (of the patient, the disease and the drug) and the time (the sea son, day and time of administration). (10a)

कृतेऽकृते वा वमने ज्वरी कुर्याद्विशोषणम् । दोषाणां समुदीर्णानांपाचनाय शमाय च ।। १० ।।

आमेन भस्मनेवाग्नौ छन्नेऽन्नंन विपच्यते । तस्मादादोषपचनाज्ज्वरितानुपवासयेत् ।।११।।

Whether vomitings occur or not, the patient of fever should fast, to help the aggravated doshas to undergo pacana (processing by heat for their diminition to normal) or samana (mitigation, leading to decrease of their symptoms). Just as fire covered with ash cannot cook the food (in the pot) so also the agni (digestive activity) covered with ama (unprocessed materials). Hence the patient of fever should be made to fast till the doshas undergo pacana (cooking, precessessing by heat) (10b-12a)

Usnajala pana – drinking hot water

तृष्णगल्पाल्पमुष्णाम्बु पिबेद्वातकफवरे ||१२||

तत् कफं विलयं नीत्वा तृष्णामाशु निवर्तयेत् । उदीर्य चाग्निं स्त्रोतांसि मृदूकृत्य विशोधयेत् ।।१३।।

लीनपित्तानिलस्वेदशकृन्मूत्रानुलोमनम् । निद्राजाड्यारुचिहरंप्राणानामवलम्बनम् ।। १४ ।। विपरीतमतः शीतं दोषसङ्घातवर्धनम् ॥ १५ ॥

In fevers caused by vata and kapha, the patient, if thirsty, should drink little quantities of hot water often; that liquifies the kapha, quickly relieves thirst, kindles the digestion, softens and cleanses the channels, helps elimination of pitta, anila (vata), sweat, faeces, and urine obstructed inside, wards off sleep, lassitude, loss of taste, and sustains life. Cold water produces the opposite effects and increase the ammumilation of the doshas. (126-15)

Sadanga paniya

उष्णमेवंगुणत्वेऽपियुञ्ञ्ज्यान्नैकान्तपित्तले । उद्रिक्तपित्ते दवथुदाहमोहातिसारिणि ॥ १६ ॥

विषमद्योत्थिते ग्रीष्मे क्षतक्षीणेऽस्त्रपित्तिनि । घनचन्दनशुण्ठ्यबुपर्पटोशीरसाधितम् ॥ १७ ॥शीतं तेभ्यो हितं तोयं पाचनं तृड्ज्वरापहम् ।

Hot water though possessing these (beneficial) qualities should not be given to those who are of pitta predominant constitution, who have aggravation (increase) of the pitta individually, who are suffering from burning sensation in the sense organs, or the entire body; from delusion, diarrhoea, poison and alcoholic intoxication, during summer (for all), those suffering from emaciation due to the injury to the chest (lungs) and raktapitta (bleeding diseases).

For such persons, cold infusion, prepared from ghana, chandana, sunthi, ambu, parpata and usira is ideal as it is a good pacana (digestive) and relieves thirst and fever. (16-18a)

ऊष्मा पित्तादृते नास्ति ज्वरो नास्त्यूष्मणा विना ।।१८ ।।

तस्मात् पित्तविरुद्धानि त्यजेत् पित्ताधिकेऽधिकम् ।

There is no heat (increase of body temperature) without pitta and there is no fever without (increase of) heat. Hence (in fevers) all things which are against pitta (which cause its increase) should be avoided, more so in those (fevers) having pitta predominance. Bath, oil massage, hot applications (poultices, pads etc) and other methods of thinning (breeze, exercise, purification therapies etc) and fasting should also be avoided. (18b-19a)

स्नानाभ्यङ्गप्रदेहांश्च परिशेषंचलङ्घनम् ॥ १९ ॥

अजीर्ण इव शूलघ्नं सामे तीव्ररुजि ज्वरे । न पिबेदौषधं तद्धि भूय एवाममावहेत् ।।२०॥ आमाभिभूतकोष्ठस्य क्षीरं विषमहेरिव ।

Just as a patient of ajirna (indigestion) should not take, pain killing medicines, though the (abdominal) pain is severe, similarly also a patient of samajvara (fever in early stage, having symptoms of ama) should not take medicines, as it will only increase the ama from which the alimentary tract is already full; just as milk fed to a poisonous serpent (will only help increase its poison). (19b-21a)

सोदर्दपीनसश्वासे जङ्घापर्वास्थिशूलिनि । वातश्रेष्मात्मके स्वेदः प्रशस्तः स प्रवर्तयेत् ॥ २१ ॥

स्वेदमूत्रशकृद्वातान् कुर्यादग्नेश्चपाटवम् । स्नेहोक्तमाचारविधिं सर्वतश्चानुपालयेत् ॥ २२ ॥

In fevers arising from vata and kapha having rashes on the skin, nasal catarrah, dyspnoea, pain in the calves, joints and bones sveda therapy ( sudation, measures causing perspiration ) is ideal, it will help the elimination of sweat, urine, faeces and flatus and also kindles the fire (improves digestion). All the regimen (of food and activities) prescribed for snehana (oleation therapy) should be followed here also. (21-22)

Jvara samanya chikitsa krama – Fever general line of treatment

लङ्घनं स्वेदनं कालो यवाग्वस्तिक्तको रसः । मलानां पाचनानि स्युर्यथावस्थं क्रमेण वा ||२३ ||

Langhana (measures which make the body thin), svedana ( sudation therapy), kala (time), yavagu ( drinking of gruels) and tiktarasa (drugs of bitter taste ) are pacana for the malas (doshas); they cook the unripe doshas and (cause their decrease); resorted either according to the stages (of fevers) or in their order of enumeration. ( 23 )

शुद्धवातक्षयागन्तुजीर्णज्वरिषु लङ्घनम् । नेष्यते तेषु हि हितं शमनं यन्त्र कर्शनम् ॥ २४ ॥

In fevers which are caused by pure vata (unmixed with other doshas or ama), by the decrease of dhatus, by external agents and in fevers of long duration, langhana (slimming measures) are not advisable; for these, samana therapy ( palliative measures which mitigate the doshas) which is not karsana (causing emaciation ) is suitable. (24)

तत्रसामज्वराकृत्या जानीयादविशोषितम्। द्विविधोपक्रमज्ञानमवेक्षेत चलङ्घने ॥ २५ ॥

By the presence of symptoms of sama jvara (such as increase of temperature, distress, non-elimination of urine, faeces and sputum, stiffness of the body, abscence of hunger etc) the physician should understand that langhana measures have not been adequate; he should await the appearance of symptoms (of ideal langhana therapy) as have.been described in Dvividhopakrama (chapter 24 of sutrasthana). (25)

Peyadi krama – regimen of liquid diet in fever

युक्तं लङ्घितलिङ्गैस्तुतंपेयाभिरुपाचरेत् । यथास्वौषधसिद्धाभिर्मण्डपूर्वाभिरादितः ॥२६ ।।

षडहं वा मृदुत्वं वा ज्वरो यावदवाप्नुयात् । तस्याग्निर्दीप्यते ताभिः समिद्भिरिव पावकः ॥२७॥

When the symptoms of ideal langhana appear, the patient should be treated with peya (different kinds of gruels) medicated with appropriate drugs, commencing first with manda, (scum or thin fluid of gruel) for six days or till the fever becomes mild; his agni (digestive activities ) becomes enhanced by these (gruels) just as the fire by dry faggots. (26-27)

ताश्च भेषजसंयोगाल्लघुत्वाच्चाग्निदीपनाः । वातमूत्रपुरीषाणां दोषाणां चानुलोमकाः ॥ २८ ॥

स्वेदनाय द्रवोष्णत्वान्मृदुत्वात्तृप्रशान्तये । आहारभावात् प्राणाय सरत्वाल्लघवाय च ।।२९ ।।

ज्वरघ्ना ज्वरसात्म्यत्वात् तस्मात् पेयाभिरादितः । उपक्रमेज्वरान् सर्वानृते मद्यसमुत्थितात् ॥ ३० ॥

Because of their combination with drugs and easy digestibility they (liquid foods) enhance agni (improve digestion), cause elimination of flatus, urine, faeces and the doshas; by their warm fluidity they cause sweating, by their softness they relieve thirst, they sustain life by being food; by their laxative property they make the body light, by being suitable for fevers they act as antifebriles; hence all types of fevers, except that due to alcoholic intoxication, should be treated first with different kinds of peya ( gruels ) ( 28-30)

Notes:-Manda, peya, vilepi and odana are the four kinds of foods of which the first three are liquids and last one solid; manda is the scum (very thin supernant fluid of the gruel without any solid particles), peya is slightly thick liquid, vilepi is semi-solid with less of fluid and more of particles, while odana is solid with only boiled grains.

प्राग्लाजपेयां सुजरां सशुण्ठीधान्यपिप्पलीम्। ससैन्धवां तथाम्लार्थी तां पिबेत् सहदाडिमाम् ॥ ३१ ॥

सृष्टविड्बहुपित्तो वा सशुण्ठीमाक्षिकां हिमाम् । बस्तिपार्श्वशिरःशूली व्याघ्रीगोक्षुरसाधिताम् ।।३२।।

पृश्चिपर्णीबलाबिल्वनागरोत्पलधान्यकैः । सिद्धां ज्वरातिसार्यम्लांपेयांदीपनपाचनीम् ।। ३३ ।।

हस्वेनपञ्चमूलेन हिक्कारुक्श्वासकासवान् | पञ्चमूलेन महता कफार्ती यवसाधिताम् ॥ ३४ ॥

विबद्धवर्चा: सयवां पिप्पल्यामलकैः कृताम् । यवागूं सर्पिषा भृष्टां मलदोषानुलोमनीम् ॥ ३५ ॥

चविकापिप्पलीमूलद्राशामलकनागरैः । कोष्ठेविबद्धे सरुजि पिबेत्तुपरिकर्तिनि ।।३६ ।।

कोलवृक्षाम्लकलशीधावनीश्रीफलैः कृताम् । अस्वेदनिद्रस्तृष्णार्तः सितामलकनागरैः ॥३७॥

सिताबदरमृद्वीकासारिवामुस्तचन्दनैः । तृष्णाच्छर्दिपरीदाहज्वरघ्नीं क्षौद्रसंयुताम् ।।३८ ।।

First, lajapeya (gruel prepared from parched rice) medicated with sun hi, dhanyaka, pippali and saindhava salt which is easily digestable should be given as food, the same may be added with dadima (juice of seeds) if the patient desires it to be sour; it may be mixed with sunthi and maksika and taken cold if the patient has loose motions or has predominance of pitta; he who has pain in the region of the bladder, flanks and head can take it medicated with vyaghri and goksura; peya prepared with prsniparni, bala, bilva, nagara, utpala and’dhanyaka and made sour, which is both dipana (improves hunger) and pacana (cooks the food) can be given for patients with both fever and diarrhoea, he who has hiccup, dyspnoea and cough can take it medicated with hrasva panchamula (saliparni, prsniparni, brihati, kantakari and goksura); he who is suffering from (increase) of kapha should take peya of yava (barley) processed with mahat panchamula (bilva, agnimantha, syonaka, kasmarya and patala); he who is constipated, should take yavagu (thick gruel) prepared with yava barley fried in ghee and processed with pippali and amalaka which help elimination of faeces and the doshas; if there is obstruction of the alimentary tract by faeces causing pain in the abdomen and cutting pain in the rectum, the patient should drink it (yavagu) medicated with cavika, pippalimula, draksa, amalaka and nagara; he who suffers from absence of perspiration, loss of sleep and thirst should take it medicated with kola, vrikshamala, kalasi, dhavani and sriphala along with sita (sugar), badara, mridvika, sariva, musta, and chandana along with honey, cures thirst, vomiting, burning sensation of the entire body and fever.

Even rasa (ineat juice / soup) and yusa (soup of pulses) can also be processed by the same drugs mentioned for preparing peya. (31-38)

कुर्यात्पेयौषधैरेवरसयूषादिकानपि । मद्योद्भवे मद्यनित्ये पित्तस्थानगते कफे ।।३९।।

ग्रीष्मे तयोर्वाधिकयोस्तृट्छर्दिदाहपीडिते । ऊर्ध्वं प्रवृत्ते रक्ते च पेयां नेच्छन्ति – तेषुतु ॥ ४० ॥

Peya should not be given to patients suffering from fever caused by drinking wines, for those who drink wine dialy, when kapha gets into the seats of pitta; (and causes fever) during summer, who are suffering from too much of thirst, vomiting, burning sensation and bleeding from the upper parts of the body. (39-40 )

द्राक्षादाडिमकाश्मर्यपथ्यापीलुपरूषकैः । समधूकैः सबदरैः सक्षौद्रान्ससितोपलान् ॥४१॥

ज्वरघ्नैस्तोयमृदितैरद्भिर्वा लाजतर्पणान् । पिबेत्सुसूक्ष्मरजसस्ततो जीर्णे तु तर्पणे ॥ ४२ ॥

यवाग्वां वौदनं क्षुद्वानश्रीयाभृष्टतण्डुलम् । दकलावणिकैर्यूषैः रसैर्वा मुद्गलावजैः ॥४३ || इत्ययं षडहो नेयो बलं दोषं च रक्षता ।

For them, lajatarpana (semisolid menu) made from fine powder of friedpaddy boiled in water along with anti-fibrile dru like draksa dadima, kasmarya, pathya, pilu, parusaka, madhuka, and badara mixed with ksaudra (honey) and sitopala ( sugar candy ) or powder of laja stirred with only water should be given. After the tarpana is digested, if he feels hungry, he should eat yavagu (thick gruel) or odana ( mess) prepared from fried rice, along with dakalavanika yusa or juice of meat of lava bird mixed with mudga.

This is the regimen for the first six days (of fever); thus, protecting the strength (of the patient) and condition of the doshas. (40-44a)

Notes :- ·Daka lavanika yusa is soup of pulses or meat with more of water and salt sufficient for taste.

ततः पक्केषु दोषेषु लङ्घनाद्यैः प्रशस्यते ॥४४॥

Next when the doshas become pakva (ripe-devoid of ama) he is best treated with langhana (fasting) and others (svedana, kala, yavagu, bitter drugs and digestives); if remnants of doshas are still found, kasayas (medicinal recipes such as powders, decoction, infusions) which are pacana (digestives) or samana (palliatives of the doshas) should be administered. (44)

Ausadha sevana – use of drugs in Fever

कषायो दोषशेषस्य पाचनः शमनोऽथवा | तिक्तः पित्ते विशेषेणप्रयोज्यः कटुकः कफे ॥ ४५ ॥

पित्तश्लेष्महरत्वेऽपि कषायः स न शस्यते । नवज्वरे मलस्तम्भात् कषायो विषमज्वरान् ।।४६ ।।

कुरुते ऽरुचिल्लासहिध्माध्मानादिकानपि । न च्यवन्ते न पच्यन्ते कषायस्तम्भितामलाः ॥४७॥

तिर्यग्गता विमार्गा वा वर्धयन्त्यपि च ज्वरम् | बद्धामकफवातत्वाच्छूलानाहादिकानपि ॥४८॥

In fevers of pitta origin (drugs of) bitter taste should be specially prescribed and in fevers of kapha origin (drugs of) pungent taste; astringent taste is not ideal and should not be prescribed, in fevers of recent origin (or early stages of fever) even though astringent taste subdues both pitta and kapha, it produces irregular (intermittant) fevers loss of appetite, nausea, hiccup, distention of the abdomen etc, by causing obstruction to the dosha obstructed by astringent ( drugs), the malas ( dosha ) neither get cooked nor get eliminated, but travelling sidewards (inside the dhatus) or wrong channels they increase the fever and also cause pain and enlargement of the abdomen etc because of obstruction of ama, kapha and vata. (45-48)

सप्ताहादौषधं केचिदाहुरन्येदशाहतः । केचिल्लघ्वन्नभुक्तस्य योज्यमामोल्बणेनतु ॥ ४९ ॥

Some say, that medicines should be administered after seven days; some others say after ten days; yet others say after the regimen of light diet, but not when ama is predominant. (49)

तीव्रज्वरपरीतस्य दोषवेगोदये यतः । दोषेऽथवातिनिचिते तन्द्रास्तैमित्यकारिणि ॥५०॥

अपच्यमानं भैषज्यं भूयो ज्वलयति ज्वरम् । यदा ज्वरो मृदुर्देहो लघुः प्रचलिता मलाः ॥५१॥ अचिरज्वरितस्यापियोजयेद्भेषजंतदा ।

When the fever is high and doshas are increasing, or when the doshas have accumilated too much causing stupor and inactivity, the medicines administered not undergoing digestion, tend to increase the fever still more.

Only when the fever is mild, body is feeling light and the malas (doshas) are moving out, medicines can be administered even though the fever is not old (recently commenced). (50-51)

मुस्तया पर्पटं युक्तं शुण्ठ्या दुस्पर्शयापि वा ||५२ ||

पाक्यं शीतकषायं वापाठोशीरंसवालकम् । पिबेत्तद्वच्च भूनिम्बगुडूचीमुस्तनागरम् ॥५३ ।।

यथायोगमिमे योज्याः कषाया दोषपाचनाः । ज्वरारोचकतृष्णास्यवैरस्यापक्तिनाशनाः ॥५४॥

पाठेन्द्रयवभूनिम्बमुस्तपर्पटकामृताः । जयन्त्याममतीसारंज्वरंच समहौषधाः । ॥५५॥

Decoction or cold infusion of parpata along with musta; or parpata along with sunthi; or parpata along with dusparsa; or patha along with usira and valaka; or bhunimba, guduchi, musta, and nagara; these recipes used appropriately (as suited to the doshas etc) help in cooking (ripening) the doshas, reducing the fever, removing loss of appetite, thirst, bad taste in the mouth and indigestion.

Decoction or cold infusion of patha, indrayava, bhunimba, musta parpataka, amrita, and mahausadha, mitigates ama, diarrhoea and fevers. (52-55)

दुरालभामृतामुस्तानागरंवातजेज्वरे | अथवापिप्पलीमूलगुडूचीविश्वभेषजम् कनीय: पञ्चमूलं च पित्ते क्षौद्रसमन्विताः | ॥५६॥

कलिङ्गमुस्तकटुका मुस्तापर्पटकं तथा ।।५७॥

सधन्वयासभूनिम्बं वत्सकाद्योगणः कफे । अथवा वृषगाङ्गेयी शृङ्गेवरदुरालभाः ।।५८ ।।

रुग्विबन्धानिललेष्मयुक्तेदीपनपाचनम् । अभयापिप्पलीमूलशम्याककटुकाघनम् ।।५९ ।।

In vataja jvara (fever caused by increase of vata) the patient should drink the decoction of duralabha, amrita, musta and nagara; or of pippalimula, guduchi, visvabhesaja or of kaniya (hrasva) panchamula.

In pittaja jvara (fever causedby increase of pitta) decoction of kalingaka, musta, katuka, mixed with honey; or of musta, parpataka dhanvayasa and bhunimba.

In kapha jvara (fever caused by increase of kapha) decoction of drugs of vatsakadi

gana (chapter 16 of sutrasthana) or of vrsa, gangeyi (musta), Sringavera and duralabha. In anila slesma (vatakapha) jvara (fever caused by vata and kapha aggravated together) with pain all over the body and constipation decoction of abhaya, pippalimula, samyaka, katuka and ghana kindles digestion and digests the food (and doshas) (56-59)

कलिङ्गकाः पटोलस्य पत्रं कटुकरोहिणी | पटोलंसारिवा मुस्ता पाठा कटुकरोहिणी ॥६० ।।

पटोलनिम्बत्रिफलामृद्वीकामुस्तवत्सकाः । किराततिक्तममृता चन्दनं विश्वभेषजम् ।। ६१ ।।

धात्री मुस्तामृताक्षौद्रमर्धोकसमापनाः । पञ्चैते सन्ततादीनांपञ्चानां शमना मताः ।।६२॥

पटोलेन्द्रयवारिष्टभद्रमुस्तामृताद्वयम् । सारिवाद्वितयंपाठा त्रायन्ती कटुरोहिणी ||६३ ||

पटोलारिष्टमृद्वीकाशम्याकत्रिफलावृषम् । चन्दनोशीरधान्याब्दगुडूचीविश्वभेषजम् ।।६४ ।।

देवदारुस्थिराशुण्ठीवासाधात्रीहरीतकीः | पञ्चपञ्च ज्वरान् घ्नन्ति योगा मधुसितोत्कटाः ।।६५ ।।

The decoction of drugs mentioned in the following five half verses, mitigate the five fevers commencing with santata (santata, satata, anyedyuska, trtiyaka and caturthaka) respectively.

a. Kalingaka, patola patra and katukarohini

b. Patola, sariva, musta, patha, and katukarohini

C. Patola, nimba, triphala, mridvika, musta and vatsaka

Kiratatikta, amrita, chandana and visvabhesaja

Dhatri, musta, amrita and ksaudra.

Similarly, the following five decoctions mixed with more of honey and sugar, also mitigate the five fevers respectively.

a. Patola, indrayava, arista, bhadramusta and the two amritas (guduchi and haritaki)

b. The two sariva patha, trayanti and katurohini

C. Patola, arista, mrdvika samyaka, triphala and vrsa

d. Chandana, usira, dhanyaka, abda, guda, and visvabhesaja

Devadaru, sthira, sunthi, vasa, dhatri and haritaki. (60-65)

सगुडा: सारिवाद्राक्षाशताह्वाकणरेणुकाः | काश्मर्यसारिवाद्राक्षात्रायमाणामृतागुडाः ।।६६।।

शतपुष्पावचाकुष्ठदेवदारुहरेणुकाः । शर्करामधुसंयुक्ताः समांसीमुस्तधान्यकाः ।।६७॥

कृष्णानुपनर्नवाद्राक्षाशताहागुडसारिवाः |शालिपर्णीबलाद्राक्षासारिवाच्छिन्नसम्भवाः ।।६८ ।।

आरग्वधो बला रास्त्रा काश्मर्यं मधुकं गुडः । शतावरीच्छिन्नरुहास्वरसो वा गुडान्वितः ||६९ ॥

सकृष्णाजीरकसितानागरश्चामृतारसः । वातज्वरंजयन्त्याशु केवलो वामृतारसः ।।७०।।

भार्ङ्गसरलगाङ्गेयीदारुकुष्ठैलवालुकम् । कोष्णंघृतगुडोपेतं पिबेद्वा वातजे ज्वरे | ॥७१ ॥

The following decoctions cure Vataja jvara (fever caused by aggravation of vata) quickly :

Sariva, draksa, satahva, kana, renuka, along with guda (jaggery )

Kasmarya, sariva, draksa, trayamana, amrita mixed with guda Satapushpa, vacha, kusta, devadaru, harenuka mamsi, musta, dhanyaka mixed with sugar and honey.

Krsna, punarnava, draksa satahva sariva along with guda Saliparni, bala, draksa, sariva and chinnasambhava

Aragvadha, bala, rasna, kasmarya, madhuka mixed with guda Satavari, juice of chinnaruha along with guda Krsna, jiraka, sita ( sugar), nagara and juice of amrita

Fresh juice of amrita alone

Bharangi, sarala, gangeyi, daru, kustha and elavaluka made into decoction, mixed with ghee, and jaggery and taken warm will also cure vata jvara. (66-71)

पटोलादिगुडूच्यादी सूत्रोक्तौ पित्तजे ज्वरे । अञ्जनादिः सकाश्मर्यः सारिवादिः सशर्करः ॥७२॥

सितामधुककाश्मर्यशीतोशीरपरूषकम् । गुडूचीसारिवालोध्रकमलोत्पलशर्कराः ॥७३ ।।

द्राक्षाभयातिक्तघनशम्याकफलपर्पटम् । श्यामापर्पटदुःस्पर्शातिक्तातिक्तसितावृषाः ।।७४।।

शर्करातिक्तकटुकात्रायमाणाबिभीतकम् । गुडूच्यामलकैर्युक्तः केवलो वापिपर्पटः ॥७५ ।।

कषायो वा हिमस्तिक्ताद्राक्षामधुकनिम्बजः । पित्तज्वरघ्नी कटुका शुक्ष्णपिष्टा सशर्करा ॥७६ ।।

The following decoctions cure Pittaja jvara (fever caused by aggravation of pitta).

a. Decoction of drugs of patoladi gana

b. of guducyadi gana

of anjanadigana along with kasmarya

d. of sarivadi gana with sugar

sita (sugar), madhuka, kasmarya, sita (chandana), usira and parusaka

f. guduchi, sariva, lodhra, kamala, utpala and Sarkara ( sugar)

draksa, abhaya, tikta, ghana, samayaka, phala and parpata

Syama, parpata, dussparsa, tikta ( katukarohini), tikta (kirtatikta) sita (sugar) and Sarkara (sugar), tikta, katuka, trayamana and vibhitaka juice of guduchi along with amalaka parpata alone.

Cold infusion of tikta, draksa, madhuka and nimba

nice paste of katuka mixed with sarkara (sugar). (72-76)

कफजेऽतिविषोशीरपटोलमरिचक्षपाः । समूर्वेन्द्रयवद्वीपिकुष्ठनिम्बवचागुडाः ॥७७ ॥

सप्तच्छदामृतानिम्बस्फूर्जातं माक्षिकान्वितम् । निशात्रिकटुकं तिक्तानागपुष्पकलिङ्गकाः ।।७८ ।।

सारिवातिविषाकुष्ठदुःस्पर्शामुस्तगुग्गुलुः । परूषं त्रिफला तिक्ता बीजं वृषकजंघनम् ।।७९ ।।

नागरत्रिफलामुस्तामूर्वापाठाः समाक्षिकाः । संसर्गसन्निपातेषु मिश्रानेतान्विकल्पयेत् ॥८० ॥

The following decoctions cure Kaphaja jvara (fever caused by aggravation of kapha).

a. Ativisa, usira, patola, maricha, ksapa (haridra) murva, indrayava, dvipi (chitraka), musta, nimba, vacha and guda (jaggery )

b. Saptachada, amrita, nimba, spurjata (kakatikta) along with maksika

C. Nisa, trikatu, tikta (katukarohini), nagapushpa (nagakesara) and kalingaka.

d. Sariva, ativisa, kustha, dussparsa, musta and guggulu

e. Parusaka, triphala, tikta, vrsaka bija (saka bija) and ghana

Nagara triphala, musta, murva, patha along with maksika (honey).

In fevers caused by combination of two dosha or all three of them, the above drugs can be suitably selected and used. (77-80)

गोकण्टकबलादर्भाः ससिता वातपित्तजे | द्राक्षामलकभूनिम्बाः सगुडूचीशठीगुडाः ।।८१ ।।

त्रायन्ती सारिवाद्राक्षा काश्मर्यच्छिन्नजागुडाः । द्राक्षामसूरत्रायन्तीगुडूचीसारिवाबलाः ||८२ ||

द्राक्षामधूकमधुकलोध्रकाश्मर्यसारिवाः । मुस्तामलकहीबेरपद्मकेसरपद्मकम् ।।८३ ।।

मृणालचन्दनोशीरनीलोत्पलपरूषकम् । फाण्टो हिमो वाद्राक्षादिर्जातीकुसुमवासितः ॥८४ ।।

युक्तो मधुसितालाजैर्जयत्यनिलपित्तजम् । ज्वरं मदात्ययं छर्दि मूर्छा दाहं श्रमं भ्रमम् ।। ऊर्ध्वगं रक्तपित्तं च पिपासां कामलामपि ॥८५ ॥

The following decoctions are useful in Vata-pittaja jvara –

a. Gokantaka, bala, darbha and sita (sugar)

b. Draksa, amalaka, bhunimba, guduchi, sathi and guda

C. Trayanti, sariva, draksa, kasmarya, chinnaja ( guduchi) and guda.

d. Draksa, masura, trayanti, guduchi, sariva and bala.

e. Draksa, madhuka, madhuka, lodhra, sariva and kasmarya.

f. Musta, amalaka, hribera, padmakesara and padmaka

g. Mrunala, chandana, usira, nilotpala and parusaka.

Receipes commencing with Draksadi and others mentioned in half-verses (e.f.g.) may be used either as phanta ( hot infusion) or hima (cold infusion), inade fragrant with jatikusuma (flowers of jasmine) and mixed with honey, sugar, laja (puffed paddy ). They even cure fever, alcoholism, vomiting, fainting, burning sensation, fatigue, giddiness, urdhvaga raktapitta (upward haemorrhagic disease) thirst and jaundice. (80-85)

कफवातेवचातिक्तापाठारग्वधवत्सकाः । ॥८६॥

पिप्पलीचूर्णयुक्तो वा क्वाथश्छिन्नोद्भवोद्भवः । व्याघ्रीशुण्ठ्यमृताक्वाथः पिप्पलीचूर्णसंयुतः ||८७ ||

वातश्लेष्मज्वरश्वासकासपीनसशूलजित् । पथ्या कुस्तुम्बरीमुस्ताशुण्ठीकत्तृणपर्पटम् ।।८८ ।।

सकट्फलवचाभार्ङ्गदेवाह्वंमधुहिगुमत् । कफवातज्वरष्ठीवकुक्षिहृत्पार्श्ववेदनाः ।।८९।।

कण्ठामयास्यश्वयथुकासश्वासान्नियच्छति ।।९० ।।

In fevers of Kaphavata origin, the following decoctions are useful –

a. Vacha, tikta, patha, aragvadha, vatsaka mixed with pippali, curna b. Decoction of chinnodbhava ( amritavalli) with pippali curna C. Decoction of vyaghri, sunthi, amrita, mixed with pippali curna will cure vataslesmajvara dyspnoea, cough, nasal catrrah and abdominal pain. d. Pathya, kustumburi, musta sunthi, kattrina, parpata, katpala, vacha, bharangi and devahva along with honey and hingu and used as decoction cures fevers of kaphavata origin, expectoration, pain of the abdomen (region of) the heart and the flanks, disease of the throat and mouth, swelling, cough and dyspnoea. (86-90)

आरग्वधादिः सक्षौद्रः कफपित्तज्वरंजयेत् । तथा तिक्तावृषोशीरत्रायन्तीत्रिफलामृताः ।। पटोलातिविषानिम्बमूर्वाधन्वयवासकाः ।।९१ ।।

वृषपुष्पच्छदरसः शर्करामाक्षिकान्वितः । पित्तश्रेष्मज्वरंहन्ति सासृपित्तं सकामलम् ॥९२ ।।

अनन्ताविश्वभैषज्यकटुकातोयतोयदाः । ज्वरतृड्भ्रमसम्मोहधूमकाम्लकनाशनाः ।।९३ ।।

The following decoctions cure Kaphapittajvara

a. drugs of aragvadhadigana, mixed with ksaudra (honey)

b. tikta, vrsa, usira, trayanti, triphala, patola, ativisa, nimba murva, dhanvayavasaka (mixed with honey)

c. juice of flowers and bark of vrsa mixed with sarkara (sugar) and maksika (honey) cures pittaslesmajvara associated with raktapitta (bleeding disease) and kamala (jaundice).

d. Ananta (murva), visvabhaisajya, katuka, toya (valaka), toyada (musta) made into a decoction and taken, cures fever, thirst, giddiness, delusions, feeling of hot fumes coming out and sourness (increased acidity). (91-93)

सन्निपातज्वरेव्याघ्रीदेवदारुनिशाद्वयम् । पटोलपत्रनिम्बत्वक् त्रिफलाकटुकायुतम् ।।९४ ।।

मुस्तापर्पटकं पथ्या मृद्वीका कटुरोहिणी | त्रायन्तीकणतन्मूलद्राक्षापथ्यामधूलिकाः ॥ ९५ ।।

त्रिफलोशीरषड्ग्रन्थायष्टीमधुबलाघनाः । नागरंपौष्करंमूलं गुडूची कण्टकारिका ।।९६ ।।

सकासश्वासपार्श्वातौ वातश्लेष्मोत्तरेज्वरे | मधूकपुष्पमृद्वीकात्रायमाणा परूषकम् ॥९७ ॥

सोशीरतिक्तात्रिफलाकाश्मर्यं कल्पयेद्धिमम् । कषायं तं पिबन् काले ज्वरान् सर्वानपोहति ॥ १८ ॥

जात्यामलकमुस्तानि तद्वद्धन्वयवासकम् ।बद्धविट्कटुकाद्राक्षात्रायन्तीत्रिफलागुडान् ।।९९ ।।

In Sannipata jvaras (fevers caused by all the three doshas aggravated together) the following decoctions are useful –

a. Vyaghri, devdaru, the two nisas, leaves of patola, bark of nimba, triphalaand katuka. b. Musta, parpataka, pathya, mrdvika and katurohini

c. Trayanti, kana, kanamula, draksa, pathya and madhulika

d. Triphala, usira, sadgrantha, yastimadhu, bala and ghana.

The following are useful in Sannipata jvaras in which vata and kapha are predominant and associated with cough, dyspnoea and pain in the flanks –

a. Nagara, pauskaramula, guduchi and kantakarika

b. cold infusion of madhukapushpa, mrdvika, trayamana, parusaka, usira, tikta, triphala and kasmarya and taken at appropriate time cures all fevers.

C. similarly so, jati, amlaka and musta; also that of dhanvayavasaka, d. if constipation is present, then cold infusion of katuka, draksa, trayanti, triphala and guda (jaggery) should be taken. (94-99).

Ahara yojana in Jvara -regimen of diet in fever

जीर्णौषधोऽन्नं पेयाद्यमाचरेच्छ्लेष्मवान्न तु । पेया कफं वर्धयति पङ्कं पांसुषुवृष्टिवत् ॥१०० ।।

When the medicines (decoctions) have become digested, the patients should be given diet such as peya etc (light liquid foods) except for those who have predominance of kapha, becuase peyas (liquid foods) will increase kapha just as rain on muddy soil increases the slush. (100)

श्रेष्माभिष्यण्णदेहानामतः प्रागपि योजयेत् । यूषान् कुलत्थचणककलायादिकृतान् लघून् ॥

रूक्षांस्तिक्तरसोपेतान् ह्रद्यान् रुचिकरान्पटून् ।।१०१।।

For patients who have predominance of kapha, yusa (soup) of kulattha, canaka, kalaya etc, which are easily digestable prepared without addition of any fats, made bitter (by processing with bitter drugs), pleasant (of good smell), tasty and salty should be given even before the administration of medicines (and later on also). (101)

रक्ताद्याः शालयो जीर्णाः षष्टिकाश्च ज्वरे हिताः । श्रेष्मोत्तरेवीततुषास्तथा वाट्यकृता यवाः ।।१०२ ।।

ओदनस्तैः स्त्रुतो द्विस्त्रिः प्रयोक्तव्यो यथायथम् । दोषदूष्यादिबलतो ज्वरघ्नक्वाथसाधितः ।। १०३ ।।

Raktasali (red variety of rice) and sastikasali (rice maturing in sixty days) and other kinds of rice which ae old are suitable foods for (patients of) fevers, for those who have predominance of kapha; yava (barley) dehusked or slightly pounded is good; odana (mess) should be prepared by washing them twice or thrice in water, boiled in decoctions of antifebrile drugs and used in accordance with the strength of the doshas, dusyas etc. (102-103).

मुद्गाद्यैर्लघुभिर्युषाः कुलत्थैश्च ज्वरापहाः । कारवेल्लककर्कोटबालमूलकपर्पटैः ।। वार्ताकनिम्बकुसुमपटोलफलपल्लवैः ।।१०४।।

Yusa (soup) of mudga ( green gram) kulattha (horse gram), and such others which are laghu (easily digestable) are cure fevers; so also those of karavella, karkota, tender mulaka, parpata, vartaka, flowers of nimba, fruits and tender leaves of patola (are going to cure fevers). (104)

अत्यन्तलघुभिर्मांसैर्जांङ्गलैश्च हितारसाः । व्याघ्रीपरूषतर्कारीद्राक्षामलकदाडिमैः ।।१०५।।

संस्कृताः पिप्पलीशुण्ठीधान्यजीरकसैन्धवैः । सितामधुभ्यां प्रायेण संयुता वा कृताकृताः ।।१०६ ।।

अनम्लतक्रसिद्धानि रुच्यानि व्यञ्चनानि च । अच्छान्यनलसम्पन्नान्यनुपानेऽपियोजयेत् ।।

तानि क्वथितशीतं च वारिमद्यं च सात्म्यतः ।। १०७ ।।

Meat juice of animals living in desert like regions are very easily digestable.

Soups of pulses or meat along with vyaghri, parusa, tarkari amalaka and dadima, and processed with pippali, sunthi, dhanya, jiraka and saindhva or not processed, usually taken with mixing with sugar and honey are ideal. Condiments prepared from takra (buttermilk) which is not sour and made tasty are also good. Soups which are clear (thin and without sediment) boiled well and made hot by fire can also used as Anupana (drink after meals) and such soups, water boiled and cooled, or wines, – to which ever the patient is accustomed to may also be used. (104-107)

कषायपानपथ्यान्नैर्दशाह इति लजिते । सर्पिर्दद्यात् कफे मन्दे वातपित्तोत्तरे ज्वरे ॥

पक्केषु दोषेष्वमृतं तद्विषोपममन्यथा ।।१०८ ।।

दशाहे स्यादतीतेऽपि ज्वरोपद्रववृद्धिकृत् । लङ्घनादिक्रमं तत्र कुर्यादा कफसङ्क्षयात् ।।१०९ ।।

Even after ten days of use of decoctions, suitable diets, fasting and other reducing measures (if the fever does not subside) and in fevers which have mild (increase) kapha and more (increase of) vata and pitta, the patient should be administered (medicated) ghee (to drink); if the doshas are pakva (devoid of ama) it will act like nector, otherwise (if ama is persisting) it will act like poison, even after the lapse of ten days, causing increase of fever and its complications (secondary diseases). In such a condition, langhana (fasting and other thinning measures) should be continued till kapha decreases. (108-109)

सज्वरंज्वरमुक्तं वा दिनान्ते भोजयेल्लघु । श्रेष्मक्षयविवृद्धोष्मा बलवाननलस्तदा ॥११० ॥

यथोचितेऽथवा काले दोषसात्म्यानुरोधतः । प्रागल्पवह्निर्भुञ्जानो न ह्यजीर्णेन पीड्यते ।।१११ ।।

The patient who having fever or relieved of it, should be given light foods at the end of the day, because there is then decrease of kapha, increase of heat and powerful digestion; or it (food) should be given at a suitable time appropriate to the doshas and habits (of the patient). He who has poor digestive capacity does not suffer from indigestion, if he takes food earlier to the end of the day. (110-111)

।। इति प्रथमोऽध्यायः ॥ Thus ends the First chapter


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