SAMPRAPTI OF JWARA FROM

CHARAKA NIDANA IN
COMTEMPORARY CONTEXT
PART 1
MN SAGAR
FIRST YEAR PG
DEPT OF ROGANIDANA
CONTENTS

1. INTRODUCTION
2. HISTORICAL PERSPECTIVE
3. MYTHOLOGICAL ORIGIN
4. NIRUKTHI
5. DEFINITION
6. SYNONYMS
7. TYPES
8. SAMPRAPTI
9. CONTEMPORARY VIEW
HISTORICAL PERSPECTIVE

• JWARA IN NON MEDICAL LITERATURE

• ATHARVA VEDA

• Fourth and last veda in hindu literature

• Ayurveda is considered as upanga of atharva veda

• The word “TAKMAN” was reffered to jvara in Atharva veda

• Jwara was also seen in puranas such as
• Mahabharata

• Agni purana

• Garuda purana

• Brhat samhitha

• kashikanda
MYTHOLOGICAL ORIGIN

• Lord Shiva is said to be responsible for the causation of jwara

• Its said that jwara was formed from the niswasa of lord shiva who was agitated by daksa
NIRUKTHI

• The word jwara originated from “JYA”

• It means the loss of life

PRATYATMIKA LINGA

• ज्वर प्रत्यात्मिकं लिङ्गं संतापो देहमानसः । ज्वरेणाविशता भूतं न हि किञ्चिन्न तप्यते ॥(CH. CHI 3/31)
• The signs and symptoms of jwara are
• increase in the temperature of the body
• mental unhappiness
• In Susrutha samhitha
• स्वेदावरोधः सन्तापः सर्वाङ्गग्रहणं तथा
विकारा युगपद्यस्मिन् ज्वरः स परिकीर्तितः || (सु.उ.39/13)

• Swedhavarodha- obstruction of channels of sweat

• Santhapa - elevated body temperature
• Sarvanga grahana- general body pain
JWARA PRABHAVA

• संताप: सारुचिस्तृष्णा साङ्गमर्दो हृदि व्यथा । ज्वरप्रभावो, जन्मादौ निधने च महत्तमः ॥( cha chi 3/26)
• Santhapa - elevated temperature
• aruchi- anorexia
• thrishna- morbid thirst
• angamarda - body pain
• hrid vyatha- discomfort in region of heart
SYNONYMS

• ज्वरो विकारो रोगाश्च व्याधिरातङ्क एव च।

नामपर्यायैर्विविधैरभिधीयते ॥ (ch.chi 3\11)
• synonyms are
• jvara
• vikara
• roga
• vyadhi
• atanaka
LOCATION

• के वलं समनस्कं चज्वराधिष्ठानमुच्यते

शरीरं, बलकालस्तु निदाने संप्रदर्शितःसंप्रदर्शितः ॥

• The entire body along with mind is the site of manifestation

JWARA NIDANAM

• मिथ्यातियुक्तै रपि च स्नेहाद्यैः कर्मभिर्नृणाम्

विविधादभिघाताच्च रोगोत्थानात् प्रपाकतः ॥
श्रमात् क्षयादजीर्णाच्च विषात्सात्म्यर्तुपर्ययात् ।
ओषधीपुष्पगन्धाच्च शोकान्नक्ष त्रपीडया ||
अभिचाराभिशापाभ्यां मनोभूताभिशङ्कयाः |
स्रीणामपप्रजातानां प्रजातानां तथाऽहितैः ॥
स्तन्यावतरणे चैव ज्वरो दोषै: प्रवर्तते |(su ut 39/19-22)
• AHARA
• Indigestion
• VIHARA
• Exertion
• Inhalation of smell from plants and flowers
• Improper conduct by women after delivery
• IATROGENIC • KALAJA
• Improper administration of panchakarma • Change in habituations and natural features of
therapy the season
• improper delivery in women • due to unfavourable zodiac consellations
• SECONDARY FACTORS • AGANTUJA
• Trauma • Due to sorrow
• suppuration /ulceration • effect of witchcraft
• ksaya • wrath of gods
• poison • possession by evil spirits
TYPES

• Acc to ethiology/karana
• vata
• pitta
• Acc to character jwara is divided into • kapha
• NIJA -Innate • vatapittaja
• AGANTHU-exogenous • vatakaphaja
• pitta kaphaja
• sannipataja
• aganthuja
 • Depending on dhatu asraya
• Rasagata jwara
• AGANTHUJA JWARA
• Rakagata
• Abhighataja-by injury
• Mamsagata
• Abhicaraja-due to exorcism
• Medogata
• Abhisangaja-ill attachments eg fear ,anxiety etc
• Asthigatha
• Abhisapaja- due to curses
• Majjagata
• Sukra gatha
• Depending on bala of dosa and kala :
• Santata
• Satata
• Anyedushka
• Tritiyaka
• Caturthaka
POORVAROOPA OF JWARA
• mukhavairsayam
• gurugathrata
• romaharsha
• annanabhilasham
• sabda sheeta atapa sahatwa asahtwam
• chakshushoagulathwam
• arochaka
• asra agamanam
• avipaka
• nidra adhikyam
• dourbalyam
• arathi
• angamardam
• jrmbha
• sadanam
• sramam
• alasya
• bhramam
• amla lavana katuka priyatha
• pralapa
VATHIKA JWARA
• NIDANAM
• Excess intake of rooksha ,sheetha and laghu susbstances
• Over administartion of therapies such as
• emesis
• purgation
• asthapana vasti

• vegasandharana
• anxiety
• excessive blood letting
• rathrijagarana
VATHIKA JWARA LAKSHANA

• lakshanas include
• irregular onset &alleviation
• irregularity in temperature • anorexia
• shifting or fixed pain in the body • liking towards hot things
• stiffness of jaw • excessive retention of stool and urine
• pain in temples • occurence of fever
• dysguesia • after digestion
• thirst • at afternoon
• dry cough • end of summer season
PITHAJA JWARA

• Nidanam
• excessive intake of usna, lavana, kshara,katu and ajeerna foods
• intake of meal while suffering from indigestion
• exposure to excessive heat of sun,fire
• Manasika karana such as
• anger
• Irregular diet
LAKSHANA
• hyper pyrexia • diarrhoea
• pungent taste in mouth • thrshna
• inflammation of • mada
• nose • occcurence of fever
• mouth • during autumn(Sarad kala)
• throat • during the process of digestion
• lips
• simultaneous manifestation and
• srama aggravation of fever
• moorcha
• sheetabhipriytha
• raktakota
KAPHAJA JWARA
• NIDANA
• Excessive intake of
• snighda
• guru
• madhura
• picchila
• lavana foods

• divasvapnam
• lack of physical excercises
LAKSHANA
• gurugathratha
• ushnabhipriyatha
• annannabilasham
• occurence of fever
• slesma prasekam
• Immediately after food
• mukha madhuryam
• vasanta kala
• hrilasa
• nidra adhikyam • whitish discolouration
• stambha • nails
• tandra • eyes
• swasa • skin
• kasa • stool
• DWANDAJA JWARA
• It includes vata pitha,vatha kapha and kapha • SANNIPATAJA JWARA
pittaja jwara
• Simultaneous vitiation of alL three dosas
• signs and symptoms pertaining to both dosha
can be found
VATA PAITHIKA JWARA
• रुक् पर्वणभेदो दाहो रोम्णां प्रहर्षणम्।
कण्ठास्यशोषो वमथुस्तृष्णा मूर्च्छा भ्रमोऽरुचिः
स्वप्ननाशो ऽतिवाग्जृम्भा वातपित्तज्वराकृ तिः|
Signs and symptoms are
Headache
Pain in fingers and toes
• Burning sensation
• Horripilation
• Dryness of throat and mouth
• Fainting
• Anorexia
VATA KAPHAJA JWARA

• शीतको गौरवं तन्द्रास्तैमित्यं पर्वणां च रुक् ॥

शिरोग्रहरतिश्यायः कासः स्वेदाप्रवर्तनम् ।
सन्तापो मध्यवेगश्च वातश्लेष्मज्वराकृ तिः ॥
Signs and symptoms are
Feeling of cold
• Heaviness
• Drowsiness
• Sirograha
• Kasa
• Absence of sweat
INFLUENZA

Acute respiratory illness

• Clinical features
• Headache
• Fever
• Chills
• Myalgia
• Cough & sour throat

• Ayurvedic view – lakshana of vatakaphaja jwara

KAPHA PITTAJA JWARA

• मुहुर्दाहो मुहुः शीतं स्वेदस्तम्भो मुहुर्मुहुः ।

मोहः कासोऽरुचिस्तृष्णा श्लेष्मपित्तप्रवर्तनम् ॥
लिप्ततिक्तास्वता तन्द्रा श्लेष्मपित्तज्वराकृ तिः ।
• Signs and symptoms
• Frequent Feeling of burning sensation and cold
• Kasa, aruchi , trishna
• Adhesion and bitterness in mouth
• Tandra
 TYPHOID

• Typhoid is an acute febrile systemic infection

• Main symptoms
• Myalgia , head ache constipation
• Rose spots- faint, salmon coloured maculopapular rash on trunk and chest
• Splenomegaly
• Anorexia
• Delirium
• Ayurvedic view- dosha dominance in typhoid fever is pitha and kapha along with vitiation of rakta
 MEASELES
Measeles or rubeola
• Have two phases – Prodromal &Eruptive
• Signs and symptoms are
• Fever , coryza
• Redness of eye, lacrimation
• Kopliks spot- Small irregular lesion with bluish white centre
• Presence of dusky red maculo papular rashes
• Ayurvedic view- kapha and pitta dosha dominance along with rasa and rakta vitiation
MANIFESTATION OF JWARA

• Jwara as Poorvaroopa:
• Urusthambha
• Unmada
• Jwara as Lakshana
• Pittaja and Dushta Pratishyaya
• Kshataj Kasa
• Yakrutodar
• Many Pittaja Vyadhis
• Jwara as Upadrava:
• Vatarakta
• Chhardi
• Prameha
• Shotha
• Kushtha
• Raktapitta
SAMPRAPTI

• .मलास्तत्र स्वैः स्वैर्दुष्टाः प्रदूषणै ||

आमाशयं प्रविश्याममनुगम्य पिधाय च |
स्रोतांसि पक्तिस्थानाच्च निरस्य ज्वलनं बहिः ||
सह तेनाभिसर्पन्तस्तपन्तः सकलं वपुः ।
कु र्वन्तो गात्रमत्युष्णं ज्वरं निर्वर्तयन्ति ते || स्त्रोतोविबन्धात्प्रायेण ततः स्वेदो न जायते । (Ah.ni.2/35)
SAMANYA SAMPRAPTI OF JWARA
specific
SAMANYA DOSA
jwara nidana KOPA NIDANA

DOSHA DUSTI

PRODUCTION OF AMA IN AMASAYA

 SAMA DOSHA

DOSHA DUSHYA SAMMURCHANA

SROTHO RODHAM OF RASA VAHA AND SWEDAVAHA SROTHAS

DISLOCATION OF AGNI FROM PAKTHI STANA TO OTHER SITES

(JATHARGNI BAHIRGAMAN)

MAKES THE BODY HOT JWARA

PATHOPHYSIOLOGY OF FEVER
INFECTIOUS
AGENTS/TOXINS/PYROGENS

STIMULATES MONOCYTES,MACROPHAGES,
ENDOTHELIAL CELLS

RELEASES PYROGENIC CYTOKINES- IL-

1,TNF,IL-6,IFN

STIMULATES ANTERIOR HYPOTHALAMUS

RESULTS IN ELEVATED THERMOREGULATORY SET POINT

INCREASED HEAT CONSERVATION(VASO CONSTRICTION)

INCREASED HEAT PRODUCTION

FEVER
THANK YOU
CONTEMPORARY VIEW
• fever often acts as an individual disease or being a symptom of another disease
• many diseases have various types of fever as their cardinal symptom
• diseases discussed here are:
• Viral fever
• chickenpox
• chikungunya
• typhoid
• measeles
• influenza
VIRAL FEVER
• Viral fever is an umbrella term used to denote viral infections presenting with fever as the
• main symptom. High fever, head ache and body ache are the usual presentation. Viral fever
• can range in temperature from 99.0F to over 103.0F.
• General symptoms:
• Chills
• Sweating
• Dehydration
• Head ache
• Anorexia
• Generalized body pain
• Fatigue
• Most of the viral fever subsides within a week or two.
• Ayurvedic view: Symptoms of vathakapha jwara can be observed in viral fever.
• deepana,amapachana, vatha kapha jwara chikitsa can be incorporated for treatment.
• Commonly used medicines:
• ✓ Amritotharam kashyam, Dasamoolakatuthrayam kashayam
CHICKENPOX

• Varicella is an acute viral infection characterized by fever and disseminated vesicular eruptions

• The disease is highly contagious.

• serious and produce grave complications.

• Causative organism :

• Varicella zoster virus (VZV) / Human alpha herpes virus-3

• subfamily of Alpha herpes viridae

Divided into two stages- Pre-eruptive stage & Eruptive stage
• Pre-eruptive stage:
• usually lasts for 24 hrs
• Sudden onset with mild/moderate fever
• Pain in the back
• Shivering
• malaise
• Eruptive stage:
• Rashes first appears on trunk and face and then on extremities
• Advances rapidly through stages of macule, papule, vesicle and scab
• The rashes are centripetal in distribution
• Pruritis is invariably associated with the rashes.
• The vesicles gradually develop crusts, which disappear over a period of 7-10 days.
• Ayurvedic view:
• Symptoms of chickenpox exhibits pitha and kapha dosha dominance, along with vitiation of rakta
CHIKUNGUNYA

• Chikungunya (CHIK) fever is a mosquito borne viral disease

• The word Chikungunya means “to become contorted” and describes the stooped appearance (that which
bends up) of the victim with arthralgia.

• Common symptoms are:

• symmetric polyarthropathy,
• fever,
• rash
• Causative organism:
• RNA virus of genus alpha virus
• Family: Togaviridae
• Stages of disease :
• Acute
• Chronic
• Clinical features:
• In Acute stage (First 10 days after disease onset)
• Fever- Usually high and poorly responsive to antipyretics
• Arthralgia - Acute bilateral symmetrical rheumatic pain.
• painful and swollen, especially inter phalangeal joints, wrists, and ankles
• Head ache
• Maculo-papular rash
• Cutaneous and mucosal symptoms like stomatitis, exfoliative dermatitis
• GI symptoms like anorexia, nausea, vomiting
• Chronic stage
• Early exacerbation
• Inflammatory relapses often triggered after exposure to cold.
• Long-lasting rheumatism and a significant loss in the quality of life

• Ayurvedic view: Symptoms of Vatadhika sannipathajwara, amavatha and vatarakta can be observed in
different stages of Chikungunya
• Treatment mainly targets on Aamapachana, Jwarahara, Treatment of residual symptoms.
TYPHOID
• Typhoid fever or Enteric fever is an acute febrile systemic infection

• its caused by dissemination of the bacterium Salmonella typhi. It can

• Causative organism:

• Salmonella typhi- Gram negative bacilli

• Family: Enterobacteriaceae.
• Clinical features:
• Stage 1 (1st week)
• Slow rising temperature (stepladder fashion) for 4-5 days along with Abdominal pain,
• myalgia, head ache, constipation
• Rose spots – Faint, salmon coloured ,blanching macula-papular rash primarily on the trunk and chest
• ➢ Splenomegaly, Abdominal distension with tenderness
• ➢ Diarrhoea
• Stage 2 (2nd week)
• ➢ Delerium and complications
• ➢ Coma and death , if untreated
• Stage 3 (3rd week)
• Febrile become toxic and anorexic
• Significant weight loss
• Typhoid state/ Typhoid facies - Thin fleshed face with staring apathetic expression
• High risk (5-10%) of haemorrhage and perforation may cause death
• Stage 4(4th week)
• Recovery period
• Ayurvedic view: Main dosha dominance in typhoid fever is pitha and kapha, along with rakta vitiation.
• Lakshanas of pithadhika sannipatha jwara
MEASELES

• Measeles or Rubeola

• Causative organism: RNA paramyxovirus

• Man is the only natural host.

• Source of infection : A case of measles.

• Clinical features:
• Prodromal phase:
• Begins 10 days after infection and lasts for 3-4 days
• Fever, coryza, cough, redness of eyes, lacrimation, photophobia.
• Koplik’s spots- Appear as small red irregular lesions with bluish-white centre on the
• mucous membrane of mouth, 1-2 days before the skin rash. They are best seen in buccal
• mucosa opposite first and second upper molars.
• Eruptive phase:
• The rashes are dusky red and macular/ maculo-papular
• First appears on forehead and behind the ears, later spreads rapidly in few hours over face and neck
• Ayurvedic view: Symptoms measles exhibits lakshanas of jwara
• Main dosha dominance here is pitha and kapha , along with vitiation rasa and rakta dhathu.
INFLUENZA
• Influenza is an acute respiratory illness caused by infection with influenza viruse
• Etiologic agent: Inflenza A,B,C viruses, members of Orthomyxoviridae family
• Source of infection: Case/Subclinical case
• Mode of spread : Droplet infection
• Infectivity period : 1-2 days before and after onset of symptoms
• Clinical features:
• Head ache
• Fever
• Chills
• Myalgia
• Malaise
• Respiratory signs like sour throat and cough
• Ayurvedic view: Lakshanas of vatakapha jwara can be observed in influenza.
• Management strategies include deepana and pachana with katu tikta rasapradhana oushadha and
Aganthuja jwara chikitsa