Jvara

Reference:
C.Ni.1, Su.U.39, A.H.Ni.2, M.Ni.2

Mythologicalorigin:
Daksha Prajaapati did not offer due share to Maheshvara in Yadnya(ritual or sacrifice), also did not perform rituals of admiring Pashupati and Aahuti.When LordShiva realized the evasion of duty by Dakshaand became angry, from this third eye wrathful fire emanated, which burnt all the Asuraas. From this fire, Veerabhadra emergedout and destroyed Yadnya of Daksha Prajaapati. Later Veerabhadra became Jvara. As a result of this, the world got afflicted with burning sensation and pain. Also all the living creatures in different directions became unconscious.

Gods, Rishi offered prayers Lord Shiva and pacified him. Thus Jvara is disease due to erratic regimens.

Nirukti:
Jvarayati S`hareeraan`i Iti Jvarah | C.Ni.1/35
Disease accompanying with fever, burning is Jvara.

Introduction:
Jvara is not only sign – fever, but a disorder affecting body, senses, and mind. It diminishes the intelligence, strength, complexion, joyfulness and enthusiasm of the sufferer and produces exhaustion, exertion, unconsciousness, and aversion to food also can lead even to death.
Hyperpyrexiaor fever (Santaapa) is characterized sign of Jvara.

Synonyms:
Jvara is also denoted by the names
        Antaka (kills a person)
        Vikaara
        Roga
        Vyaadhi
        Ojos`hana (deplete Ojas)
        Rogapati (King of the diseases)
        Kshaya (emaciates body)
        Tama (causes Moha – darkness or delusion of mind)
        Paapmaa (result of wrong behavior or thought)
        Mrityu (cause of death)
        Yamaatmaka (like Yama – god of death)

Pravritti:
Pravritti is Origin of Jvara (Prathama Aavirbhaava) due to acquisition (Parigraha). Jvara isoriginated because of the ferocious wrath of Rudra.

Svabhaava:
The responsible factors for manifestation of Jvara are S`haareera Dosha; Vaata, Pitta, Kaphaand two Maanasa Dosha; Rajas and Manas.

Clinical presentation:
It is invariable manifestation of Jvara
        Santaapa (raised temperature) is characteristic sign of Jvara.
        Angamarda (malaise)
        Loss of perspiration (Sveda Avarodha)
        Body pain / limb seizure / spasm (Sarva Anga Graha)
        Aruchi (tastelessness of mouth)
        Trishn`aa (morbid thirst)
        Hrid Vyathaa (pain in cardiac region)
When all these symptoms are present in a person at one time, the condition is named as Jvara.

Adhishthaana:
Site of manifestation of Jvara S`hareera (body) and Manas (Mind).

Types:
There are 8 causes of Jvara.Due to 8 reasons Jvaragets manifested.

1.    Nija Jvara:
1.    Vaataja
2.    Pittaja
3.    Kaphaja
4.    Vaata Pittaja
5.    Vaata Kaphaja
6.    Pitta Kaphaja
7.    Sannipaatika (13 types)
2.    Aagantu Jvara

Other types according to various factors:
Adhisht`haana:

S`haareera
Maanasa

Svabhaava:

Saumya
Aagneya / Teekshn`a

Vega:

Antarvegee
Bahirvegee

Saadhya Asaadhyatva:

Saadhya
Asaadhya

Praakrita Vaikrita:

Praakrita
Vaikrita

Aas`hraya:

Antaraas`hrita
Bahiraas`hrita

Avasthaa:

Saama
Niraama
Pachyamaana

Dosha Kaala Bala: (according to strength and weakness of Dosha and time)

Santata
Satata
Anyedyuh
Triteeyaka
Chaturthaka

Aashraya: (according to the site of manifestation)

Rasasthita Jvara curable (Saadhya)
Raktasamsthita Jvara – curable (Saadhya)
Maamsasthita Jvara – curable (Saadhya)
Medasthita Jvara – curable (Saadhya)
Asthisthita Jvara difficult to cure (Krichchhra Saadhya)
Majjaagata Jvara – difficult to cure (Krichchhra Saadhya)
Shukragata Jvara can not be cured

Saamaanya Sampraapti:-

Three aggravated Dosha, either individually or jointly in the combinations of two or three spread through Rasa Dhaatu.
These Dosha dislodges the Jaat`haraagnifrom its own place.
With their own heat and the heat of Jaat`haraagni, the heat pervades the entire body.
The channels of circulation get obstructed by Saama Dosha and they being further aggravated pervade the entire body to produce excessive heat.
Therefore the persons temperature increases all over the body and this condition is called as Jvara.

Vaataja Jvara Sampraapti:

Vaata gets aggravated due to the over indulgence in Vaata aggravating causative factors (Ruksha Gun`a, Chala Gun`a)
This aggravated Vaataafflicts Aamaas`haya.
Vaata gets mixed up with Agni.
Collectively both aggravated Vaataand Agni, follow the course of first Dhaatu Rasa.
They obstruct the Svedavaha and Rasavaha Srotas.
Suppresses the activity of Agni and compelthe Agni (Ushmaa Paachakavahni) from the site of digestion (Paktisthaana – Paachakaagnisthaana).
This Agni spreads all over the body and Vaataja Jvara gets manifested with Vaataja signs and symptoms.

Pittaja Jvara Sampraapti:

Pitta gets aggravated due to the over indulgence in Pitta aggravating causative factors (Drava, Ushn`a Gun`a)
This aggravated Pitta afflicts Aamaas`haya and impelsthe Agni (Ushmaa Paachakavahn)
This Agni follows the course of first Dhaatu Rasa.
They obstruct the Svedavaha and Rasavaha Srotas.
Suppress the activity of Agni due to the liquidity of Pitta (Drava Gun`a) also compel Agni (Ushmaa Paachakavahni) from the site of digestion (Paktisthaana – Paachakaagnisthaana) and spread all over the body manifesting Pittaja Jvara.

Kaphaja Jvara Sampraapti:

Kapha gets aggravated by the excessive intake of Kapha aggravating factors. (S`heeta Gun`a etc).
Aggravated Kapha enters Aamaas`hayaand gets mixed up with Agni.
Collectively, Kapha and Agni, follow the course of Rasa and obstruct Rasavahaand Svedavaha Srotas.
Suppressesthe activity of Agni and compels Ushmaa (Agni) from the site of digestion. It spreads all over the body manifesting Kaphaja Jvara.

Dvandvaja Jvara:-

Dvandvaja Jvara are:

Vaatapittaja
Pittashleshmaja
Vaatashleshmaja

These Dvandvaja Jvaramanifest with the combination of the symptoms of Vaataja Jvara, Kaphaja Jvara, Pittaja Jvara. Excessive consumption of causative factors leads to aggravation of Dosha.With the combinations of causative factors, two Dosha or all the three Dosha get vitiated. According to this vitiation, Dvandvaja or Saannipaatika Jvaramanifest.

Saannipaatika Jvara:
Though in Sannipaata, all three Dosha are vitiated, according to quantitative vitiation and their combinations,13 types of Sannipaataare explained as follows:

No	*Sannipaata*	*Vaata*	*Pitta*	*Kapha*
1	Vaata Pitta Ulban`a, Manda Kapha	———	———	—
2	Vaata Kapha Ulban`a, Avara Pitta	———	—	———
3	Pitta Kapha Ulban`a, Manda Vaata	—	———	———
4	Vaata Ulban`a, Pitta Kapha Anuga	———	—	—
5	Pitta Ulban`a, Vaata Kapha Anuga	—	———	—
6	Kapha Ulban`a, Vaata Pitta Anuga	—	—	———
7	Kapha Ulban`a, Pitta Madhyama, Vaata Heena	—	——	———
8	Pitta Ulban`a, Kapha Madhyama, Vaata Heena	—	———	——
9	Vaata Ulban`a, Kapha Madhyama, Pitta Heena	———	—	——
10	Kapha Ulban`a, Vaata Madhyama, Pitta Heena	——	—	———
11	Vaata Ulban`a, Pitta Madhyama, Kapha Heena	———	——	—
12	Pitta Ulban`a, Vaata Madhyama, Kapha Heena	——	———	—
13	Sannipaata (vitiated in similar manner)	———	———	———

——— – Ulban`a (Severely Vitiated Dosha)
—— – Madhya (Moderately Vitiated Dosha)
— – Heena(Mildly Vitiated Dosha)

Types of Sannipaata Jvara:
Sannipaata is called as Abhinyaasa Jvara or Hataujas Jvara. According to Hemaadri, Sannipaata is predominated by Vaayu

Abhinyaasa Sannipaata Jvara if the patient sleeps excessively in Sannipaata Jvara. Abhinyaasa is predominated by Kapha
Hataujasa Sannipaata Jvara if the patient is emaciated. Hritaujasa is predominated by Pitta
Hritaujasa Sannipaata Jvara a Jvara which takes out the Ojas
Sannyaasa Sannipaata Jvara if the limbs are immovable. (Sannyasta Gaatra)
Daahaadi Sannipaata Jvara When patient feels burning sensation first at the onset of Jvara.
S`heetaadi Sannipaata Jvara When patient feels cold sensation first at the onset of Jvara.

Other types:

When burning sensation is first in Sannipaata, then it is difficult to cure than in Sannipaata where cold sensation.
When Aahaara Rasa becomes partly digested or when Pitta and Kapha are vitiated then half of the body turns cold and half remain hot. It resembles to Narasimha (man-lion) or S`hiva.(Ardhanaarinat`es`hvara– half man and half woman)
When vitiated Pitta remains in the body and Kapha in hands and feet, then it produces hotness in the body except hands and feet, whereas hands and feet remain cool.
When vitiated Pitta remains in the hands and feet and Kapha in the body, then it produces hotness in the hands and feet except the body which remain cool.
The symptoms are observed in the Jvara caused by Vaayu, Pitta and Kapha should also be known in those located in Dhaatu. When symptoms of all Dosha are found in fever located in Dhaatu it should be diagnosed as caused by Sannipaata. Similarly, that produced by two Dosha combined should be known by the synonyms of the respective Dosha.

Aagantu Jvara:

This Jvara is caused due to some exogenous factor. It is precededwith pain (Vyathaa). It remains exclusively exogenous for sometime and afterwards becomes associated with Dosha.
Then the symptoms due to Dosha get manifested.
In Aagantu Jvara, these symptoms due to association of Dosha appear after 7 days.
This is the eighth type of Jvara.

Aagantu (exogenous) Jvara can be caused due to following factors:

Trauma(Abhighaata)
Propensity or inclination or the state of being possessed by evil spirits (Abhishanga)
Exorcising or incantation or employment of spells for a malevolent purpose (Abhichaara)
Charge, accusation by the harmed or Rishi, Elderly (Abhishaapa)

The Jvara caused by external factors are in the beginning independent. Subsequently, they get mixed up with the signs and symptoms of Nija(endogenous) types of Jvara. Then also, Aagantu Jvaraashave their own specific causative factors and treatment.

Due to manifestation of disease, inflammation (Vidaaha), and Trauma; another type of Jvaraappears by the same or different causative factors, however, it does not transcend the symptoms of Dosha.

Abhighaataja Jvara:-}
This is caused by an assault / trauma and associated mainly with Vaata.
It resides in the vitiated blood (Dusht`a S`hon`ita) and symptoms are pain, Oedema

Abhishangaja Jvara:-
This is caused by evil spirits. (Bhootaabhishangaja) and associated with vitiated Vaata and Pitta on the physical level. Vaayu aggravates due to ungratified Kaama, Shoka, Bhaya; Pittaaggravates due to Krodha; all the three Dosha aggravate due to Bhootaabhishanga, so Abhishangaja Jvarais associated with Tridosha. Chakrapaan`iconjuncts that Kaamaabhishanga Jvara, a type of Abhishanga Jvara, is associated with Vaataand Pitta.

It is manifested in resemblance with the symptoms of Unmaada. The symptoms which are seen in Unmaada, (eight types of Unmaadadue to taking possession by (Aavesha) Deva, Pishaacchaetc.); also appear in this Abhishangaja Jvara(Bhoota Jvara) There is sudden laughing or crying seen in person who is attacked by Graha.

Abhishangaja Jvara may occur due to contact with poisonous air of the toxic plants and such other toxins. It is cured by specific antidotes.

Graha Aaves`ha, Visha Aushadhiand Vishaall three Dosha are aggravated
Bhaya, Kaama, S`hoka Vaayu is aggravated
Krodhaja Pitta is aggravated

Abhichaaraja Jvara:
Abhichaara is evil Taantrika rituals. Itis frightful. (Ghora / Suduhsaha)
This is Sannipaata Jvara. Due to the evil rituals in Atharva Veda, affected person manifests the symptoms of Manas Taapa. (Poorvam Chetah Tapyate |)

Abhishaapaja Jvara:

Abhishaapa is charge or accusation of Siddha (who have attained spiritual perfection who are expert). It is caused by all the three Dosha (Sannipaata)
This Jvarais intolerable (Ghora / Suduhsaha) and highly frightful.

Praakrita Jvara:
Jvara manifested in spring (Vasant Ritu) and autumn (Sharad Ritu) is curable (Saadhya) Depending upon the nature of the season, Praakrita Jvarais described. Generally Jvara caused by Vaayu is difficult to cure.

Praakrita Jvara in Sharad Ritu:

Pitta which is hot in nature, in autumn (S`harad Ritu) aggravates due to hot causative factors.
Kapha gets aggravated in winter (Hemanta and S`hishira Ritu), and gets precipitated (Prakopa) during spring season.
During rainy season, the water and herbs become sour (Amla) in Vipaaka(post digestion taste)
This results in accumulation of Pitta in rainy season. This accumulated Pittagets precipitated (Prakopa) in autumn (S`harad Ritu) because of the sunlight.
This immediately produces Jvara. The associated Dosha (Anubala) is Kapha.

Praakrita Jvara in Vasanta Ritu:

During first part of winter (Hemanta), the water and herbs become sweet in taste and are cold.
This helps in the accumulation of Kapha. (Chaya) This Kapha gets liquefied (Prakopa) in the subsequent spring (Vasanta Ritu) because of the strong sunrays. The secondary associated Dosha are Vaayu and Pitta.

Vaikrita Jvara:

Vaatika Jvara irrespective of its season of occurrence.
Paittika Jvara if it is occurring during the seasons other than autumn (S`harad Ritu)
Kaphaja Jvara if it is occurring during the season other than spring (Vasanta Ritu)

*Ritu/Dosha*	Praadhaana Dosha	Anubandhee Dosha	Type of Jvara	Saadhya / Asaadhya
*Varshaa*	Vaayu	Pitta, Shleshma	Praakrita	Hard to cure (Duhsaadhya)
*Sharad*	Pitta	Kapha	Praakrita	Curable (Saadhya)
*Vasanta*	Kapha	Vaayu, Pitta	Praakrita	Curable (Saadhya)

In Praakrita Jvara, fasting can not cause any trouble to the patient as it is a nature of Praakrita Jvara. Moreover, Varshaa and S`harad Ritucontribute to Visarga Kaalaso there is no harm in fasting. In Vasanta Ritu, as Kaphaplays a major role in manifesting Jvara, there is no harm in fasting.

Vishama Jvara
All these types of Jvaraare referred as Vishama Jvara because Jvara manifests unequally, irregularly, dissimilarly, differently or inconstantly. It is called as Vishama Jvaraas its onset is irregular, its symptoms and time are irregular and treatment is also irregular.

Irregular onset it may start form head or back or calf region.
Irregular symptoms it may give burning or cooling sensation.
Irregular time it may occur in the morning, afternoon etc.
Irregular treatment it may be cured by Brinhan`a or Langhana etc.

In Vishama Jvara, generally there is association of Aagantu Jvara.

Santata,
Satata,
Anyedyuh,
Triteeyaka,
Chaaturthaka are mostly caused by Sannipaata

Doshagati and manifestation of Jvara
When the channels of Rasa are affected by vitiated Dosha, the spread is all over the body as it is the most proximal of all Dhaatu. As the obstruction becomes distal Rakta, Maamsa etc. the Dosha take longer to reach and thus longer time to manifest. In case of Rakta affection the fever surfaces twice in a day and night, while in case of Maamsa it occurs once a day. In case of Meda affection the fever occurs a day (alternate day). In case of Asthi and Majja affection, fever occurs after every two days (every fourth day)The more distally situated Dosha are the weaker they on e hence owing to the distal situation, they take equally longer time to reach the Aamaas`haya to produce fever.

Some scholars say that Vishama Jvara is caused by invasion of evil spirits (Bhoota Abhishanga)

Manifestation of Jvara in a particular time or the change of its time of occurrence takes place because of the following factors: Strength or weakness of Ritu (Season), Aha (Day), Raatra (Night), Dosha, Manas (Mind), Kaala and Artha (Karma) sensory inputs. Some of the examples are highlighted below.

Satata Jvara dominated by Vaayu and occurring in the rainy season (Varshaa) becomes Anyedyushka Jvara in autumn (S`harad) as a result of the latter season, which counteracts the aggravation of Vaayu.
Chaturthaka Jvara dominated by the Vaata Dosha and occurring in the mid day or mid night of spring (Vasanta) may turn to Triteeyaka Jvara during afternoon or after mid night if patient consumes dry things (Rooksha).
Because of the mental strength of the patient, the Satata Jvara may change to Anyedyushka Jvara.
Otherwise, Chaturthaka Jvara may change to Triteeyaka Jvara, if there is mental weakness.
Because of various acts in this life or the maturity of the result of actions in the past life, the patient becomes free from the miseries of Jvara and gets happiness. Sinful acts lead to more miseries.

Vishama Jvara Sampraapti:

A lean person, when cured from Jvara, indulges in faulty diet and activities, Dosha even if in small quantity aggravate.
These Dosha are excited by Vaayu.
Thus produce Satata, Anyedyushka, Triteeyaka, Chaturthaka, Pralepaka Jvara according to division of the sites of Kapha in successive order.

*Vishama Jvara*	*DoshaSthaana***	**Dhaatuinvolved**	Nature of fever
Santata	Kapha Sthaana	Rasa	Continuous, acute onset
Satata	Aamaas`haya	Rakta	Twice a day
Anyedyushka	Uras	Maamsa	Once a day
Anyedyushka viparyaya	Uras	Maamsa	Remission once in forenoon
Triteeyaka	Kan`t`ha	Meda	Alternate day
Triteeyaka viparyaya	Kan`t`ha	Meda	Remission on third day
Chaturthaka	S`hira	Asthi/ Majja	After every two days
Chaturthaka viparyaya	S`hira	Asthi/ Majja	Remission on forth day
Pralepaka	Sandhi		Continuous

Santata Jvara Sampraapti:

Aggravated and stagnant Dosha due to heaviness, Saama Dosha spread all over the body through the channels carrying Rasa etc. Dhaatu, (especially Rasa Dhaatu Srotas) causing Jvara called as Santata Jvara.
This Jvara is very acute (S`heeghrakaaree) in onset.
Either it gets cured or kills the patient on 7^th, 10^th or 12^th day. It is extremely difficult to endure. (Suduhsaha). It cannot be perverted (Nishpratyaneeka), therefore, it is known to be unbearable.
This is caused due to all the three Dosha. But it manifests according to the dominance of Dosha in respect to the Kaala. (Dosha Kaala Bala Abala)
In Santata Jvara, Dosha involved in manifestation of Santata Jvara, is similar in attributes of season (Kaala), Dhaatu (Dooshya), physical constitution (Prakriti).
In this type 12 factors, viz. 7 Dhaatu, 2 Mala (Mootra, Pureesha), 3 Dosha are also simultaneously involved in this Jvara inevitably.
Chakrapaan`i has opined that Santata Jvara is not a type of Vishama Jvara, as it does not show irregularity. It remains continuously.

Relation of Dosha and duration is specified by Agnives`ha

Vaata cures after 7 days.
Pitta cures after 10 days.
Kapha cures after 12 days.

Depending on the cleanness and uncleanness of Dhaatu, Haatira says that either Santata Jvara gets cured or kills the patient by 14 or 18 or 22 days respectively for Vaata, Pitta and Kapha predominant Jvara.

Satata Jvara Sampraapti:

When channels of Rakta Dhaatu are obstructed and distal then Dosha spread over the body comparatively in longer time, it is Satata Jvara.
Dosha are located in Rakta Dhaatu generally.
Satata Jvara occurs twice in a day and night.
It gets aggravated and subsided depending upon the nature of time. When a time is favorable for Dosha, Jvara manifests. In adverse condition of Dosha, Jvara subsides.

Anyedyushka Jvara Sampraapti:

When Dosha traverse from chest to stomach in a day and night, next day they produce Anyedyushka Jvara.
When these Dosha spread in the channel of Maamsa which has its openings obstructed and they are further longer.
In the day and night, it occurs only once.

Anyedyushka Viparyaya:

When Dosha are situated in chest and stomach, they produce Jvara opposite to Anyedyushka.
This Jvara continuous for whole day and night with remission only once in forenoon.

Triteeyaka Jvara Sampraapti:

When Dosha traverse from throat (Kan`t`ha) to stomach in two days and night, on the third day they produce Triteeyaka Jvara.
The channel of Meda is more distal to Maamsa, so the Dosha reach there relatively in more time and Jvara occurs after one day (at the third day from the previous paroxysm), this is Triteeyaka Jvara.

o It has following subtypes:

Trika Graahee Jvara due to aggravation of Kapha and Pitta Onset is from sacroiliac region.
Prisht`ha Graahee Jvara due to aggravation of Vaata and Kapha onset is from back.
S`hiro Graahee Jvara due to aggravation of Vaata and Pitta onset is from head.

Triteeyaka Viparyaya:

When Dosha are situated in throat, chest and stomach they produce Jvara opposite to Triteeyaka Jvara which has remission on third day.
It remains for first two days.

Chaturthaka Jvara Sampraapti:

When Dosha traverse from head (S`hira) to stomach on the fourth day they produce Chaturthaka Jvara.
The channels for Asthi are more distal so the Jvara occurs after every two days, this is Chaturthaka Jvara.

o It has following subtypes:

Janghaa Poorva Jvara (it afflicts calf muscles in the beginning) due to Kapha Dosha.
S`hiro Poorva Jvara (it afflicts head in the beginning) due to Vaata Dosha.

Chaturthaka Viparyaya:

When Dosha are situated in head, throat, chest and stomach, they produce a Jvara opposite to Chaturthaka Jvara which has remission of fourth day.
It remains for three days. Chaturthaka Viparyaya occurs on second and third day and pacifies on fourth day.
When Dosha afflicts Asthi and Majja, Jvara produced is Chaturthaka Viparyaya. It is again of three types; either Vaataja or Pittaja or Kaphaja. This Jvara subsides on fourth day and continues to be for two days.

Pralepaka Jvara:

When Dosha are situated in joints (Sandhi) they produce Jvara, which is continual.
This Jvara is seen in Raajayakshmaa only.

Some Other Types of Jvara:-

Kaamaja Jvara
Shokaja Jvara
Bhayaja Jvara
Krodhaja Jvara
Vishaja Jvara
Aushadhee Gandhaja Jvara

In some of these Jvara, fever appears first and then the signs and symptoms of Kaama (Passion) etc. are manifested, and in others it happens the other way. The specific features of Kaama etc., described in the context of Jvara get manifested also in other diseases like Unmaada etc., caused by these factors.

In Kaamaja Jvara etc., the mind is first afflicted by passion etc., but the Jvara does not gain strength till such time as the Dosha of the body are vitiated. Similarly, vitiation of Dosha in the body does not gain power for the production of Jvara till such time as the mind is not afflicted by Kaama etc.

Punaraavartaka Jvara (Recurring fever):-
Patient suffering from fever should follow strict Pathyaapathya. This should be continued though he becomes free from fever. Diet and other factors, which trigger Dosha Vriddhi, Jvara reappears. This is called as Punaraavartaka Jvara.

Jeern`a Jvara:
After 3 weeks Jvara can be called as Jeern`a Jvara. Dhaatu become weak and this condition is usually presented with Raukshya, Pleehaa Vriddhi and Agnimaandya.

Diagnosis of Jvara:
Specific diagnosis of Jvara should be confirmed for further treatment decisions. Type of pathology, involved Dosha, Avasthaa, etc are important factors to decide treatment.

Last updated on February 10th, 2021 at 09:58 am