7. Description and treatment of Fever (Jvara)

Jvara or fever occupies the first place among physical ailments. So Somesvara's Manasollasa describes it first and tells that Jvara or fever is the king of all diseases. 104. ksiramadhye ksipennilam dugdham cennilatam vrajet | indranilah sa vijneyo ravinandanavallabhah || 2.4.505. 105. gauravam svacchata kantih kathinyam ratnaja gunah || 2.4.531. 106. dosaistyakto gunairyukta indranilo mahamanih | yasya haste bhavet tasya vittamayurbalam yasah || 2.4.504. 107. sevalavallaricchayam suragam trasavarjitam | anarghyam tam marakatam prahuh sarva visapaharam || 2.4.518.

344 108 Caraka-Samhita says that there are eight types of Jvara. In Manasollasa it has no definite number. Somesvara divides on the basis of dosas, viz. Vatapitta Jvara, 110 vata-jvara, and so on (1.19.160-196). 109 Caraka-Samhita 111 further tells the causative factors of the fever. The factors responsible for the causation of fever in human beings are vata, Pitta, Kapha, vatapitta, vatakapha, Pittakapha, Vatapittakapha. There is other extrinsic factor also. Only the immediate causes of fever are mentioned here. These causes are concerned with the fever of human beings only. Those of the other animals like horses, elephants, cows, and birds may be different. 108. carakasamhita - nidanasthana 102. samkhya tavadyatha astau jvarah, pancagulma, sapta kusthanyevamadih | 109. bilvam bala prthakparni nagaram dhanyakotpalam | etaih peya krta deya vatapittajvarapaha || 1. 19.160. 110. murva - nimba-patola tivisa-dhanvayavasakaih | sunthi-mustamrtayataih kvatho vatajvarapahah || 1.19.185. ||| . carakasamhita - nidana sthana | .17. atha khalvastabhyah karanebhyo jvarah samjayate manusyanam tadyatha-vatat pittatu, kaphatu vatapittabhyam vatakaphabhyam pitta- kaphabhyam vatapittakaphebhyah, agantorastamat karanat || -

• 345 Somesvara's Manasollasa gives the names of animals' fever, 112 Fever birds' fever, the fever of plants and so on. caused by all these categories has one thing in common, that is, pain precedes the occurrence of fever in all such causes, hence they are treated as of one type in the eight-fold classification of Jvara. Hence, Somesvara says "there is only one type of Jvara, but it has many names." Treatment of fever During the stage of Purvarupa (premonitory symptoms) or in the primary stage of Jvara, intake of light food or fasting is useful, because amasaya (stomach including small intestine) is the site of origin of this disease. There is no contradiction in these statements because the intake of light diet is only a form of Langhana and 112. jvaro naresu vikhyatah pakajasyamajanmasu | abhitapasturangaisu revako ramesvasau || ustrenvalasakah prokto gosu proktastathesvarah | agniko dandasakesu haridro mahisesvapi || ajaviko pralepassyanmrgarogo mrgisvapi | avapatah sakuntesu matsyesvindramadabhidhah || gulmesu granthiko jyotirvanaspatyosadhisvapi | puspesu parvatah prokto rupako nalinisvapi || 1 dhanyesu curnakah khyatah kodravesu lalah smrtah | sakesu madhuko bhumyamuparo'psu ca nilika || 2.6.639-643.

346 113 produces lightness in the body. Further in Vatika type of Jvara complete fasting is prohibitted as it aggravates Vata taking part in the pathogenesis of the disease. In such a condition, intake of light diet is Normally, even light diet should aggravate prescribed. 3 Vata, but it does not do so in a patient suffering from Jvara because the site of origin of disease is amasaya and all aggravated dosas residing here including Vata are corrected by the intake of light diet. Manasollasa discusses the preparation of medicines or Kasayas and its utility for fever and other diseases. In all the types of chronic fever, and other diseases 114 intake of ghee is beneficial, because it acts both against the diseases as well as the dosas involved. "As people spray water over a house set on fire, so also ghee should be used with a view to alleviate chronic 113. ekabhaktam tatha peya mando va kosnavarina | dosakopanusarena langhanam vividham smrtam || 1.19.53. 114. saktupistakamasniyat pibecca svatu panakam | Cf. ghrtam va kevalam pitam madatyayaharam param || 1. 19.225. mahabharata santiparva 309.18. viraktasya yatha samyag ghrtam bhavati bhesajam | tatha nirhrtadosasya pretya dharmah sukhavahah || """

347 115 fever and other diseases. Vata is alleviated due to latter's unctuousness, Pitta due to coldness and even Kapha due to suitable method of preparation. In the Manasollasa, Somesvara further discusses all types of Jvara, and many varieties of medicines. Raktapitta (a disease characterised by bleeding from various parts of the body) is caused by the heat of Jvara. This Raktapitta is not the combination of rakta (blood) and pitta. `It is only a pathological state of pitta. This disease manifests itself in two ways either through upper tracks or through the lower tracks. In a patient having the dominance of Kapha in his body, the disease manifests itself in blood coming out through the upper tracks, viz. ear, nose, eyes, and mouth. In a patient whose body is dominated by Vata, the disease manifests itself in blood coming out through the lower tracks, viz. the urethra 115. carakasamhita nidanasthana | . 38. yatha prajvalitam vesma parisincanti varina | narah santimabhipretya tatha jirnajvaro ghrtam || 116. tato ghranasya karnebhyah payu-mehanamargatah | pravartati tatah khyatam raktapittam bhisamvaraih || ekadosam navam cordhvam valinascanupadravam | raktapittam sukhat sadhyamadhasced yanyamucyate || adhascordhvam ca calitam tridosam bharyupadravam | asadhyam raktapittam tat tyajaniyam bhisamvaraih || 1.19.201 - 203.

348 the tracks enumerated above. and anus. In a patient whose body, is dominated by both Kapha and Vata, the disease manifests itself through both The first type of the Raktapitta, where the upper tracks are affiliated, is curable because of its amenability to purgation therapy and also because varieties of drugs are available for the treatment of this condition. The second type of Raktapitta is called by Somesvara as Yapya. Yapya type of Raktapitta, where the lower tracks are afflicted, is palliable because of its amenability to emetic therapy and also because of the limited varieties of drugs available for its treatment. The third type where both the upper and lower tracks are afflicted is incurable because it is neither amenable to purgation nor to emetic therapy and no medicine is suitable for the treatment of this condition. Hence Somesvara's advice is "the enlightened Physician should not take incurable patient in hand. The palliable patient should be maintained with appropriate therapy. The curable one should be treated carefully 117 with proper medicine leading to cure. Somesvara 117. carakasamhita nidanasthana 2.27. tatrasadhyam parityajyam yapyam yatnena yapayet | sadhyam cavahitah siddhairbhesajeh sadhayed bhisak || :

349 describes the Kasaya which is meant to control the Raktapitta. 118 After dealing with fever, its characteristic features, and remedies, Somesvara continues to explain on similar lines many other diseases. The details of them are given below. (1) Ksaya: Somesvara says that highly polluted air enters the body and increases Pitta and Kapha. Then it enters the joints of the body. Thus Ksaya is caused. According to him, the patient of this disease should swallow the Curna of Rasna, Tila and Bala mixed with ghee, Yastik (Jesthamadhu) and Utpala to get cured from this disease. 119 118. syama trivrtkasayena tatkallena sitanvitam | loham vipanitam dadhat karsamatramasrgharam || pippali triphala syama sarkara trivrta madhu | etaih krto modako'yam sannipatottharaktajit || 1.19.204-205. 119. bhrाm prakupito vatah kaphapittamudirayet | dehasandhin samavisya ksayarogam samavahet || rasna - tila-balacurna saptarpiryastakotpalam | avalidham harecchesamagnimandham ca nasayet || 1. 19.213 2140

350 (2) Chardi-roga (Vomitting): Somesvara has mentioned that this disease is caused by taking into the stomach the food which is not at all suited for health. 120 According to him this disease can be remedied by making the patient drink the mixture of honey, Kasaya made from the budding leaves of Jamboo, Cuta, Bala, Usira, Vata and Sunga. 121 122 (3) Madatyaya, Moha, Bhrama, Tandra, and Pralapa. Somesvara says that these are caused by excessive and faulty drinking of wine. Madatyaya lasts for about five to seven days. If it lasts for more days than this, it 123 is to be understood that it is some other disease. f 120. anistannopayogena marutah kupito bhrsam | udanah kurute (chardi nabhiprstharujanvitam || 1.19.215. 121. jambu - cuta - balosira - vatangavarohajah | caudrena sahitah kvathah pitaschardivinasanah || 122. hinamithyatipanena bhavatyasu madatyayah | chardirmoho namastandra pralapo jayate tatah || 1.19.218. 123. pancaham saptaratram va jayate'sau madatyayah | ata urdhva prasaktasced rogo'nyah parikirtyate || 1. 19.219. i

351 Somesvara has said that this disease can be remedied by eating 'Saktupista' with the mutton extract of goat, deer, rabbit, Tittira and Lava birds or by drinking sweet 124 Somesvara says that these are the Panaka or ghee. best remedies to cure such diseases. (4) Arsas: He says that this is a disease caused by the protrusions (Ankura) appearing in the region of Gudadvara (Anus) and intestine (Antravali) as a result of 125 prolonged maladharana (constipation), Somesvara has suggested that this disease be remedied by applying the paste formed by the mixture of Sxngi, Haritaki, Kusta, Bhallataka fruits, and Tuthya (Blue-vitriol) at the region Further he has suggested that applying of Gudadvara. 126 124. svapah pralapabahule yojaniyo madatyaye | chaga- tittira-lavaina- sasamamsarasairyutam || saktupista = kamasniyat pibecca svadu panakam | ghrtam va kevalam pitam madatyayaharam param || 1.19.224-225. 125 gudantravalisambhuta vistadharanahetukah | akkurah kathitah prajnairarsarsasityabhidhanatah || 1.19.226. 126. srksni haritaki -kusta-bhallatakaphalaih krtaih | laipastutthasamopeto gudakilavinasanah || 1. 19.227.

352 the paste formed by Mula, (Amarphophallus), Sighrublja (Drumstick seed), Nimba (Neem) and Asvatha leafs, Bilvafruits, akroda root (or palumula) and Ramatha at the Gudadvara eradicates the Ankuras (Protrusions). 127 (5) Atisara : Somesvara says that this is due to over-drinking of water. He has hinted at the remedies * for the three types of this disease. Disease 1. Amatisara Remedy Kasaya of the curnas of Ramatha, or Nagara, `Musta, Ghurnavallabha, should be taken along with food into the stomach to promote digestion of food. 127. mulaih sinubhavairbijairnimbasvatthadalairapi | bilvena pilumulena ramathenapi lepatam || 1. 19.228. 128. atyambupanajjayeta sutaramatisarastu | amah pakvah sarakasca tridha'sau vyadhiriritah || tatrane nagaram musta tatha va ghunavallabha | taccurnam vatakah kvathah pacanaya prayujyate || 1.19.230-231. 1

353 2. Pakvatisara 3. Raktatisara The mixture of honey, with boiled Jambupallava, Dhataki, Jiraka, cutabija, Mahavrksatvaca, Bilva, Aranala, Gokanta, Pancangula and Yava is the medicine for this 129 disease. The Kasaya of the mixture of Visa, Kutajabija, Musta, Valaka and Bilva is a medicine for this 130 disease. kh Further Somesvara has stated that a person who does not take hygenic food while suffering from Atisararoga, suffers from a disease called Grahaniroga. He has said that Grahaniroga can be remedied by taking the Kasaya of Sunthi, Atlvisa Musta and also Guduc 1. 129. pakvatisare datavyam jambupallava - dhataki | jirakamh cutabijam ca mahavrksatvacastatha || bilvaranala-gokanta - pancangulayavaih ta | svinna ksaudrayuta pathya pakvatisarabhesajam || | .19.232-233. 130. visam kutajabijam ca musta valaka - bilvakam | ta . kvatho vinihantyasu raktatisaramulbanam || 1.19.234.

17 354 Regarding Mutrakrchra, Somesvara says that it starts pain in the joints of the body especially in Mehana (Urine track). He has mentioned the remedies for the Mutrakrchra disease. According to him this disease can be remedied by making the patient drink Kasaya made from Urabuka, Bala, Bilva, two pancamula (Laghu Pancamula and Brhat Pancamula), Yava, Punarnava, Bhirumula, Kulattha, Badara, Matsyaksa, Matsyabheda and mixed with ghee as well as oil. The fat of a hog and bear mixed with fine lavanas (Samudra, 131 Saindhava, Bidala, Pade and Kacala lavana) should be fy added to the Kasaya Somesvara says that these are the best remedies to cure such diseases. Thus we find that Somesvara has shown keen interest in the eradication of various diseases. This also exhibits his deep knowledge regarding the use of various medicinal plants and herbs, though he was a king. 131. urubako bala bilvam pancamuladvayam yava | punarnava bhismulam kulatyam badaram tatha || " matsyaksam-matsyabhedam ca tat sarvam ca samam krtam | tatkvathena sakalkena sarpistailayutena ca || sukarasyacchamallasya vasaya misritena ca | panca silavanaih sarddham sulam pitena hanyate || 1. 19.240-242.