Diagnosis of Jwara (w.s.
r
to Fever Disorders)
Dr K Kiran B.A.M.S. M.D (Ayu), (PhD)
Essential criteria for Diagnosis
Nava/purana/Madhyama- kala ; Acute/prolonged
Nidana- aharaj-vihara=nija; agantuja
Roopa – pradhana and anubandhi lakshanas
Roopa- Nature of jwara, Jwara vega, vishama jwara
Upashaya,anupashaya- Soumya and agneya
Essential Criteria for Diagnosis
Samprapti- sankhya – Doshic predominance- 8 types
Dhatu gatatwa- Rasadi dhatu- based on clinical features
Prognosis- Dhatu gatatwa, Dosha pradhanata, Kala of
jwara Avastha,vishama jwara
Jwara with other conditions- santamaka shwasa,
jwaratisara
Jwara with upadravas- ojonirodhaja, marmabhighata
Nava/purana/Madhyama- kala ;
Acute/prolonged
• Based on the chronicity of jwara
• Nava/Taruna jwara- Acute- Most of the fever conditions
• Madhyama- fever by systemic infections, multisystemic
involvement
• Purana- chronic unexplained fevers, PUO
Nidana- aharaj-vihara=nija; agantuja
• Nija= as per samprapti of jwara
• Mithyahara vihara- due to faulty food and regimen
• Contact with agni=ingestion, inhalation etc
• Agantuja- other routes of infection= direct contact transmission;
sankramika roga= contagious conditions, entry through mucous
membrane/wounds/cuts/skin
Roopa – pradhana and anubandhi lakshanas
• Jwara with other lakshanas-
• sandhi shoola- vata pradhanaja jwara, antarvega jwara- viral
fevers/post viral arthritis etc
• shira shoola- flu, viral fevers, with sinusitis etc
• twak vikaras- Rashes/lesions
• vibandha
• Kasa- URTI, LRTI
Roopa- Nature of jwara, vishama jwara
• Sustained/constatnt/continuous fever
• Intermittent
• Remittent
• Irregular pattern
Upashaya,anupashaya- Soumya and agneya
• Soumya jwara- sheeta pradhanata- ushna upashaya- fever with
chills/rigors
• Agneya jwara- ushna pradhanata- sheeta upashaya- fever with
profuse sweating/intense heat
Samprapti- sankhya – Doshic predominance- 8
types
• Doshic lakshanas
• Eka-dwi-three dosha lakshanas- fever conditions
• Vata- pains/cramps/temporal head ache,exhaustion etc
• Pitta- daha/raga/bhrama/chardi/hyperpyrexia
• Kapha-continuous fever/heaviness/kasa/shwasa
• Dominant features to be considered for diagnosis
Dhatu gatatwa- Rasadi dhatu- based on
clinical features
• Rasa gata-gurutwa, bahistaapa,angamarda
• Rakta gata-pidaka,sarakta shteevana,daha,raga etc
• Mamsa gata-antardaha,trushna,moha,srushtavit
• Meda gata-atisweda, pipaasa,pralaapa,chardi
• Asthi gata-vireka,vamana,asthibheda,prakoojana,gatra vikshepana
• Majja gata-hikka,shwasa,tamodarshana,marmacheda etc
• Shukra gata-shukra vinasha,prana nashana
Prognosis- Dhatu gatatwa, Dosha pradhanata,
Kala of jwara Avastha
• Sadhya/Sukha Sadhya- rasa raktashrita, mamsa and medashrita
jwara;
• Krichra Sadhya-asthi-majjagata jwara;sannipataja without
upadrava
• Asadhya –shukra gata;sannipataja jwara with upadrava
Jwara with other conditions-
• Santamaka shwasa
• Jwaratisara
Jwara with upadravas-
• Ojonirodhaja- Oja visramsa
• Marmabhighata- shira-hrudaya-basti marmabhighata by jwara
• Raktapitta- bleeding as a complication
Take away message…
• Clarity of lakshanas of various jwara
• Diagnosis-Prognosis
• Various fever disorders can be understood with this approach
• Treatment principles as per classics
