Fever (Jwara)

Fever is the first disease discussed in Ayurveda. This is because it can be so serious if not treated effectively and efficiently as it may lead to complications such as Chronic Fatigue Syndrome and wasting. Also every human experiences a fever from time-to-time and it is clinically important to know the causes and how to cure it.

There are eight types of fever in Ayurveda ranging from internal to external to parasitic to seasonal and mental. Here we will deal with the internal physical types.

Cause (Nidana): Mityahara Viharabyam dosha amashaya asraya:

Incorrect food and wrong behaviour disturbs the agni which accumulates in the stomach. In turn this disturbs the balance of the dosha which collect in the stomach and then overflow into the skin and circulatory system (rasa dhatu).

Incorrect food is food that

• is taken before the previous meal has been digested
• causes allergenic reactions
• is incompatible (eg. milk and fruit)
• is constitutionally inappropriate for the person eating the food (ie kapha types eating ice cream in the middle of winter).

Premonitory signs: (Purvarupa )

Signs of ama, heaviness, laziness, fatigue, low agni, indigestion, yawning, uncertainty, dissatisfaction, depletion of strength, paleness, watery eyes, feeling chilly.

Vataja : excessive yawning, indigestion

Pittaja : burning sensation, sore throat

Kaphaja : aversion for food, heavyness

Signs and Symptoms: (Rupa)

Increase in body temperature, absence of perspiration, disturbed digestion, unusual bowel habits, lack of appetite, body stiffness, muscle aches and mental restlessness.

The general signs of the three dosha are:

Vataja jvara: Commonly appears in the summer and winter (as vata has accumulated in the spring and autumn). Feeling cold, desires hot things, dryness of the throat and lips, insomnia, absence of sneezing, dryness of body (skin, mouth, stools, cough), headache, bad taste in mouth, hard stools, colic, bloating, flatulence, yawning, alternating hot and cold, mild temperature, weakness.

Pittaja jvara: Commonly manifests during the autumn (as pitta has accumulated in the summer). Feeling hot, high temperature, fast onset, diarrhoea, desires cold things, restless sleep, nausea, vomiting, sore throat, red eyelids, excessive perspiration, acrid taste in mouth, fainting, burning sensation, yellow stools, thirst.

Kaphaja jvara : Commonly manifests in the winter and spring (as kapha accumulates in the early winter). Feeling cold, heavy, damp, phlegmatic, desires hot things, slow rise in temperature, sweet taste in mouth, burning and cold sensation . kapha fever has many signs of ama.

They can combine to form mixed patterns requiring appropriate treatment.

Pathogenesis (Samprapti)

1. Ama and agni, which should be contained within the gastrointestinal tract overflow into the plasma and lymphatic system (rasa) and blood (rakta) and circulate all over the body.
2. Pacaka pitta in the stomach gets vitiated by ama and is taken into the bloodstream. These two circulate causing the typical symptoms of fever- aching, heaviness, high temperature etc.
3. The three aggravated dosha spread throughout the plasma tissue (rasa dhatu) and dislodge the digestive fire (jatharagni) from its place causing it to enter the circulation. Being supplemented with its own heat plus the heat of the jatharagni, the body temperature rises and causes symptoms of fever.
4. The channels (srotas ) also get obstructed by the vitiated dosha and, and this further aggravates the dosha and the intermingling with misplaced digestive fire thus causing more heat

Treatment (Cikitsa)

Order of treatment:

• Fasting (langana)
• Sweating (swedana)
• Waiting/Patience (kala)
• Light diet (yavagu)
• Bitter drugs (tikta bheshajam)
• Detoxification (ama pachana)

1. Except when vata is heavily aggravated fasting (langhana/ is the best treatment . Take a liquid diet of vegetable broths or just hot ginger water. This alleviates the aggravated dosha and stimulates the appetite. Avoid sleeping during the day, stop taking baths, avoid massages, heavy food, sex, anger, exposure to wind, exercise and astringents herbs and foods. Try and provoke a sweat at this stage.
2. Purify the body of toxins (ama pacana). Use hot water and ginger to digest toxins. Mix bitter and pungent herbs to rapidly clear toxins from the system (Guduchi and ginger is a favourite mixture).
3. When the fever progresses to being a full blown fever with vitiated pitta and ama stronger medication is required. Traditionlly Mahasudarshan Churna is given but this banned in the UK, so we have made Andrographis Tonic Formula instead. It helps to burn ama whilst reducing fever and toxins.
4. Ayurveda always uses a mild purgative regime after a fever breaks. This is to expel the remaining ama. I often use castor oil or our Triphala Plus mixture.
5. Follow a preventative regime to reduce the chances of a reoccurrence. For vata and kapha types, take strong digestive formula such as Asafoetida Plus or Trikatu to burn out ama. For pitta types use milder digestives such as our Amalaki Formula.