Charak Samhita – Nidana Sthana – Chapter 1 (Jwara Nidana)

Abstract

Charak samhita is an ancient text which deals with medicine. It is written by acharya charaka and is completed by Dridbala. It is

one of the most referenced classical texts by everyone, the students, teachers, practitioners, researchers and Scholars. There are eight parts of the Charak samhita named as Sutra sthana, nidana sthana, Vimana sthana, Sharira Sthana, Indriya sthana, Chikitsa Sthana, kalpa sthana and Sidhi Sthana. In this article we will deal with the first chapter of the Nidana Sthana named Jwara Nidana.

Chapter 1, Charaka Samhita, Jwara Nidana, Nidana Sthana, Synonyms of the Nidana, Types Of Nidana, Jwara, Fever, Symptoms Of The Jwara, Types Of Jwara

Introduction

This chapter deals with knowing the basic principles of Disease which helps in Diagnosis that is Nidana Panchaka that gives a view of the disease. The causes, signs and symptoms, pathogenesis and diet of the disease. The manifestation of the fever, how it is formed in the body, the Doshas involved which are vata, pitta, kapha, tridosha (Three doshas, Vata, Pitta and Kapha), dwandja (with two Doshas, Vatapitta, pitta kapha, Kapha Vata) and the sign symptoms according to that and the importance of ghrita in fever are explained in this chapter.

Synonyms Of The Nidana

  • Hetu
  • Nimitta
  • Ayatana
  • Karta
  • Pratyaya
  • Samuthana

Types Of Nidana

  1. Asatmeyaindriyarthsanyoga (Unsuitable conjunction of the Sense organs)
  2. Pragyapradha (Incompatibility of senses)
  3. Parinaam Or kala (Transformation of time)

Types Of Somatic Diseases

  1. Vataja
  2. Pittaja
  3. Kaphaja

The Psychic are of Two Types

  1. Rajsic
  2. Tamasic

Synonyms Of The Roga

  • Vyadhi
  • Amaya
  • Gada
  • Atanka
  • Yakshma
  • Jwara
  • Jwara

Nidana Panchaka

Nidana panchaka are nidana (etiology), purvarupa (Pre dominal symptoms), Linga (Sign and Symptoms), Upasaya (Therapeutic Suitability) and Samprapti (Pathogenesis).

Nidana (Etiology)

Nidana is the Etiological factor or the disease.

Purvarupa (Pre-dominal symptoms) – The unmanifested symptoms which tend to appear in a disease form.

Linga (Sign and Symptoms)

The manifested Sign and the symptoms.

The synonyms of the Linga are Akriti, Lakshana, China, Samsthana, Vyanjana and Rupa.

Upasaya (Therapeutic Suitability)

The suitable use of the Diet, drugs, And behavior which are contrary to the nidana.

Samprapti (Pathogenesis)

Samprapti is the pathogenesis, Synonyms of the Samprapti is jati and agati.

It is divided according to the sankhya (Number), Pradhanya (Pre dominance), Vidhi (Types), Vikalpa (Proportional variation) and balakala (Aggravation time).

  • Sankhya (Number) – The numbers such as eight types of fevers, 5 types of the gulmas, Seven types of kushta (Leprosy).
  • Pradhanya (Pre dominance) – It consists of Tara and Tama. the prdominance of the dosa is known by relative degrees.
  • Vidhi (Types) – There are two types of Diseases- Innate and Exogenous 3 types according to Tridosha- Vata, Pitta, Kapha.
  • Four Types according to the Prognosis like curable, Incurable, Mild and Severe.
  • Vikalpa (Proportional variation) – Variation in the Strength of the Doshas is known as Vikalpa.
  • Balakala (Aggravation time) – It is the time of aggravation of the Diseases according to the Season going, day, night and intake of the food.

In this chapter , the beginning is with the Nidana (Etiology), The eight diseases arise from Greed, Anger, Malice with the therapeutic principles in brief. Among the Disorders the fever comes first because of its first appearance in the Somatic Diseases.

The eight Causative Factors of Fevers (Jwara)

  1. Vata
  2. Pitta
  3. Kapha
  4. Vata-pitta
  5. Pitta-kapha
  6. Kapha-vata
  7. Tridosha

The vata gets Vitiated by the overuse of rough, Cold and light Substances, Excessive physical exertion, Improper administration of the emetic therapy, Purgation Therapy, Non unctuous enema, errhine therapy (Shiro Virechana). Due to suppression of the natural urges, Prolonged Fasting, INjury, Excessive Sexual Intercourse, Excitement, Anxiousness, Excessive usage of bloodletting therapy and Uneven posture of the body.

Samprapti Of The Fever (Jwara)

Vataja Jwara

Due to various factors the vata doshas get vitiated and entres into the Amasya (Stomach), There it is mixed up by the heat which is the initial dhatu that is produced by food Digestion which is known as Rasa, It blocks the channels of the Rasa and Sweda which affected the agni and extract out the heat from the seat of the digestion and Spreads it to whole body.

Symptoms Of The Vataja Jwara

  • Irregular oncet
  • Unstable mind
  • Irregular Temperature
  • The fever gets aggravation at the end of the Digestion, Day, Night and the Summer
  • Roughness in nails
  • Reddishness in the Nails, Urine, Stool, Face and skin
  • Tearing of the nails
  • Shifting pains in the body
  • Numbness
  • Cramps in calf muscles
  • Laxity in the joints
  • Lassitude in thighs
  • There are aching, burning, churning, pressing, extracting and constricting pain in the back, side, waist, shoulder, arms, scapula and Chest region.
  • Tinnitus
  • Loss of jaw function
  • Pain in temporal lobes
  • Astringent taste in mouth
  • Dryness of the mouth
  • Dryness of the throat and palate
  • Thirst
  • Cardiac Pain
  • Vomiting
  • Dry cough
  • Loss of appetite
  • Aversion towards the food
  • Indigestion
  • Malaise
  • Yawning
  • Bending
  • Giddiness
  • Exhaustion
  • Giddiness
  • Horripilations
  • Interest for Hot Things
  • Suitability of the contrary and unsuitability of the factors mentioned in aetiology.

Pittaja Jwara

Due to intakes of pitta aggravating factors such as excessive use of hot, saline, sour, alkaline food, Intake of food during Indigestion, Excessive exposure to the sun and fire, anger, unstable meals, the pitta dosha gets vitiated. This pitta dosha when comes in contact with the heat in the amasaya (Stomach), It hampers the rasa dhatu which is formed by the digestion of the food which blocks the channels Carrying Sweda and rasa, this disturbs the agni due to liquidity and extract out the heat from the site of the digestion and spread it to the whole body which produces pain and fever.

Symptoms Of The Pittaja Jwara

  • Fever arises simultaneously in the body
  • In mid digestion of the food
  • At Midday or midnight
  • Autumn season
  • Inflammation of the nose, Mouth, Lips, Throat and Palate
  • Thirst
  • Narcosis
  • Fainting
  • Giddiness
  • Fainting
  • Vomiting of the bile
  • Diarrhoea
  • Dislike for Food
  • Sorrow
  • Malaise
  • Sorrow
  • Delirium
  • Red Patches on the body
  • Yellowishness and Greenishness of the Nails, Eyes, stool, urine, Mouth and Skin
  • Hyperpyrexia
  • Burning sensation
  • Desire for cold things
  • Unsuitability of the Etiological factors

Kaphaja Jwara

Due to intake of the kapha aggravating factors such as Excessive use of the heavy, oily, sweet , slimy, cold, sour, substances. Day sleep, Happiness and Lack of Physical Exercise, It gets vitiated. This vitiated Kapha entres the Amasya (Stomach), it mix up with the heat in the Amasya (Stomach), It hampers the rasa dhatu which is formed by the digestion of the food which blocks the channels Carrying Sweda and rasa, which impaired the agni and takes out the agni from the site of the Digestion and spread it to whole body.

Symptoms Of The Kaphaja Jwara

  • Increased temperature in the body immediately after meals, Forenoon, Early night, or in Spring seaso
  • Heaviness
  • Aversion towards the food
  • Increased Salivation
  • Sweet in taste
  • Nausea
  • Sensation of the coolness
  • Vomiting
  • Loss of appetite
  • Increased sleep
  • Stiffness of the body
  • Cough
  • Dyspnoea
  • Whitishness in the nails, face, eyes, urine, skin and stool
  • Appearance of the Urticarial patches
  • Desire towards heat

Tridoshaja Jwara (Sanipattika Jwara)

Intake of improper food, Irregular meals, Fasting, Seasonal disturbances, smell, Poisonous water, poisonous substances, Improper administration of the Unctuous, sweeting, emesis, Purgation.

Improper diet regime after the purificatory measures, Abnormal Delivery, Improper postpartum management, Mixing of the causes mentioned, Aggravation of the tridoshas, Leads to tridoshaja jwara.

There are mixed symptoms of the Jwara depending on the Dosha aggravation in tridosha jwara. If the 2 dosha are involved it is termed as dwi doshaja.

These are the 7 types of fever, which can be distinguished on the basis of the symptoms, Treatment and Causes. It is managed with general measures.

Pyrexia is the only specific symptom of the Fever which is of two types according to the liking (Desire for cold and desire for heat) and also for the character innate (nija) and Exogenous (Agantuja).

The innate (Nija) is again of two types, Three types, four types, seven types.

  1. Two types (by combination of the 2 doshas)
  2. Three types (Caused by the 3 Single Doshas)
  3. Four Dosha (By 3 single doshas and sannipata)
  4. Seven types (Caused by the 3 single doshas, three duals and sanipattaja)

Prodromal Symptoms Of Fever

  • Loss of taste in mouth
  • Heaviness in the body
  • Aversion towards food
  • Congestion in the Eyes
  • Lacrimation
  • Excessive Sleep
  • Uneasiness
  • Bending
  • Yawning
  • Trembling
  • Exhaustion
  • Giddiness
  • Delirium
  • Horripilations
  • Sensitivity in teeth
  • Intolerance towards the sound, wind, Coldness and Sun
  • Loss of Appetite
  • Food is not Digested properly
  • Debility
  • Pains in body
  • General weakness
  • Decreased vitality, lassitude, lethargy
  • Hampers normal activities
  • Aversion towards the Activities
  • Intolerance towards the words of the Elders
  • Dislikeness towards childrens
  • Absent minded
  • Difficulty in use of Garlands, food and Paste
  • Desire for Sour, Saline, Pungent Things
  • 0Rise in body temperature

Fever is basically arrived at by the anger of the Maheswara, fever takes away the life of all the Living beings and also causes disturbances in the body, senses, Decreases the intellect, Strength, Complexion, Joy and Enthusiasm. It produces tiredness, Confusion and makes it difficult to take food. It is named as Jwara because it brings Displeasure to a person. There is no disease other than jwara which is so severe, Complicated and is difficult to manage. It is considered as the King of all diseases and it has many different terms in various animals. All the living beings are born with fever and die with Fever. It is a Great Bewilderment, Because of the presence of the jwara the living beings do not recollect anything of their previous birth and it itself takes away the life at the end.

In the beginning, when the prodromal symptoms appear, Intake of the light food or saturation (fasting) is advised. This is because the fever originates from Amasya. Afterwards according to the condition of the patient the administration of the extracts, Massage, fomentation, unctuous, Pasting, Sprinkling, emesis, Purgation therapy, Non unctuous and Unctuous enema, Measures of Pacification, Snuffing, Fumigation, Collyrium, smoke, Milk and other dietary regimens are to be done.

Although, In all types of chronic fever (Jirna jwara). Consumption of the ghee make of proper drugs is recommended because the Ghee does the pacification of the Vata due to Unctuousness property, Pachifies kapha because of its processing and pitta dosha due to its cold effect, So all the Chronic Fevers the ghruta is beneficial and wholesome just like water on the substances which are burning with fire.

Verses

The effect of the sprinkling of the water on the burning House, is the same as the administration of ghee in chronic fever. Ghee pacifies the Vata dosha because of Unctuousness, Pitta dosha due to Coldness and Kapha Dosha due to similar properties during processing. Ghee is considered as the best among all fats due to its properties of samkara (Processing with the drugs).

Conclusion

In first chapter of the Nidana Sthana, the threefold aetiology with the explanation of the symptoms, synonyms, Fivefold Diseases their synonyms and symptoms of the disease, Eightfold fever, its causes, Prodromal symptoms, Symptomatology and Management has been explained.