The Divine Dhanvantari, who in his first incarnation arose out of the primordial Ocean with a pitcher of ambrosia on his head, (when it was churned by the gods and the demons) and who conferred immortality on Indra and his brother celestials, was thus interrogated by his disciples, Sus'ruta and others "You have instructed us, O, you, the foremost of physicians, the subject on all the concomitant distressing symptoms (Upadrava) of Ulcer Vrana). Now let us have a general outline and detailed description of the concomitant distressing symptoms, physiological an 1 pathological conditions e. g. fever, dysentery, cough, etc. showing in an ulcer-patient. An ulcer attended with many a concomitant symptom Upadrava) may be cured only with the greatest difficulty and such concomitant symptoms appearing in an emaciated and weak ulcer-patient, take time to be subdued because of the loss of his Doshas and Dhatus. Hence illumine us fully, O sir, on those diseases affecting the whole body (and not localised in any particular limb or organ) observed by the holy sages of yore, and instruct us the nature and application of the therapeutic agents to be employed in their cure". 2.
To the query of the disciples, the divine physician, Dhanvantari replied as follows: - "First 1 shall discourse on the nature and origin of fever for it is the king of all bodily distempers in as much as it affects the whole orgainsm at a time. It was begotten by the fire of wrath of Rudra, and afflicted the whole animal world or organic kingdom. The different names by which it is designated amongst the different kinds of animals are well known. Its presence is perhaps an indispensable condition under which a creature can come into being or can depart from this life, and hence it is called the lord of ailments and none but a god or man can bear the heat of fever. Men may become gods by virtue of their good deeds (Karma) in life and would again revert to humanity (mortality) at the close of their blissful effects, and it is this divine or godly element in man that enables him to bear this abnormal heat of fever whereas the lower animals are simply lost under its influence. 3.
Definition and Classification of
Fever: -The disease which is marked by the arrest of the flow of perspiration, by increased heat (of the skin), by pain all over the body and by a sense of numbness in the limbs, is called Jwara (fever). Cases of fever of which the causes are numerous, are divided into eight types according as they are brought on through the derangement of the three bodily Doshas separately, or through that of any two of them in combination or through their cencerted action, or by any extraneous causes * 4-5.
When the Doshas of the body are deranged by their respective aggravating causes and in the hours of their specific dominance † they bring on an attack of fever by of deadly incantations or charms, curses (from Brdh-manas and superiors), any fancied dread or anxiety, effects of miscarriage or untimely parturition, injudicious conduct of life on the part of a woman after delivery, and the first accumulation of the milk in the breast (after delivery) are the causes which lead to an attack of fever, the derangement and aggravation of the fundamental vital principles (Doshas) of the body being the existing origins of the disease. The stomachic heat is propelled by the extremely deranged and aggravated Doshas of the body, and, coursing through the wrong channels in the orgainsm, tends to escape through the surface (the skin of the body) and, by incarcerating the vitiated Rasa Dhatu generally causes a rise in the bodily temperature and puts a stop to perspiration. 8 - 9.
* There can be three cases of fever due to the derangement of the three Doshas separately, three cases from the derangement of two of them at a time and one case only from the concerted action of the three Doshas These are the seven cases while that due to an extraneous cause is the eighth.
† Kapha is aggravated in the morning, Pitta, at noon and Vayu, in the evening. Fever follows a distinct periodicity determined by the spreading through the whole organism. The deranged bodily Doshas augmented or enraged by their specific aggravating causes, enter into the Amas'aya and soon find lodgment in the Rasa (lymph-chyle) by virtue of their inherent heat Ushman). The Doshas thus deranged and mixed with Rasa obstruct the Rasa-carrying and sweat-earning ducts, impair the digestive fire and expelthe inherent heat (Ushman) out of its seat in the Pakvas'aya, and spreading all over the body during the period of their specific dominance, bring on fever and causes its rise and exhibit their specific colour on the skin, etc. (of the patient), 6 - 7.
Pathology: - The improper and excessive application of Sneha, etc., any kind of blow, the presence of any other affection in the organism, suppuration (of an existing boil or ulcer in the body), over-fatigue, any process of physical waste, indigestion, introduction of any extraneous poison or poisonous matter into the system, infringement of any habitual rule of diet and conduct, the sudden change or contrariety of seasons, the smelling of any kind of poisonous herb or flower, grief, the malignant influences of inaus picious stars or p'lane':s (at the time of birth), dynamics time of aggravation of the deranged bodily Doshas ushering in the attack An attack of fever due to the deranged Kapha comes on in the morning or after dusk ; one due to the deranged Pitta comes on at noon or midnight, one due to the deranged Vayu comes on in the afternoon or during the small hours of the night. In a case of Dvi-doshaja fever (due to the combined action of the two deranged bodily Doshas) the heat is aggravated during the specific hours of domination of the stronger Dosha and continues through those peculiar to each of them. All night attacks should be regarded as connected with the action of the deranged Pitta. In a Tri-doshaja case, the heat comes on with the specific hour of the strongest one and is abated on the approach of the time peculiar to the weakest. Vayu is aggravated in the Varsha (rainy) season, Pitta, in the S'arat (autumn) and Kapha, in the Vasanta (spring).
A sense of fatigue or physical languor, aversion to all sorts of work, paleness of complexion, bad taste in the mouth, tearfulness of the eyes, alternate liking and dislike for heat, cold and air, constant yawning", aching of the limbs, a sense of heaviness of the body, horripilation, disrelish for food, darkness of vision, depression and a feeling of creeping cold in the body are the general premonitory symptoms which usher in an attack of fever Constant yawning, burning of the eyes and aversion to food are the special premonitory symptoms of the derangement of Vayu, Pitta and Kapha respectively. The derangement of all the three Doshas is marked by the presence of all the symptoms, while, in the derangement of any two of these, the special symptoms of those two Doshas appear. 10.