Even a small residue of the deranged bodily Dosha, lurking in the system after the apparent cure of fever, is aggravated by a course of injudicious conduct and indifference to strict regimen of diet, and thus invites a fresh attack * which is known as the Vishama Jwara. A case of Sintata (remittent or continuous) fever has its seat in the vitiated Rasa (serum) and blood † of the organism; while a case of Anyedyilh finds location in the contaminated flesh of the body. The type known as the Tri-tiyaka (tertian-fever coming on every third day) affects the principle of Meda (fat), while the one called Chattuitkaka (quartan-fever coming on every fourth day) affects and is infiltrated into bones and marrow. The last named type is very dangerous. It brings on a simultaneous attack of several other diseases and often terminates fatally. Several authorities include cases of fever due to the malignant influence of evil spirits within the category of Vishama Jwara. 30.
The type of fever which continues for seven, ten or twelve days without any break or remission, is called Santata. A case of Satataka fever is characterised by two distinct aggravations in the course of day and night. Fever of the Anyedyushka type comes on only once a day and one of the Tri-tiyaka type comes on every third i. e. on every alternate day, while a case of Chaturthaka fever sets in every fourth day. 31.
* A case of fever may lapse into a Vishama type even from the very commencement of the attack.
† Vijaya Rakshita, the commentator on Madhava Nidana, says, on the authority of Charak, that by the term Santata are meant here both Santata and Satataka and that they have their origin in the vitiated Rasa and blood respectively.
Just as the ocean is overflown when its water is swollen up by the gusts of wind (Vayu), so the bodily Doshas are aggravated by the bodily Vayu, and give rise to different kinds of fever. Just as the water of the occean floods the shore at flow-tide and rolls back to its former place during ebb-tide, so fever being augmented by the deranged Doshas of the body, rushes out of its lurking place in the organism and manifests itself (or comes to the surface of the skin) during the hours of the specific aggravation of the Doshas, only to be driven back into the deeper tissues and vital principles of the body during the period of their specific abatement, or to be expelled from the organisim at the completion of their perfect assimilation in or elimination from the system. 32.
A case of fever due to any extraneous blow or injury should be treated in the light of its periodicity and aggravation or in other words the nature of the deranged bodily Doshas underlying, or involved in such a case should be ascertained from the periodicity of its aggravation. A case of fever due to the effects of poison is marked by such symptoms, as blackness of the face, burning sensation, diarrhoea, catching pain in the region of the heart, aversion to food, thirst, piercing pain in the limbs, epileptic fits and extreme weakness. A case of fever caused by smelling the pollens of any kind of (strong smelling) herbs (as Hay fever) is marked by fainting fits, pain in the head and sneezing. A case of fever incidental to an un-gratified amorous longing of the heart, or due to any such ardent passion is characterised by aberration or a distracted slate of the mind, drowsiness, languidness, aversion to food, pain at the cardiac region and a speedy emaciation of the body. Delirium marks a case of fever due to grief or terror and shivering characterises one due to a fit of anger. Thirst and fainting fits are the concomitants of a case of fever due to any curse, or ushurcd in through the dynamics of deadly incantations. Anxiety, laughter, shivering and weeping mark a case due to the malignant influence of evil genii. 33 - 34.
The bodily Vayu deranged and aggravated by fatigue, physical waste or by a blow spreads through the entire organism and begets (traumatic) fever. There is another kind of fever which is due to any extraneous cause or which results from the acute stage of any other disease attendant on the body. It exhibits all the symptoms characteristic of each of the deranged bodily Doshas involved therein * 35 - 36.