Abatement of the bodily heat, lightness of the body and an easy passing of stool and urine are the indications from which the assimilation of the deranged bodily Doshas should be presumed, and it is then that febrifuges should be administered according to the nature of the deranged bodily Doshas underlying the case under treatment *. Some, however, believe that the assimilation of the deranged Doshas should be presumed from the changes in the symptoms characteristic of the Doshas. 51.
A crushing sensation in the region of the heart, drowsiness, salivation, aversion to food, non-assimilation of the deranged bodily Doshas, suppression of stool (and wind), copious discharge of urine, laziness, sense of heaviness in the abdomen, stoppage of perspiration, undigested stool, dissatisfaction, somnolence, heaviness and numbness of the limbs, dulness of appetite, bad taste in the mouth, a sense of physical languor and increased virulence and continuity of the attack of fever (abnormal rise in the bodily temperature) are the symptoms by which a learned physician should ascertain the undigested state of the deranged bodily Doshas ushering in an attack of fever. 52.
* Some read these two lines in a different way. They would mean that the non-assimilation (A'ma) of the deranged Doshas would he presumed by the presence of high fever, heaviness of the body and stoppage of the excreta (Mala), and the reverse is the sign of their assimilation (Paka).
According to several authorities, medicines (febrifuges) should be given in a case of fever after the seventh, or according to others after the tenth day of the attack. Febrifuges may be administered earlier in the cases of Pittaja fever, or in the event of the deranged bodily Doshas being digested earlier. An administration of (febrifugal) medicine in an undigested stage of the fever is sure to produce a recrudescence of the disease. Corrective, purifying and soothing (Samaniya) remedies (in a case of fever with undigested Dosha) helps the lapse of the disease (fever) into a Vishama type. 53 - 54
The spontaneous motions of the bowels (Mala) of a patient suffering from fever should not be stopped unless they are excessive, when the case should be medically treated as one of Atisara (Diarrhea). 55.
A suitable purgative should be administered even in a case of acute fever if the digested Malas (frecal matter etc.) are accumulated in the internal passages of the Koshtha (abdomen), in as much as their presence in the organism in that undigested state may usher in an attack of Vishama Jwara attended by distressing symptoms, or may produce loss of strength. Hence they should be eliminated from the system with the helf of emetics, etc. Emetics, Asthapana-enemas, purgatives, Siro-virechana and errhines should be successfully employed for the purpose. Emitics should be at the outset exhibited in a case of Kaphaja fever where the patient would be found to be a person of considerable physical strength, and purgatives should be given in a case of fever marked by the predominant action of the deranged Pitta in the event of there being laxity of the bowels (intestines). Nirudha-vasti should be applied in a case of Vataja fever attended with aching pain in the limbs and with Udavarta (obstinate constipation of the bowels), whereas Anuvasana-vasti should be prescribed for a patient with a strong appetite, if there be pain in the regions of the back and the waist. Siro-virechaiia (head-purgative) should be adiministered in cases marked by the accumulation of the deranged Kapha in the head, as the pain in and heaviness of the head would be relieved, and the sense-organs roused up thereby to their normal functions. 56-A.
A plaster composed of Deva-daru, Vacha, Kushtha, S'atahva, Hingu and Saindhava pasted together with Kanjika should be applied lukewarm to the abdomen in a case of fever attended with painful tympanites if the patient be weak, whereas a medicated plug (Varti) prepared with the above drugs should be applied into the anus in a case marked by the upward coursing of the bodily Vayu attended with suppression of stool and urine, and Yavagu prepared with Pippali, roots of Pippali Yamdni and Chavya should be given to the patient as a potion, it being remedial for the deranged bodily Vayu 56.