Ayurveda describes Jwara as the most powerful disease which is capable of affecting the body, mind and the sense organs. Increase in temperature of body and mind (disturbed mind or thoughts) is considered as the main symptom of the disease.
Jwara is a Rasadhatu Pradoshaja disease which affects the Abhyanthara roga marga which includes the kosta or the amashaya and pakvashaya together. Thsese roga are usually treated by langhana and the same is used in the management of Jwara.
Signs and symptoms of COVID-19 reveal that this disease affects the Abhyantar roga marga with fever and respiratory symptoms as the main manifestations. Therefore, the management principles of Jwara can be used in the management of COVID-19 Patients too.
COVID-19 caused by the SARS-CoV-2 virus has already been spreading so fast and has acquired an epidemic nature. But, Epidemics like COVID-19 are not new to Ayurveda. Our classical textbooks have given a vivid description of such epidemics in the name of ‘Janapadodhwamsa’ where various aspects of such epidemics with respect to their cause (nidana), effects, management and prevention are clearly described.
Charaka samhita has clearly explained that such epidemics appear as a result of vitiation of air, water, environment and season which are common to all individuals. Therefore, such epidemics affect people irrespective of their physical constitution and the strength of affliction depends on level of dosha vitiation of the person.
Pragyaparadha or misuse of one’s intellect is a causative factor for vitiation of all three doshas and it is considered to be the main cause of ‘Janapadodhwamsa’ too. Proper use of medicines to improve the physical health, administration of five elimination or Panchkarma therapies and rasayana, along with Daivavyapasraya chikitsa has been mentioned as preventive and as treatment for diseases leading to Janapadodhwamsa.
This Jwara can also be classified as being agantuja (external) caused by Bhoota Abhishanga (virus), which aggravates all the three doshas. Considering the nature of COVID-19 as agantu and janapadodhwamsa, it can be considered as a type of Sannipata Jwara with fever, tiredness, dry cough, nasal congestion, runny nose, aches and pains, sore throat, diarrhea etc as the main symptoms.
STAGES OF JWARA
CLINICAL FEATURES OF AMA JWARA (1st STAGE)
The ama jwara/first stage of jwara represents itself with the following clinical features
- Anorexia, indigestion, heaviness in the stomach
- Feeling of heaviness in cardiac region, drowsiness and laziness
- Continuous, fever with acute onset.
- Non-elimination of the dosha along with mala or waste products
- Excess salivation, loss of appetite,nausea and tastelessness in the mouth.
- Rigidity, numbness and heaviness of the body
- Excessive urination
- Improper formation of stool
CLINICAL FEATURES OF PACHYAMANA JWARA (2nd STAGE)
- High grade fever and excess thirst
- Excess evacuation of wastes
CLINICAL FEATURES OF NIRAMA JWARA (3rd STAGE)
- Restoration of hunger
- Lightness in the body
- Reduced fever
- Elimination of the dosha along with the waste products from the body are the clinical features of nirama jwara (Body is free from ama or toxins or aggravated doshas).
- These features generally appear on the 8th day.
PRECAUTIONS AT INETIAL STAGES OF JWARA
The patient, in the state of nava jwara/first stage fever, should avoid certain things such as
- Daytime sleep
- Heavy to digest food
- Sexual intercourse
- Direct exposure to wind
- kashaya (astringent foods)
CONTRAINDICATION OF LANGHANAM (FASTING)
Langhanam is prescribed in the initial stage of jwara except those caused by
- kshaya consumption
- vata dominant jwara
- fear, anger, passion, grief
- Physical exertion
BENEFITS OF LANGHNAM IN JWARA
- Langhana reduces the aggravated dosha and stimulates the agni(Digestive fire)
- As a result of this jwara subsides and the body becomes light and the person’s appetite is restored to normal
- Langhana should be performed only to an extent where it does not hamper the vitality or strength of the individual.
MANAGEMENT PRINCIPAL OF JWARA
- Langhana (fasting)
- Swedana (fomentation)
- Kala (waiting period of eight days)
- Yavagu (medicated gruels) and tikta rasa(Bitter taste) drugs and all digestive enhancers prescribed in the taruna jwara (the initial stage of jwara)
VARIOUS DRINKS TO MANAGE THIRST IN JWARA
If the patient feels thirsty, he should be given :
- Hot water to drink if the jwara caused by aggravation of vata and kapha
- If the jwara is pitta dominant, water boiled with bitter drugs and then cooled, sgould be is given.
- Both of these are dipana, (digestive fire enhancer), pachana (enhancing digestion), and jwaraghna (alleviators of jwara). They help in cleansing the channels of circulation and promote strength, sweating, appetite and auspiciousness.
Boil the water with musta, parpataka, ushira, chandana, udichya and nagara. Once it cools down give it to patient for the alleviation of thirst and jwara.
After six days of light diet, the jwara patient should be administered decoctions, which are either pachana (stimulant of digestion) or shamana (alleviator of doshas).
DECOCTION INDICATED ARE
- Musta and parpataka can be taken either in the form of decoction (pakya) or shita kashaya (crushing and soaking the herbs overnight in water and then filtering the content and using the filtrate in morning).
- Parpataka decoction may be given to the patient along with nagara and duralabha.
- The decoction made from kirata tikta, guduchi, musta and vishva bheshaja.
- The decoction of patha and ushira along with udichya plant.
All these above mentioned decoctions which are used for the treatment of jwara are jwaraghna. They stimulate the digestive fire, help in the pachana of the doshas, relieves thirst, anorexia and treats mukha vairasya (bad taste of the mouth).
CONTRA INDICATIONS OF KASHAYAM
In the first stage of jwara, the astringent tasted drugs or decoctions are prohibited. Because if we give it in 1st stage, Doshas will not undergo paka.
YUSHA (SOUP) INDICATIONSThe patient should be given light diet which includes yusha (soup) prepared from vegetables and pulses and rasa (soup) of the meat of animals inhabiting arid regions, up to the tenth day, to treat the jwara.
INDICATIONS AND CONTRAINDICATIONS OF GHEE
- In case of less aggravated kapha dosha and excess aggravated vata and pitta dosha, and in patients with pakwa dosha stage or no ama, ghee should be given. It is like amrita (nectar) for them.
- If the kapha dosha isl predominant even after 10th day and if the signs and symptoms of langhana have not appeared, then ghee is contra indicated. In such cases decoctions should be administered til body becomes light.
- The patient should be given light diet along with the meat soup of wild animals and birds. This will kill the strength of the doshas and enhances the strength of the body.
A patient should be given milk in nirama stage in the body
- When the patient has excessive burning sensation and thirst
- If vata and pitta dosha are dominant
If fever patient feels thirsty, Hot water should be given to drink depending upon the doshas involved and the strength of the patient.
VARIOUS DIETARY FOODS USED IN JWARA
For this purpose, rakta shali, shashtika shali, specially purana shali (preserved for over a year) rice are the best. These should be given in the form of yavagu (gruel), odana (boiled rice), laja (fried paddy) to decrease the fever of the patient.
TEN TYPES OF YAVAGU USED IN TREATMENT OF JWARA
- The peya prepared with laja (fried paddy) and boiled with pippali and nagara is light to digest. It should be given to the patient in the beginning of the jwara as the digestive fire is reduced.
- If there is movement of bowel and the patient is desiring sour foods, then this peya should be made sour by adding dadima and should be given with nagara.
- Once this peya is cooled, add honey before giving it to paittika type of patient.
- A patient suffering from shoola (pain) in the parshva (flanks), basti (urinary bladder) and shira (head) regions should be given peya prepared from red variety of shali rice by boiling it with shvadamshtra and kantakari as this alleviates jwara.
- A patient suffering from jwaratisara (fever associated with diarrhea) should be given peya which is sour and is boiled with prishniparni, bala, bilva, nagara, utpala and dhanyaka.
- If jwara is associated with kasa (bronchitis), shwasa (difficulty in breathing) and hikka (hiccups), then give yavagu which is prepared by boiling with the group of drugs belonging to vidarigandhadi gana, as it will acts as a stimulant of digestive fire and promotes sweating.
- Patient suffering from jwara associated with koshthabaddhata(constipation) should be given Peya prepared of yava (barley) boiled with pippali and amalaki. It causes anulomana (downward movement) of dosha.
- Mix this peya with ghee and give it to the patient suffering from jwara with constipation.
- Jwara associated with constipation and pain – Peya prepared by boiling with mridvika, pippali mula, chavya, amalaka and nagara should be consumed.
- Patient suffering from Absence of sweating, sleeplessness and thirst – Peya prepared by boiling with nagara and amalaka fried with ghee and mixed with sugar.
BENEFITS OF GHEE CONSUMPTION
If in a person of ununctuous disposition or snigdha sharer, jwara doesn’t get cured by the use of decoctions, emesis, fasting and by light diet, then medicated ghrita should be given to him by adding it with the decoctions.
MANAGEMENT OF SANNIPATAJ JWARA
Langhanam and all the above mentioned therapies are administered in the following conditions
- When the jwara is in the sama(dosha are still inaggravated form with indigestion) stage
- When jwara is produced by the aggravated kapha dosha
- When both the kapha and the pitta dosha are aggravated together
- Vamana, virechana and bastī therapies should be administered to cure the jwara caused by the aggravated vāta, pitta and kapha dosha respectively.
- In the case of saṁsṛṡṭra and sannīpātaja (combination of two or all the three doshas) type of jwara, the lesser, greater or equal status of the vitiated doshas should be found out and the treatment should be planned according to that dosha and specific drugs assigned for the particular dosha should be given.
- Sannipātaja jwara should be treated by increasing one dosha, reducing the excessively aggravated one or by correcting the sites of the doshas in order, beginning with the site of kapha.
MANAGEMENT OF JEERNA JWARA
When the fever turns into chronic stage and there is weakness in the the body, such patients should be given nourishing foods which promote the strength of the body.
MANAGEMENT OF JWARA LOCATED IN VARIOUS DHATUS
- RASA DHATU – Vamana and upavāsa (emesis and fasting) should be done.
- RAKTA DHATU – Seka and pradeha (pouring of hot medicated liquids and Medicated paste application) should be done.
- MAMSA AND MEDAS – Virecana and upavāsa should be done.
- ASTHI AND MAJJA DHATU – Nirūha and anuvāsana bastīs should be given.
SIGNS OF COMPLETELY CURED JWARA
- Disappearance of klama (mental fatigue) and santapa (temperature or fever)
- Absence of pain in body parts
- Clarity of senses or clear thoughts
- Gaining natural mental faculties
PRECAUTIONS AFTER BEING CURED FROM JWARA
A person suffering from jwara and the person who has just become free from it (do not have fever anymore)
- Should not consume food and drinks which are vidahi (causing burning sensation), guru (heavy to digest), asatmya (unwholesome diet) and viruddha (mutually contradictory)
- Should avoid sexual intercourse, work that causes excessive exhaustion.
- Exercise, bathing, chankramana (brisk walking) should be avoided by the person who is now free from fevera till he regains his strength back.
- By following these rules fever gets alleviated and does not occur again.
Chandigarh Ayurved Centre has manufractured a Kit for COVID-19 Prevention, which contains formulations like : Trikatu syrup, Amrit tulasi ras, giloy capsules, garlic capsules.
All these helps in digestion of AMA which causes the fever.