Jvara Upadrava ( complication of Jvara)

1. 13 TYPES OF VARIOUS SANNIPATHA
JVARA AND THEIR MANAGEMENT
Presented by Dr. D.K.R Keerthirathne
MD in Ayurveda Kayachikithsa and Board Certification
Postgraduate Institute of Indigenous Medicine
University of Colombo

2. INTRODUCTION
 Symptoms of fever due to simultaneous vitiation of the three doshas
combine in different modes to continue the fever is called Sannipata Jvara.
 If there is obstruction or non- elimination of doshas ( mala or excreta), if the
Agnis are completely destroyed and if all the signs, and symptoms are fully
manifested, then Sannipata Jvara is incurable, otherwise it is difficult of cure.
(Cha/Ni/ 29)
 Such diseases included in 13 types of various sannipatha Jvara are
mentioned in Bhavaprakasha, Deshiya chikithsa sangrahaya and Hansa raja
nidanaya.

3. INTRODUCTION….
13 types of this sannipatha Jvara are as follows,
01. Sandhika Sannipatha - Curable
02. Tandrika Sannipatha
03. Karnika Sannipatha
04. Kanta kubja Sannipatha Curable with difficulty
05. Jihvaka Sannipatha
06. Chitta vibhrama Sannipatha
07. Rugdaha Sannipatha - May be treated with great effort
08. Antaka Sannipatha
09. Shitanga Sannipatha
10. Bhugna netra Sannipatha Incurable
11. Raktastivi Sannipatha
12. Pralapaka Sannipatha
13. Abhinyasa Sannipatha

4. 01. SANDHIKA SANNIPATHA
Signs and Symptoms
 Vywa’itzaiytaÉvet! ñywusNyutasiNxzu
àÉutk)tamuoeivgtinÔta kasék
smStimitkeitRtm!Évitlún yÇJvre
iÇdae;jintebuxE sihing*tesiNxg . (Bha/M/1/500)
 Shvayatu sanyutha sandhishu (Pain of the Joints associated with the swelling)
 Prabhuta kaphata mukhe (Excess mucous in the oral cavity)
 Vigata nidrata (Insomnia)
 Kasa(Cough)
 Ruk (Pain of the body)

5. 02. TANDRIKA SANNIPATHA
Signs and Symptoms
 tNÔatIvttôu;a‘itsrnm!ñasae ixk:kasékœ sNtÝaitRtnugRle
ñywuna sa*Rík{fª:k)
suZyama rsna¬m:öv[yae miNxNc dahSttayÇ SyaTs ih
tiNÔkaeingidRtaexae;ÇyaeTwaeJvr (Bha/M/1/414)
 Ativa tandra (Severely dozing)
 Trusha (Thirst)
 Atisaranam (Diarrhea)
 Shvasa (Dyspnoea), Kasa (Cough), Ruk (Pain)
 Santapta (High temperature)
 Tanurgale (Bleak voice due to itchy edematous throat excess mucous)
 Shvayathuna sardyashcha kandu kapha (Swelling of the neck and stiffness
with itching)
 Sushyama rasana (Blackened tongue)
 Klama (Tiredsomeness of senses)
 Manda sravana (Reduced hearing)
 Daha (Burning sensation throughout the body)

6. 03. KARNIKA SANNIPATHA
Signs and Symptoms
 xae;Çyenjint: iklk[RmuletIìa JvreÉvittuñywuVywac
kNq¢haebixrta ñsnm!Àlap:àSvedmaehdahnaincki[RkaOy
(Bha/M/1/504)
 Thivra Jvara (High temprerature)
 Kila karna mule bhavati tu shvayatu (Pain full swelling root of the Ear)
 Vyathacha ( pain of the body)
 Kanta graha (Throat is congested)
 Shvasa (Dyspnoea)
 Pralapa (Delirium)
 Prasweda (Perspiration increases)
 Moha (Consciousness is lost) and
 Dhahanani (Increased burning sensation)

7. 04. KANTA KUBJA SANNIPATHA
Signs and Symptoms
 k{q: zukZtaéÏvditñas àlapae éicdaRhae dehéja Çuza ipc
hnuStMÉ izrae iwRStwa
maehae vepwuna sheitsklm! ilNgm! iÇdae; Jvre yÇ SyaTs ihm! k{q k…â Aidt àa½Ez!
icikTsabux: ( Bha/M/1/505)
 Kanta shuka shataruddha ( Throat of painfully congested with spinous
tissue eruptions)
 Ati Shvasa (Severe dyspnoea)
 Pralapa (Delirium)
 Aruchi (Loss of taste)
 Daha (Burning sensation)
 Deha ruk (Body pains)
 Trusha (Thirst)
 Hanustamba (Lock jaw)
 Shiro arati (Headache)
 Moha (Impairment of consciousness)

8. 05. JIHVAKA SANNIPATHA
Signs and Symptoms
 iÇdae; jinte Jvre Évit yÇijVhaæuzMìutakiqnkNqœkEStdnu iniÉRrm!mukta
öuit]itbl]itñasn kassMtÝa puratn iÉ;GvraStimh ijVhkm!c]te .
(Bha/M/1/499)
 Jivha brushamvruta katina kantakai (Tongue is covered with throni growth)
 Mukata (There may be loss of speech)
 Sruti ksha ( Impairement of hearing)
 Ati Balaksha ( Fatigue)
 Ati shvasa (Dyspnoea)
 Kasa (Cough)
 Santapta (High fever)
Ham.Raj/Jvara/39/6
 Hrith parshvodara nasikadhara gale shotam (Swelling of the heart, abdomen,
throat, nostril and lips)
 Visangam (Unconsciousness)

9. 06. CHITTA VIBHRAMA SANNIPATHA
Signs and Symptoms
 gayt!ÜuTyitàlpit iv³…tm!inirKzte muýte
dahœVywa_yataeRnrStuicÄämeJvreÉvit . (Bha/M/1/ 503)
 puTkarkm!k…éte dxait mdtam!,æmat! (Hansa.Ni./Jvara/43/10)
 Gayati nrutyati vikrutam (The patient sings aloud, dances, laughs, talk
liberally and incoherently)
 Nirikshate (gazes or stares at viciously)
 Muhyate (Faints in between)
 Dahya (Suffers from burning sensation)
 Vyata (Body pains)
 Bhayarta (Phobias)
 Bhrama ( Giddiness)
 Puthkarakam kurute dadhati ( Blow like a animal)
 Mada (confusion)

10. 07. RUGDAHA SANNIPATHA
Signs and Symptoms
 dahae’ ixkae Évit yÇ Çu;ac tIìa ñasàlap ivéicämmaehpIFa
mNyahnuVywn kNq éj ïmí éGdah sNˆj %idtStIì Évae Jvrae’ ym! . (Bha/M/1/502)
 Daho ‘dhike (Severe burning sensation)
 Trusha (thirst),Thivra shvasa (dyspnoea),Pralapa (delirium)
 Viruchi (loss of luster),Bhrama (vertigo),Moha (loss of consciousness)
 Tivra Jvara (High fever), Manya hanu vyatana (development of motor
deformities)
 Kanta ruja (Pain of the throat)

11. 08. ANTAKA SANNIPATHA
Signs and Symptoms
 ySmE‘][metdiStsklEdaeR;EéiditteJvre jöm!mUixRivËnnm!sksnm!
svaRNgpIfaixka
ihŠañass dahmaehsihtadehe AitsNtÝtavEkLyNcìuwavcaiNsmuiniÉ
sNkaeiÅtRtsaeNtk . (Bha/M/1/501)
 Murdhi vidunanam (The tone of the neck muscles is lost and so
there may be jerky movement of the neck)
 Kasa (Cough), Sarvanga pida adhika (Severe body aches)
 Hikka (Hiccough),Shvasa (Dyspnoea),Daha (Burning sensation)
 Moha (Loss of consciousness)
 Ati san taptata(Severe rise of body temperature)
 Vaikalyacha (Development of motor deformities)
 Sanka (Delirium)

12. 09. SHITANGA SANNIPATHA
Signs and Symptoms
 ihmaizr zirr: siÚpatJvir y:ñsn ksna ihŠa maeh kMp àlap
¬m b÷ k)vata dahv_yNg pIfa Svriv³…itiÉraÄR: zIt gaÇ s %´:. (Bha/M/1/413)
 Himashira sharira: (Temperature doesn’t rise and body surface is
cold like ice )
 Shvasana (Dyspnoea), Kasana (Cough), Hikka (Hiccough), Moha (Stupor)
 Kampa (Rigors), Pralaapa (Delirium)
 Klama (Lowered sensory function)
 Daha (Burning sensation)
 Abyanga pida (Body pains), Svara vikruti (Changed voice)
 Abhi arti (Severe uneasiness)

13. 10. BHUGNA NETRA SANNIPATHA
Signs and Symptoms
 æuzm! nyn v³tañsn kas tNÔaæuzm! àlap md vepwu
öv[hain maehaStwa
puraeinikldae;je Évit yÇilNfœn! Jvre puratn icikTskE: s #h ÉuGÚeÇae mt:,
(Bha/M/1/497)
 Bhushan nayana vakrata (Eye balls are deflected)
 Shvasana (Dyspnoea)
 Kasa (Cough),
 Tandra (Severe drowsiness)
 Pralapa (Delirium)
 Vepathu (Fasciculation)
 Moha (Stupor), Sravana hani (Defective hearing)
 Mada (Loss of consciousness)

14. BHUGNA NETRA SANNIPATHA (ACUTE CEREBRAL
EDEMA)
Vision become distorted (Bhushan nayana
vakrata)
Eye of cerebral edema

15. 11. RAKTASTIVI SANNIPATHA
Signs and Symptoms
 inòIvae éixrSyr´sÔ‚zn! ³…:[m! tnaE mflm!
laeihTym! nyne Çu;a ‘éic vimñasatIsar æma
AafœmanNc ivsNˆjta ptnn! ihŠa’ NgpIfa æuzn!
r´ZqIivin siÚpatjinte ilNˆ¶! Jvre jayte. (Bha/M/1/416)
 Nishtivo (Constant emitting of blood from oral cavity)
 Rakta mandalam(Urticarial rashes)
 Lohitam nayane (Redened sclera)
 Aruchi (Loss of taste perception)
 Vami (Nausea),Atisara (Diarrhea),Bhrama (Vertigo)
 Admana (Distended abdomen)
 Visangata (Loss of consciousness)
 Patanan (Inability to sit or stand), Hikka (Hiccough)
 Anga pida brushan (Severe body pain)
 Raktashtivi (Blood stained sputum)

16. 12. PRALAPAKA SANNIPATHA JVARA
Signs and Symptoms
 yÇ Jvre inikldae; intaNtrae;jate àlap b÷la shsaeiTwtaí
kMp Vytaptndah ivsNˆjta SyunaRNmaàlapk #it àiwt àuiwVyam! .
(Bha/M/1/495)
 àlip puÇgehn! àyait Jvrae tapipfa NˆGkMp àyas
Çuza zaek sNgaivnaz àvad
izr kMp maehaNg daha ivinÔa . ( Hansa.Ra.Ni/Jvara/51/12)
 Pralapa bahula sahasotthitashcha (The patient is deliriant with
frequent disturb sleep)
 Kampa (Tremors), Visangata (Loss of consciousness)
 Daha (Burning sensation)
 Prathita prutuvyam (Instability)
 Taapa pidaa (Pain of the body), Trusha (Thirst), Shoka ( worry )
 Sanga vinasha ( Numbness), Mohaanga (Hallucinations)
 Vinidra (Insomnia)
 Pralapaka Sannipatha is very similar to the Severe Encephalitis

17. 13. ABHINYASA SANNIPATHA
Signs and Symptoms
 dae;aStIìtra ÉviNt biln sveR ipyÇ Jvre
maehae AtIv ivce:tta ivklta ñasae æuzn! mUkta
dahiScKK[manNc dhae mNdae blSy]y
Sae’ iÉNyas#it àkIiÄRt #h àaNˆjaeiÉR;iÉ . (Bha/M/1/416)
 Moho (The patient loses his consciousness)
 Vicheshtatha and Vikalata (His motor functions are lost and deformities
are developed)
 Athiva shvasa (Severe dyspnoea)
 Brushan mukata (Speech is blocked)
 Brushan daha (Severe burning sensation)
 Chikkanata deho (Clammy face)
 Mando balasya (Digestive capacity and stamina are completely lost)
 Kshaya (Emaciated)

18. TREATMENTS OF SANNIPATHA JVARA
 संनिपतज्वरे पूवं क
ु र्यादयम कफय पहं
 क्षीणे श्लेष्म बलेशयन्तं पपत्त वयतौ िर्ेत् क्रमयत्
 लङ्घिं वयलुकय स्वेदॊ िस्र्ं निश्टॆविम ् तथय
 आवलेहोञ्जिम ् चैव प्रयक् प्रर्ॊज्र्म् त्रिदॊषजे II
(Sararta sangraha/ Jvara chi/ 107-108)
In treatment of tridhoshaja type fever, first of all, the treatments should be done for
alleviating Kapha and Ama, after been reduced the Kapha dosha, should be done
alleviation of pitta and Vata respectively. First it is usefull of Langana, Valuka sveda,
Nasya, Nishteevanaya as well as Avaleha and Anjana should be administered separately.
Treatments of Sannipatha Jvara Upadrava
 छर्दि मूछछि र्ििछसछ दीन र्िरोदछत् ज्िरस्यच
उिद्रिछञ्जयेच्चछर्ि प्रत्यर्नके न हेतुनछ I (Su/U/39/292)
 Complications, vomiting, fainting, thirst etc. , should be treated with
contrary measures without antagonising the fever.

19. MANAGEMENT OF HEMORRHAGE
Cha/chi/4/7-8
It should be applied pitta shamaka, rakta stambana and
jvaragna drugs, and antagonist to Kapha aggravation.

20. TREATMENT FOR DYSPNOEA ETC. IN FEVER
Agni karma
 A cauterization performed using a sickle heated on burning wild cow
dung cakes, on the thoracic cage cures severe dyspnoea. (Bha/ M/
1/849-858)
Dashanga decoction:
 It is pacified dyspnoea and aggravation of doshas. (Bha/ M/ 1/843-
844)
Treatment for hiccough:
 Powdered rock salt is dissolved in water and used as nasal drops
which relieves hiccough in fever.
 Powders of sugar and shunti applied nasally cures hiccough.
 Fumigation of Hingu also relieves this condition. ( Bha/ M/ 1/860)
Treatments for Vomiting:
 Vomiting subside by drinking the decoction of Guduchi mixed with
honey
 Drinking the decoction of chandana and Sugar ( Bha/M/1/852)

21. MANEGEMENT OF MURCHA (FAINTING)
(Su/U/46/6)

22. MANEGEMENT OF MURCHA (FAINTING)
 The patient is treated with massage and smorking. Producing
various types of movements in the body and rubbing the
fruits of Kapikachchu. (Su/U/46/22)
 If consciousness is not revived and the patient devolope
hardness of bowel, salivation and dyspnoea, he should be
discarded. (Su/U/46/24)
 If he regain consciousness, he should be evacuated with
emesis and purgation followed by intake of light and
wholesome food.
 He should use formulation of shilajathu, tripala, chitraka and
shunti with sugar for a month
 According to dosha, in all types of fainting, anti-pyretic
decoction should be used. (Su/U/46/25)
 Kasturi kapuru Makaradwaja churna

23. MANEGEMENT OF MURCHA (FAINTING)
 Emergency care for Coma, Unconscious,
Hypoxia patients
 The ABCD Sequence
 A = Airway Disorders
 B = Breathing Disorders
 C = Circulation/Cardiovascular Disorders
 D = Disability (Neurological Disorders)

24. 01. TREATMENTS OF SANDHIGA SANNIPATHA
 It should be done Ama pachana, shamana, valukasweda and
dosholbana chikithsa.
Decoctions:
 රාස්නා මෘතා ද්රාවිඩ වෘද්ධ දාරු කෂාය
(Deshi.chi/12/jvara/p.205- 210)
 සුරදාරු ශථි සුධාලතාදී කෂාය (Bha/ M/ 1/663)
02. Treatments of Tandrika Sannipatha
 Decoction of Kantakari, guduchi, pushkaramula, shunti and
haritaki
 Nasal administration of Agasti leaves ( Katurumurunga)mixed
with the powder of trikatu
 Nasal administration of drugs like maricha, balaka,
daruharidra, kushta, vidanga, shunti and indravaruni grinded
in goats urine ( Bha/M/1/644-646)

25. 03.TREATMENTS OF KARNIKA SANNIPATHA
Paste – Haridradi paste
 Kulattadi paste applied warm frequently to reduced the
swelling.(Bha/M/1/686 -687)
04. Treatments of Kanta kubja Sannipatha
 Decoction of tripala, trikatu, musta, katurohini, kutaja,
vasa and daruharidra.
 Decoctions made of Kiratadi gana (Bha/M/1/693-694)
05. Treatments of Jihvaka Sannipatha
 A paste of kiratatiktadi kept in mouth
 Brahmiadi powder suck with honey clears the tongue and
helps in normalizing the blurred speech. (Bha/M/1/651)

26. 06. TREATMENTS OF CHITTA VIBHRAMA SANNIPATHA
Anjana:
 Fine powder of Pippalyadi grinded in goat’s urine.
 NG: Jaggery, Shunti and Pippali are added to the Juice, extracted from bark
of Agastya tree. (Bha/ M/ 1/679-681)
For Jalatrasa ( hydrophobia)
 The patient is given to drink old Ghee, and evacuative drugs mixed with
latex of Arka. Shvetha punarnava should be given mixed with Datura root.
 If bitten by animal, causing jalatrasa, after draining the site of bite (with
pressure) and cauterizing with Ghee, it should be pasted anti poisonous
formulation. The combination of crushed sesamum, sesamum oil, latex of
Arka and Jaggery destroyes the poisons of animal.( Su/ Ka/ 7 49-52)
07. Treatments of Antaka Sannipatha
 Treatment should be stopped and meditate asking life for
Parameshwara.(Bha/ M/1/665-667)

27. 08. TREATMENTS OF RUGDAHA SANNIPATHA
 Shadanga panaya
 Patyavaleham – Haritaki powder is consumed to combat burning
sensation, along with either gingerly oil/ ghee/honey
 Application of chandana and nimba leaves griended with buttermilk.
 A thin cloth soaked either Kanjika or boiled buttermilk (after cooling it )
is covered on the body to subside burning sensation.
 Powdered rice flakes mixed with sugar and honey may nourish a person
emaciated due to burning sensation and vomiting. (Bha/ M/ 1/668-675)
09. Treatments of Shitanga Sannipatha
 ðrl mqIalr Nd¾.s කෂාය
 මාතුලුඟාබ්ද භූනිම්බ ශුන්ටි කෂාය
(De.chi.sa/ jvara chi/ p. 212)

28. 10. TREATMENTS OF BHUGNA NETRA SANNIPATHA
 NG: තුරඟගන්ධා ලවණ ොග්රගන්ධා දී කෂාය
( Bha/M/1/652)
11. Treatments of Raktastivi Sannipatha
 Cold in fution of Yashti maduka, parushaka, balaka, tejapatra, devadaru,
and gambari fruits. (Bha/ M/ 1/649-651)
 Emesis with decoction of Koshataki ( T. vatakolu), madanaphala and
ankotha (Ruk Aguna) should be administered followed by intake of alkali
waterof barley, kapikachchu and two types of Vruhati. (Su/Ka/7/13-15)
12. Treatments of Pralapaka Sannipatha
 A decoction of Tagaradi (Bha/ M/ 1/647-648)
 Decoction of Jaladharadi.. Deshi/chi/Jvara/p.210)

29. 13. TREATMENTS OF ABHINYASA SANNIPATHA
 Nasya- Powder of Peper, sahindava, tippili,
nirgundi leaves, seeds of maduka, katphala are
griended with bee honey and mixed with hot water .
When it is administered in 4 , 8 drops , stimulates
the sense organs and motor organs.
 Decoction of shrungadi…
 Decoction of Matulungadi….
 Decoction of Bhargi pushkaramuladi…
Deshi/chi/Jvara/p.210)
 Decoction of Karavi pushkara erandadi…

30. CONCLUSION …
No Sannipatha Jvara Similar disease
01. Sandhika Sannipatha Sarcoidosis
02. Tandrika Sannipatha Meningitis
03. Karnika Sannipatha Severe Glandular fever with CNS
complication
04. Kanta kubja Sannipatha Whooping cough with
pneumothorax
05. Jihvaka Sannipatha Kawasaki Disease
06. Chitta vibhrama Sannipatha Rabies
07. Rugdaha Sannipatha Ebola hemorrhagic fever (EHF)
08. Antaka Sannipatha Quad fever in Neurogenic Shock
due to infection
09. Shitanga Sannipatha Septic shock due to Pneumonia
10. Bhugna netra Sannipatha Acute Cerebral edema
11. Raktastivi Sannipatha Severe Leptospirosis
12. Pralapaka Sannipatha Severe encephalitis
13. Abhinyasa Sannipatha Reye’s syndrome