An English Translation of the Sushruta Samhita, Vol. III: Uttara-tantra — trans. Kaviraj Kunja Lal Bhishagratna (1916)

1^5 THE SUSIIRUTA SAMHITX. [Chap. XXXIX.

cated under the surface of the skin, produce cold (shivering) during the first istage of fever, while the deranged Pitta brings on the characterstic burning sensation at its latter stage after the subsidence of the deranged Kapha and Viyu. In certain cases the burning sensation is engendered by the deranged Pitta at the outset, cold (shivering) being brought on by the deranged Kapha and Vâyu at the latter stage after the subsidence of the deranged Pitta. Both these two types of fever are brought on through the combined action of two deranged Doshas of the body and of these two, the type which is ushered in by a burning sensation in the body is extremely hard to cure. A case of continued fever resulting from an abnormal psychic condition (such as anger, grief, desire, etc.) or due to any blow or hurt is likewise hard to cure. 26 — 28.

Fever of the Vishama type attacks a man in various ways and follows a distinct periodicity, it being aggravated during the six specific times of dominance of the deranged bodily principles (Doshas) as mentioned before * in the course of day and night. This Vishama fever never finds complete remission, (but lurks in the deeper organic principles of the body) and produces a sen^ of physical langour and heaviness of the limbs as well as the characteristic emaciation. It is called Vishama-jwara because its abatement is always confounded with its cure and remission, and this confounding is due to the fact that the disease (fever) lies dormant in a very small degree in the deeper principles of the vital organism to be patent only at the slightest exciting cause, just as a feeble fire fed with an insufficient supply of fuel, becomes patent at the slightest excitingcause. 29.

* See chapter XXI.^Sutra-sthdnaChap. XXXIX.]

UTTARA-TANTRA.

Seat of Vishama Jwara 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 Santata (remittent or continuous) fever has its seat in the vitiated Rasa (serum) and blood + of the organism ; while a case of Anyedyuh 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 Chstturthaka (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.

Duration of Vishama Jwara 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 An^edyushka 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 Chs(turthaka fever sets in every fourth day. 3T.

* A case of fever may lapse into a Vishama type even from the Very commencement of the attack.

t Vijaya Rakshita, the commentator on Mddhava 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.

THE SUSHRUTA SAMHITX. [Chap. XXXtX.

iflo

Influence of Vafyu on Vishama

Jwara > — Just as the ocean is overflown when its water is swollen up by the gusts of wind (V£yu), so the bodily Doshas are aggravated by the bodily Vdyu, and give rise to different kinds of fever. Just as the water of the occean floods the shore at flowtide 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 organising at the completion of their perfect assimilation in or elimination from the system. 32.