Abhinyasa Jwara: Symptoms, Prognosis, Treatment Principles

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

AIAPGET Points

– ABHINYASA Jwara is considered to be a type of Sannipataja Jwara.

– According to some experts, HATAUJASA Jwara is a synonym of ABHINYASA Jwara.

– Acharya Sushruta has explained ABHINYASA and OJO NIRODHAJA Jwara as the variants of Sannipataja Jwara.

– Abhinyasa Jwara is a type of VISHAMA TRIDOSHA type of Sannipataja Jwara according to some experts.

– ABHINYASA Jwara is caused when all three aggravated doshas occupy and affect the URAH SROTAS, along with ama. It is incurable. This fever severely affects BUDDHI, INDRIYA and MANAS.

– Symptoms of ABHINYASA JWARA include – loss of perception of sound, vision, smell and touch, lack of interest in all kinds of activities, abnormal head movements, aversion to food, cooing sounds from throat, pricking pain in body parts, changing positions in the bed and less speech.

– Other symptoms (Sushruta) – Na ati ushna shito, loss of consciousness, BHRANTA PREKSHI (unsteady eyes), loss of voice and coarseness of the tongue, dryness of throat, SWEDA VIN MUTRA VARJITA – absence of sweat, faeces and urine, eyes are reddish and irregular, discomfort in chest, loss of complexion, dyspnoea, falling from the cot and lies on the floor, irrelevant talk

– According to Sushruta – ABHINYASA Jwara is marked by excessive sleepiness, HATAUJASA Jwara – by marked loss of ojas and SANNYASA – by loss of conscious activity of the body.

– ABHINYASA Jwara is correlated with – Severe influenza / Swine Flu (H1NI), Severe Viral Pneumonia (COVID 19), Septic Shock or MODS (Multiple Organ Dysfunction Syndrome), Fevers caused due to severe Toxaemia or Hyperpyrexia or Severe Toxaemic Condition of Enteric Fever (Typhoid).

– Abhinyasa Jwara has been explained in Madhava Nidana Chapter 2 & Sushruta Uttara Tantra Chapter 39.

Abhinyasa Jwara is a special type of fever explained in the context of Sannipataja Jwara i.e. fevers caused by simultaneous aggravation of all three doshas. It is said to be a severe and fatal form of fever.

Doshas – Abhinyasa Jwara is caused by simultaneous aggravation of all three doshas i.e. vata, pitta and kapha and hence is a Sannipataja Jwara variant. In spite of all doshas being aggravated, predominant involvement of kapha and vata is clearly seen.

This fever presents with severe and life-threatening symptoms. It is also characterized by severe depletion of Ojas. Acharya Vagbhata has mentioned that Sannipataja Jwara itself can be called by the names Abhinyasa Jwara or Hataujasa Jwara. Thus, according to Vagbhata, Abhinyasa Jwara and Hataujasa Jwara are synonyms of Sannipataja Jwara.

On the other hand, Acharya Sushruta has described Abhinyasa Jwara and Ojo Nirodhaja Jwara (in place of Hataujasa Jwara) as separate conditions, but after explaining Sannipataja Jwara, making these two conditions as variants of Sannipataja Jwara. He further states that Abhinyasa Jwara is called as Hataujasa Jwara by some other experts.

Also –

Because there is marked destruction of eyes in this disease, some experts also call Abhinyasa Jwara by the name 'Hataujasa Jwara' (Hata = destroyed, Aujasa = Eyes = eyes).

Abhinyasa Jwara is considered to be Vishama Tridosha type of Sannipataja Jwara.

Pathogenesis and Symptoms of Abhinyasa Jwara

Three angry evils followed by the source of the chest.
The intellect, senses and mind are knotted together by the growth of us.
They cause a very terrible reaction and a strong fever.
The hearing and the eyes become asleep and no movement is attempted.
Nor will his sight be capable of seeing form.
Neither smell nor touch nor sound is perceived.
He shakes his head and does not appreciate food frequently
He barks and beats himself except for the change
He speaks little and is called a little abhinyasa.
Rejected, he is the greatest, and no one here accomplishes it.(Ma.ni.2)

Pathogenesis of Abhinyasa Jwara

All the three aggravated doshas i.e. vata, pitta and kapha occupy and circulate in the Urah Srotas i.e. channels of the chest cavity (includes thoracic cavity, heart, lungs and respiratory passages). While doing so, these doshas become matted due to excessive formation / increase and later, with association of ama (doshas get mixed with excessively increased ama and get matted and hence congested). Such doshas in association with ama would affect the intelligence, sense organs and mind and cause a severe and lethal form of fever. This fever is called ABHINYASA Jwara.

Symptoms of Abhinyasa Jwara

Shrutau Netre Prasuptihi – numbness of sense organs (functioning) of hearing and vision (loss of perception of sounds and visual objects i.e. the person can neither hear or see anything)

Na cheshtam kinchidihate – lack of interest in any kinds of activities

Na cha drishtihi bhavet tasya samartha rupadarshane – the eyes (sense organs of vision) lose their capacity to perceive visual objects

Na ghranam na cha samsparsham shabdam va naiva budhyate – the person cannot perceive smell, touch or sounds (the related sensory systems fail in perceiving their respective objects)

Shiro Lothayate Abhikshnam – the person keeps throwing / moving his head in different directions

Aharam na abhinandati – the person will not appreciate food (aversion towards food)

Kujati – makes cooing sounds like pigeon

Tudhyate – has pricking pain all over the body

Parivartanamihate – desires to change positions in the bed,

Alpam prabhashate – speaks very less

Prognosis

Abhinyasa Jwara is said to be incurable since there are less chances for a person suffering from this condition to survive.

Symptoms of Abhinyasa Jwara as described by Acharya Sushruta

He was not very hot or cold He had little consciousness He looked confused He lost his voice
He had a donkey's tongue and a dry throat and was devoid of sweat stool and urine
He was overcome with tears and his heart was filled with tears.
He lies down breathing heavily and is disturbed by talking
Others say that he is deprived of his energy.

Abhinyāsa Jvara

The Below mentioned are the symptoms of Abhinyasa Jwara, also called as Hataujasa Jwara by some other experts –

Na ati ushna shito – body neither very hot nor very cold (moderate increase of body temperature),

Alpa Sanjna – loss of consciousness,

Bhranta Prekshi – unsteady eyes,

Hata Swaraha – loss of voice,

Khara Jihwa – coarse tongue,

Shushka Kanta – dryness of the throat,

Sweda-Vin-Mutra Varjita – absence of sweat, feces and urine;

Sasro Nirbhugno – eyes reddish and irregular,

Nirbhugna Hrdaya – discomfort in the chest,

Bhakta Dweshi – aversion to food,

Hataprabha – loss of complexion,

Shwasaha – dyspnoea,

Nipatitaha Shete – falling from the cot and lies on the floor,

Pralapa – suffers from irrelevant talk

Prognosis of Abhinyasa Jwara (Sushruta – Su.Ut.39/41-42)

Others consider the fever of conjunctivitis to be difficult and incurable.
He fell asleep and became exhausted and depleted of energy.
Renunciation of the body should be known as renunciation in the all-pervading fever.

Sannipāta jvara is difficult to cure. According to some other experts it is incurable.

Among Sannipata Jvaras,

– Abhinyāsa Jwara – should be understood when the patient is sleepier i.e. has more of sleep;

– Hataujasa Jwara – is a condition marked loss / decrease of eyes and

– Sannāysa – is when there is loss of conscious activity of the body

This explanation points towards Abhinyasa, Hataujasa and Sannyasa being different types / forms of Sannipata Jwaras.

Treatment Principles

Abhinyasa Jwara should be treated on the lines of treatment of Sannipata Jwara.

Other treatments – Immunity of the person should be improved and the Ojas should be restored by administering Rasayanas.

Related Reading – Sannipata Jwara – treatment principles

Modern Correlation

Experts have correlated Abhinyasa Jwara closely with the below mentioned conditions –

– Severe influenza / Swine Flu (H1N1)

– Severe Viral Pneumonia (COVID – 19)

– Sepsis – Septic Shock or MODS (Multiple Organ Dysfunction Syndrome)

Acharya Gananathsen has correlated Abhinyasa Jwara with fevers caused due to severe toxemia or hyperpyrexia. The same symptoms can be traced in the severe toxemic condition of enteric fever (typhoid).