Part 3 - Visama-jvara (chronic fever)

If a little of the abnormal excess of the three faults (viz. vayu, pitta, and kapha) is left unremedied, even after the remission of nava-jvara, that fault aggravated by unhealthy food, etc., may affect any one of the seven dhatus^[1] and bring about a relapse of fever. Such a fever is called visama-jvara.

This fever is of five kinds, according to difference in duration and time of attack, viz. santata, satata, anyedyu, tritiaka, and chaturthaka. Santata and satata affect the chyle and blood; anyedyu affects the flesh, tritiyaka affects the fat, and chaturthaka affects marrow and bone. The last-mentioned i.e. chaturthaka is accompanied by many other diseases. It is as terrible as Death himself.

Santata is a visama-jvara which lasts for seven, ten, or twelve days, at a stretch, without any remission. Satata (dyahika or daikalika) is a chronic fever which attacks its patient twice a day. Anyedu attacks its patient only once a day. It is also called aikahika and is followed by remission every day. Tritiyaka (or tryahika) attacks its patient on every third day, and chaturthaka attacks its patient on every fourth day. Tritiyaka is of three different kinds, viz. (1) that due to an excess of kapha and pitta, (2) that due to an excess of kapha and vayu, and (3) that due to an excess of vayu and pitta.

The distinctive features of these three fevers are:—(1) pain in the trika or junction of the spine and the waist; (2) pain in the back, and (3) pain in the head, respectively. Chaturthaka fever is also of two kinds viz. that due to an excess of kapha (phlegm), and that due to an excess of vayu (wind). The first is characterised by pain in the thighs which gradually spreads all over the body, and the second is characterised by pain in the head which gradually spreads all over the body. There is another kind of chronic fever called chaturthaka biparyaya (i.e. chaturthaka in a reverse order). The patient suffering from this fever is free from it every first and fourth days, but is attacked with it every second and third days.