Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Akshepaka = convulsions
Jwara = fevers
Akshepaka Jwaras are fevers which manifest along with convulsion – ‘convulsive fevers’ or ‘febrile seizures’.
We do not find ‘Akshepaka Jwara’ being mentioned or described in the context or main chapters dealing with Jwara. We find a short description of this fever in the ‘Parishishta’ section of Madhava Nidana.
In this article I will discuss Akshepaka Jwara.
Akshepaka Jwara
Definition of Akshepaka Jwara
यस्मादाक्षिप्यन्ते, प्रायेणाङ्गानि यान्ति संकोचम्।
घोरो ज्वरश्च संज्ञाहृदसावाक्षेपकः प्रोक्तः॥
When a person suffers from severely troublesome fever associated with the below mentioned symptoms, it will be considered as Akshepaka Jwara –
– Akshepa – convulsions / seizures
– Anga samkocha – contractures of the body parts
– Samjna hrt – loss of consciousness
Nidana: Etiological factors of Akshepaka Jwara
बहुजनसमवायो यत्र देशे विशेषादय च यदि सदा स्यात्पांसुधूमप्रसारः।
नदि रक्षयति वासं तत्र जीवाणुजातो ज्वर इह खलु जायेतातिदुःखप्रदोऽयं॥
Akshepaka Jwara is caused when the microorganisms affect the people –
– Living in thickly populated areas – places congested due to inhibition by many people, the places being unclean and unhygienic not ideal for health (and hence having plenty of microorganisms around)
– Living in places which are excessively dusty, polluted and smoky
These fevers are said to be dreadful and life-threatening.
Samprapti: Pathogenesis of Akshepaka Jwara
पूर्वोक्तहेतोरुदितं विषं हि, मस्तिष्कमूले मनुजस्य यस्य।
प्रायेण नूनं परितः सुषुम्नाकाण्डं च तच्छादिकलाऽन्तराले।
क्रमाल्लसीकामतिपूयतुल्यां संहत्य दोषान्निखिलान्प्रकोप्य॥
चेष्टावहनाडिकाव्रजानामस्युत्तेजनहेतुरो जनानाम्।
बह्वाक्षिपदङ्गानि शाखाः संकोच्य प्राणिहन्ति चेतनां च॥
आक्षेपकगदस्यैषा संप्राप्तिवैध्यनिश्चिता।
प्रायेणात्र नृणां लोके जीवितं दुर्लभं भवेत्॥
The toxins produced by the microorganisms
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Enters the meningeal layers of the spinal cord situated at the base of the brain
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Affects the lasika (cerebrospinal fluid?) therein and largely converts it into pus like material (infected material) and later
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Would cause aggravation of all the doshas and
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Excessively excites the chestavaha nadis – motor nerves which
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Consequently causes severe fever
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Associated with severe convulsions in the body parts and contractions in the limbs along with loss of consciousness
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Such a fever associated with convulsions, contractions and loss of consciousness is called Akshepaka Jwara, the pathogenesis of such fevers is thus, as explained by the wise physicians and
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Survival of people who suffer from these fevers become difficult i.e. it carries bad prognosis
Lakshanas: Symptoms of Akshepaka Jwara
उग्रा पीडा जायते यस्य शीर्ष्णि च्छर्दिः शैत्यं जातु चिद्वेपथुश्च।
ग्रीवास्तम्भोऽपि प्रसह्याथ शीर्षं पश्चाद् यत्राकृष्यतेऽद्धाऽऽमये तु॥
गच्छन्त्यङ्गान्येव संकोचभावं स्यातां वक्त्रे चक्षुषी नूनमेव।
शाखाः स्तब्धाः सन्ति वृद्धिर्ज्वरस्याजस्रं प्रायो लक्ष्यते स्पष्टतोऽपि॥
तन्द्रा मोहोऽपि प्रलापोऽथ शरवत् स्यादाक्षेपो गात्रमध्ये जनानाम्।
नूनं रक्तश्यावलक्ष्मोद्भवश्च नाशो जायेतेन्द्रियाणां क्रमेण।
आक्षेपकज्वरभवं निखिलं तु चिह्नमेतन्मतं सुभिषजां गदितं मयेत्थम्।
स्याद् यत्र रोगिपुरुषे स मृतो भवेदेकाहाञ्च कश्चिदथवा त्रिदिनादवश्यम्॥
एवं क्लिष्येंस्त्रिचतुरदिनान्येव सप्ताहमद्धा कश्चिद्वाऽसून्नियतिवशतः प्रायशः संजहाति।
कश्चित् पूर्वार्जितसुकृतितः सन्ञ्चिकित्साप्रसङ्गाज्जीवेदाक्षेपकपदयुतेन ज्वरेणार्दितोऽपि॥
Below mentioned are the symptoms of Akshepaka Jwara –
– Severe headache
– Vomiting
– Feeling ‘cold’ in the body
– Tremors / shivers
– Stiffness / catch in the neck
– Head is pulled backwards / feel of pulling in the occiput
– Contractions / contractures of the body parts
– Crookedness / deviation of eyes
– Stiffness / rigidity of the limbs
– Regular increase of fever
– Stupor
– Unconsciousness / confusion
– Delirium
– Repeated convulsions of the body / body parts
– Manifestation of red or blackish brown colored spots / patches on different parts of the body
– Loss of power of perception by respective indriyas
The patient of Akshepaka Jwara having most of these symptoms would eventually die in 1, 3, 4 or 7 days after having suffered from troubles of intense nature due to misfortune. Sometimes, due to good fortune or the effect of good deeds, some persons suffering from these symptoms of Akshepaka Jwara would luckily survive.
Modern Correlation
Akshepaka Jwara has been closely correlated to cerebro-spinal fevers or meningitis. It can also be correlated to febrile seizures.
Ayurveda treatment principles
Specific treatment of Akshepaka Jwara has not been explained but it shall be treated on the general principles of treating jwara. Nidana Parivarjana – avoidance of causative factors is very important.
Since the convulsions or seizures are part and effect of fevers, separate treatment for Akshepaka is generally not needed. If convulsions or episodes of seizures continue even after remission of fever, it shall be treated on the lines of akshepaka, vata vyadhi or apasmara.
Brimhana and Balya – strengthening medicines and Rasayanas – immune modulators will be required in the recovery period.
