Nidan Panchak
- Nidana
- Ritu sandhi, viruddha ahara, ajirna, vega dharana, ratri jagarana, mosquito exposure, contaminated water and food, srama.
- Purvarupa
- Jrimbha, angamarda, aruchi, netra daha, romaharsha, shrama without exertion.
- Rupa
- Santapa with sweda-avarodha, aruchi, trishna, angamarda, shirahshoola; type-specific patterns such as alternate-day rise or step-ladder fever.
- Sama lakshana
- Heaviness, coated tongue, no appetite, no sweating, unclear urine, malaise out of proportion — treat as Ama.
- Nirama lakshana
- Appetite returning, clear tongue, free sweating, light body, clear urine — only now Brimhana and Rasayana are appropriate.
Day 1 to 3 — Ama avastha
- Langhana: only ushna jala, laja peya, thin moong yusha. No milk, no ghee, no heavy food.
- Pachana with Shadanga paniya sipped warm through the day — this alone reduces the fever curve.
- No Brimhana, no Rasayana, no snehana in this window.
- Document temperature chart, urine output, and platelet-relevant signs from the first visit.
Day 4 to 7 — Pachana to Shamana crossover
- Continue Pachana; add Jwaraghna drugs once Ama lakshanas begin to clear.
- Persisting fever beyond day 5 without a clear pattern means investigate, not escalate the prescription.
- Watch for the defervescence-phase deterioration typical of dengue — the patient looks better and gets worse.
Day 8 onwards — Jwaramukta and Rasayana
- Once Nirama, correct Dhatu kshaya: Shatavari, Amalaki, Drakshasava, gradual laghu-santarpana diet.
- Jirna Jwara or Vishama Jwara pattern needs Guduchi-based Rasayana over 4–6 weeks.
- Address post-viral debility, cough and joint pain separately rather than continuing Jwaraghna drugs.
Reading the fever type at the desk
- Alternate-day or third-day spikes with rigors and sweating — think Vishama Jwara / malaria; test.
- Step-ladder fever with relative bradycardia and abdominal discomfort — think typhoid; test.
- High fever with severe body ache, retro-orbital pain, rash and falling platelets — dengue; monitor closely.
Formulations, dose and anupana
Doses are for an average adult and are adjusted to Agni, Bala, Vaya and associated conditions. Pregnancy, lactation, renal or hepatic compromise need individual revision.
| Formulation | Dose | Anupana | Timing / note |
|---|---|---|---|
| Shadanga paniya | Sip 500–1000 ml through the day | Taken warm as the drinking water itself | All day, from day 1 |
| Guduchi (Amrita) satva | 500 mg twice daily | Lukewarm water | After food |
| Sudarshana churna / vati | 1–2 g or 2 tablets twice daily | Lukewarm water | After food |
| Tribhuvankirti rasa | 125–250 mg twice daily | Adraka svarasa with honey | With sheeta-purvaka jwara |
| Mahasudarshana kwatha | 40 ml twice daily | Equal warm water | Before food |
| Amritarishta | 20 ml twice daily | Equal water | After food, from day 4 |
| Papaya leaf svarasa (dengue with thrombocytopenia) | 10–15 ml twice daily | Plain water | Alongside allopathic monitoring, never instead of it |
Pathya
- Ushna jala, laja peya, moong yusha, patient's own hunger as the guide to feeding
- Complete rest, light cotton clothing, mosquito protection
- Small frequent sips of Shadanga paniya rather than large volumes
- Return to normal diet only after appetite genuinely returns
Apathya
- Milk, ghee, curd, non-vegetarian food and sweets during Ama avastha
- Snana with cold water in early fever, exposure to wind
- Day sleep in Sama avastha, exertion, sexual activity
- Suppressing fever early with heavy Brimhana or premature tonics
Red flags — refer immediately
- Platelets below 50,000, bleeding gums, petechiae, or persistent vomiting — admit
- Postural hypotension, cold extremities, narrowing pulse pressure — dengue shock, refer immediately
- Altered sensorium, neck stiffness, seizure — suspect meningitis or cerebral malaria
- Fever beyond 7 days without diagnosis, or fever with jaundice, breathlessness, or oliguria
- Fever in pregnancy, infancy, or immunocompromised patients — co-manage from day one
Frequently asked
- Should medicines be started immediately in fever?
- Yes, but Langhana and Pachana drugs only. Nourishing and strengthening formulations are withheld until Nirama lakshanas appear, otherwise the fever prolongs.
- Can Ayurvedic treatment manage dengue fever?
- Ayurvedic drugs help symptom load and recovery, but platelet counts and warning signs must be monitored, and any warning sign is referred for admission. It is co-management, not replacement.
- How is Shadanga paniya prepared?
- Equal parts of Musta, Parpataka, Ushira, Chandana, Udichya and Nagara are boiled in water, reduced, and given warm as the day's drinking water.
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