Use Of Herbal Decoctions In Fever -Kashaya In Jwara

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

Kashaya means herbal decoctions. Like in any other diseases kashayas have a great role in the treatment of fevers too.

Decoction is contraindicated in acute fevers

As a rule, decoction is contraindicated in newly manifested or acute fevers. Decoction is mentioned among the different things contraindicated for usage during acute fevers.
Read – Charaka – Jwara Chikitsa 3rd Chapter

Principles for administration of decoction in fevers

Decoctions should be administered 6 days after the manifestation of the fever.

It should be given after the patient has taken the food. Food should be antagonistic to fever and causative doshas.

Two kinds of decoctions should be considered. They are –

  • Pachana Kashaya for apakva doshas – these decoctions target digestion of ama associated with fever causing dosha(s). When  ama is associated with fever the doshas are said to be apakva i.e. unripe. This condition is usually present during the first 6-7 days of acute fevers. But as per rule the decoctions are not prescribed for the first 6 days and the physician should wait until first six days have passed. In the first 6 days digestion of ama should be done by administering either fasting, sudation, time duration (wait for 8 days), gruels and bitter tasting herbs (used to process gruels, drinks and water). These decoctions help in ripening the unripe doshas after 6 days i.e. to digest and separate ama from the doshas.
  • Shamana / Shamaniya Kashaya for pakva or nirama doshas – these decoctions target towards pacifying doshas. These decoctions should be administered in fevers not associated with ama or after ama associated with doshas have been digested after administering pachana decoctions.
    Read – Qualities And Symptoms Of Ama – Ama Guna Lakshana

Master Sushruta opines –

‘If ama associated with doshas is not digested by means of fasting and use of gruels and if doshas are not ripened by these measures, decoctions which are capable of digesting ama, good for heart and are antipyretic in nature should be served. These decoctions will also cure tastelessness, manifestation of awkward and opposite tastes in the mouth, thirst and anorexia associated with fevers’.

Later he tells ‘According to other authors, the medicines (decoctions) should be given after 7 nights’. This explanation also tells that decoction should be administered on 8th day.
Read – Kashayam Remedy For Fever, Thirst And Burning Sensation

Shadahe Ateete – After 6 days?

Decoction should be given after 6 days counting from the day of manifestation of fever.

On the 7th day ‘light to digest food’ should be given to the patient. On the 8th day the decoctions should be administered.

Already we have seen that the ama digesting decoctions should be given in association of doshas with ama. This condition is present only during the first 7 days of the fever. Among the ama digesting measures ‘ashtaha’ i.e. 8 days is mentioned. This means to tell that 8 days is the maximum period for ama digestion and it should be achieved by that time.

While mentioning the principles for administration of gruels as part of ama digesting measure, the limitation of administration of gruels have been said. Gruels should either be given until the fever becomes mild (intensity of the fever should get reduced) or for 6 days after manifestation of fever, whichever is earlier. This means to tell that for the first 6 days, medicated gruel itself will bring about digestion of ama and there is no need of giving decoctions here.
Read – Ayurveda Lifestyle and Diet For Fever – 45 Important Things To Know

On the 7th day light food should be given.

On the 8th day if ama is still persistent with doshas and have not been totally destroyed, pachana decoction should be administered. If signs of association of ama with doshas are not found and if the doshas have become ripened on 8th day, palliative decoctions i.e. shamana kashaya should be given to pacify the doshas.

Rule – Ama digesting measures i.e. fasting, sudation, time period of 8 days, gruels and bitter tasting herbs should be used for digesting ama only before 8 days. After 8 days these measures should not be used for ripening the doshas i.e. for digesting ama. After 8 days decoctions should be used for this purpose’.
Read – How To Do Fasting? A Step By Step Guide For You

Skilful administration of decoctions in fever as per commentator Chakrapani and other authors

1. If fasting is given for 1, 2 or 3 days, gruels should be administered for 5, 4 and 3 days respectively. The total sum of these days will be 6 days in each case, starting from the first day of manifestation of fever.

Langhana (fasting) Yavagu / Peya (medicated gruels) Laghu Bhojana (light food) Kashaya (decoction)
Pachana Kashaya – if ama persists (digestive decoction) Shamana Kashaya – if ama is absent (palliative decoction)
Given for 1 day Given for 5 days (2nd to 6th day) 7th day 8th day 8th day
Given for 2 days Given for 4 days (3rd to 6th day) 7th day 8th day 8th day
Given for 3 days Given for 3 days (4th day to 6th day) 7th day 8th day 8th day

Sudation shall be skillfully used as and when required to hasten the process of ama digestion and can be plugged into any of the above schedule. Gruels are anyways prepared with medicinal herbs, mainly the bitter herbs. Kala means 8 days. Pachana with fasting etc measures will complete by 8 days as per principles of treatment of acute fevers. In either case decoctions are started on day 8.

2. In cases contraindicated for fasting, like vata fevers etc – gruels shall be given right from 1st day, for duration of 6 days. Light food is given on 7th day and decoction on 8th day.

3. In fevers wherein due to association of excessive ama and in fevers caused by aggravation of all three doshas fasting needed to be done for 6 days, use of gruels doesn’t come into question. After the completion of fasting, gruel should be administered not for digesting ama but should be administered to kindle the digestive fire which has become weak due to excessive administration of fasting. Here gruel is not needed for digesting ama because fasting for more number of days would have done the job. Even in this condition decoction should be given on 8th day after the digestive fire has been kindled.
Read – Understanding Digestion Process From An Ayurveda View

4. In conditions wherein gruels have been contraindicated, tarpana i.e. satiating drinks should be substituted in place of gruels for same number of days and should be administered in the same methods with same calculations as described above.

Duration of Acute fever i.e Taruna Jwara

According to references from Master Charaka, acute fevers include the first 7 days of the fever. After 7 days the fever is called as ataruna jwara. Here fasting, gruels etc ama digesting measures should not be administered.

Master Pushkalavata tells –

  • Taruna Jwara – acute phase of fevers – is for first 7 nights
  • Madhyama Jwara – intermediate phase of fevers – if for 12 nights
  • Purana Jwara – chronic phase or old fevers – is the name given for fevers after 12 days have elapsed

Master Harita too opines –

‘Fasting, hot water, water processed with Musta (Cyperus rotundus) etc and gruels should be given for 6 days and nights and on 7th day morning, antipyretic decoctions processed with medicinal herbs should be administered from 7th night onwards’.

Summing up –

Summing up the opinions of all the masters, medicated decoctions should be administered either on 7th night or on 8th day morning. The difference in opinions doesn’t make much difference since both durations are close enough.

Another reference tells that after having analyzed the strength and weakness of the involved doshas in fevers, gruels, decoction, milk, ghee and purgation should be given for 6 days each. This also puts these treatment principles in a sequence with 6 days gap between each other. Here also the decoction is said to be given after gruels and after a gap of 6 days. This concept creates a little confusion because according to this the decoction should be given on 7th day but the maximum duration for the fever to become ripened i.e. to get rid of ama is on the 8th day. Thus, even on the 7th day the ama still persists. Therefore, the average opinion for administering kashaya is on 7th night / evening or on 8th day morning.
Read – Ayurveda Home Remedy For Fever

Effects of administering Decoctions in acute fevers

  • Doshas get blocked
  • Ama associated with doshas doesn’t get digested even after a long time period
  • Causes vishama jwara – intermittent fevers

Which types of Decoctions are contraindicated in acute fevers?

Five type of decoction formulations are mentioned – fresh juices, paste, cold decoction, hot decoction and infusion. These formulations are prepared with herbs having all tastes except salt i.e. sweet, sour, pungent, bitter and astringent. All these formulations are not contraindicated in fevers. Among these only the decoctions prepared with herbs having astringent taste are contraindicated in acute fevers because they alone have capacity to constipate doshas and ama and worsen the fevers.
Read – Six Tastes Of Ayurveda: Qualities, Benefits, Therapeutic Action (Shad Rasa)

Important antipyretic decoctions

1. Musta Parpataka Kashayam

Hot or cold decoction prepared using Musta – Cyperus rotundus and Parpataka – Fumaria officinalis.

2. Parpata Nagara Kashayam

Decoction of Parpataka – Fumaria officinalis and Ginger.

3. Parpataka Duralabha Kashayam

Decoction of Parpataka – Fumaria officinalis and Duralabha – Fagonia cretica is useful especially in pitta and kapha or pitta-kapha types of fever associated with depletion of digestive capacity.

4. Kiratatiktadi Kashayam

Decoction prepared with the below mentioned ingredients is best for fevers of vata and kapha or vata-kapha origin.

5. Pathadi Kashayam

Decoction prepared with the below mentioned ingredients is beneficial in fever of pitta origin.

All the above said decoctions are –

  • Best antipyretics
  • Kindles digestive fire
  • Digests ama
  • Pacifies thirst
  • Cures anorexia and tastelessness

Decoctions to cure vishamajwaras – intermittent fevers

Sl No Name of the Kashaya Ingredients Benefits
1 Kalingakadi Kalinga – seeds of Holarrhena antidysenterica Patola patra – leaves of Trichosanthes dioica Katukarohini – Picrorhiza kurroa Cures Santata type of intermittent fever
2 Patoladi Patola patra – leaves of Trichosanthes dioica Sariva – Hemidesmus indicus Musta – Cyperus rotundus Patha – Cissampelos pareira Katukarohini – Picrorhiza kurroa Cures Satata type of intermittent fever
3 Nimbadi Nimba twak – Bark of Azadirachta indica Patola patra – leaves of Trichosanthes dioica Haritaki – Terminalia chebula Bibhitaki – Terminalia bellirica Amalaki – Emblica officinalis Mridvika – Vitis vinifera Musta – Cyperus rotundus Vatsaka – seeds of Holarrhena antidysenterica Cures Anyedhyushka type of intermittent fevers
4 Kiratatiktadi Kiratatikta – Swertia chiraita Guduchi – Tinospora cordifolia Chandana – Santalum album Vishwabheshaja – Zingiber officinale Cures Tritiyaka type of intermittent fevers
5 Guduchyadi Guduchi – Tinospora cordifolia Amalaki – Emblica officinalis Musta – Cyperus rotundus Cures Chaturthaka type of intermittent fevers

Antipyretic decoctions

Vatsakadi Kwatha

Sl No Ingredients Method of preparation Benefits
1 Indrayava – Seeds of Holarrhena antidysenterica These ingredients should be taken in equal proportions. Cold or hot decoctions are prepared from these ingredients and used as and when needed. Cures fevers
2 Aragwadha – Pulp of Cassia fistula
3 Patha- Cissampelos pareira
4 Vacha – Acorus calamus
5 Katuki – Picrorrhiza kurroa
6 Murva – Marsdenia tenacissima
7 Ativisha – Aconitum heterophyllum
8 Nimba – Azadirachta indica
9 Patola – leaves of Trichosanthes dioica
10 Dhanvayasakam – Alhagi camelorum / Fagonia cretica
11 Vacha – Acorus calamus
12 Musta – Cyperus rotundus
13 Ushira – Vetiveria zizanioides
14 Madhuka – Glycyrrhiza glabra
15 Haritaki – Terminalia chebula
16 Bibhitaki – Terminalia bellirica
17 Amalaki – Emblica officinalis
18 Bala – Sida cordifolia

Madhukadi Sheeta Kashayam

Sl No Ingredients Method of preparation Benefits
1 Madhuka pushpa – flowers of Madhuca longifolia All these ingredients should be taken in equal quantity and pounded. Their coarse powder should be left immersed in hot water overnight, filtered and consumed in the morning. Cures fevers
2 Musta – Cyperus rotundus
3 Mridvika – Vitis vinifera
4 Kashmarya – Gmelina arborea
5 Parushaka – bark of Grewia asiatica
6 Trayamana – Gentiana kurroo
7 Ushira – Vetiveria zizanioides
8 Haritaki – Terminalia chebula
9 Bibhitaki – Terminalia bellirica
10 Amalaki – Emblica officinalis
11 Katuki – Picrorhiza kurrooa

Jatyadi Kwatha

Sl No Ingredients Method of preparation Benefits
1 Jati patra – leaves of Jasminum grandiflorum The decoction prepared from equal quantities of these ingredients should be consumed mixed with jaggery. It helps in elimination of the constipated doshas.
2 Amalaki – Emblica officinalis
3 Musta – Cyperus rotundus
4 Dhanvayasa – Alhagi camelorum / Fagonia cretica

Triphaladi Kwatha

Sl No Ingredients Method of preparation Benefits
1 Amalaki – Emblica officinalis Decoction prepared with equal quantity of these herbs should be given. Destroys morbid kapha and pitta and expels vata through downward route.
2 Haritaki – Terminalia chebula Same decoction given mixed with Trivrit – Operculina turpethum and sugar Cures pitta fever, kapha type of fever or pitta-kapha fevers.
3 Bibhitaki – Terminalia bellirica    
4 Trayamana – Gentiana kurroo
5 Mridvika – Vitis vinifera
6 Katukarohini – Picrorhiza kurrooa

Read – An Ancient Way Of Using Triphala As An Anti Ageing Remedy

Brihatyadi Kwatha

Sl No Ingredients Method of preparation Benefits
1 Brihati – Solanum indicum The decoction prepared from equal quantities of these ingredients should be given. Cures fevers caused by aggravation of all three doshas (sannipata jwara)
2 Kantakari – Solanum xanthocarpum
3 Vatsaka – seeds of Holarrhena antidysenterica
4 Musta – Cyperus rotundus
5 Devadaru – Cedrus deodara
6 Mahaushadham – Zingiber officinale
7 Kolavalli – Scindapsus officinalis

Shatyadi Varga Kwatha

Sl No Ingredients Method of preparation Benefits
1 Shati – Curcuma zedoaria The decoction prepared with equal quantity of these ingredients should be served. Cures fevers caused by aggravation of all three doshas (sannipata jwara). It also cures cough, congestion in the heart region, pain in flanks, dyspnea and drowsiness.
2 Pushkaramula – Inula racemosa
3 Vyaghri – Solanum xanthocarpum
4 Shringi – Pistacia integerrima
5 Duralabha – Fagonia cretica
6 Guduchi – Tinospora cordifolia
7 Nagara – Zingiber officinale
8 Patha – Cissampelos pareira
9 Kirata – Swertia chirata
10 Katurohini – Picrorhiza kurrooa

Brihatyadi Gana Kwatha

Sl No Ingredients Method of preparation Benefits
1 Brihati – Solanum indicum Decoction prepared with equal quantity of these ingredients should be served. Cures sannipata fevers, cough associated with these fevers and coughs with complications
2 Kantakari – Solanum xanthocarpum
3 Pushkara – Inula racemosa
4 Bharangi – Clerodendron serratum
5 Shati – Curcuma zedoaria
6 Shringi – Pistacia integerrima
7 Duralabha – Fagonia cretica
8 Vatsaka – seeds of Holarrhena antidysenterica
9 Patola – Tricosanthes dioica
10 Katurohini – Picrorrhiza kurrooa

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