The Diagnosis of Fever and Related Matters

Verse 1 (garuda.1.147.1)

धन्वन्तरिरुवाच । वक्ष्ये ज्वरनिदानं हि सर्वज्वरविबुद्धये । ज्वरो रोगपतिः पाप्मा मृत्युराजोऽशनोऽन्तकः । क्रुद्धदक्षाध्वरध्वंसिरुद्रोर्ध्वनयनोद्भवः

dhanvantariruvāca vakṣye jvaranidānaṁ hi sarvajvaravibuddhaye jvaro rogapatiḥ pāpmā mṛtyurājo'śano'ntakaḥ kruddhadakṣādhvaradhvaṁsirudrordhvanayanodbhavaḥ

Dhanvantari said: I shall declare the diagnosis of fever, for the full understanding of every kind of fever. Fever is called Rogapati, Papma, Mrityuraja, Ashana, and Antaka; it arose from Rudra's upward eye, opened in anger when he destroyed Daksha's sacrifice.

Verse 2 (garuda.1.147.2)

तत्सन्तापो मोहमयः सन्तापात्मापचारजः । विविधैर्नामभिः क्रूरो नानायोनिषु वर्तते

tatsantāpo mohamayaḥ santāpātmāpacārajaḥ vividhairnāmabhiḥ krūro nānāyoniṣu vartate

That burning, full of delusion, born of heat and of misconduct, cruel in nature, exists across the different species of beings under many names.

Verse 3 (garuda.1.147.3)

पाकलो गजेष्वभितापो वाजिष्वलर्कः कुक्रुरेषु । इन्द्रमदो जलदेष्वप्सु नीलिका ज्योतिरोषधीषु भूम्यामूषरो नाम

pākalo gajeṣvabhitāpo vājiṣvalarkaḥ kukrureṣu indramado jaladeṣvapsu nīlikā jyotiroṣadhīṣu bhūmyāmūṣaro nāma

In elephants it is called Pakala; in horses, Abhitapa; in dogs, Alarka (rabies); in aquatic creatures, Indramada; in plants, Nilika; and in the earth, Ushara.

Verse 4 (garuda.1.147.4)

हृल्लासश्छर्दनं कासः स्तंभः शैत्य त्वगादिषु । अङ्गेषु च समुद्भूताः पिडकाश्च कफोद्भवे

hṛllāsaśchardanaṁ kāsaḥ staṁbhaḥ śaitya tvagādiṣu aṅgeṣu ca samudbhūtāḥ piḍakāśca kaphodbhave

Nausea, vomiting, cough, stiffness, coldness of the skin, and the eruption of pustules on the limbs — these arise in the kapha-born fevers.

Verse 5 (garuda.1.147.5)

काले यथास्वं सर्वेषां प्रवृत्तिर्वृद्धिरेव वा । निदानोक्तोनुपशयो विपरीतोपशायिता

kāle yathāsvaṁ sarveṣāṁ pravṛttirvṛddhireva vā nidānoktonupaśayo viparītopaśāyitā

In each humor's own proper time, these signs arise or intensify. What is stated as unfavorable in the diagnosis is the aggravating factor; its opposite is the favorable one.

Verse 6 (garuda.1.147.6)

अरुचिश्चाविपाकश्च स्तंभमालस्यमेव च । हृद्दाहश्च विपाकश्च तन्द्रा चालस्यमेव च । वस्तिर्विमर्दावनया दोषाणामप्रवर्तनम्

aruciścāvipākaśca staṁbhamālasyameva ca hṛddāhaśca vipākaśca tandrā cālasyameva ca vastirvimardāvanayā doṣāṇāmapravartanam

Loss of appetite, indigestion, stiffness, and lassitude; burning of the heart, indigestion, drowsiness, and lassitude again; distension of the bladder, cramping, and failure of the humors to be eliminated —

Verse 7 (garuda.1.147.7)

लालाप्रसेको हृल्लासः क्षुन्नाशो रसदं मुखम् । स्वच्छमुष्णगुरुत्वञ्च गात्राणां बहुमूत्रता । न विजीर्णं न च म्लानिर्ज्वरस्यामस्य लक्षणम्

lālāpraseko hṛllāsaḥ kṣunnāśo rasadaṁ mukham svacchamuṣṇagurutvañca gātrāṇāṁ bahumūtratā na vijīrṇaṁ na ca mlānirjvarasyāmasya lakṣaṇam

Salivation, nausea, loss of hunger, a flavorless mouth, limbs that are clear, hot, and heavy, and excessive urination — without proper digestion and without exhaustion — these are the signs of ama-fever, the undigested type.

Verse 8 (garuda.1.147.8)

क्षुत्क्षामता लघुत्वं च गात्राणां ज्वरमार्दवम् । दोषप्रवृत्तिरष्टाहान्निरामज्वरलक्षणम्

kṣutkṣāmatā laghutvaṁ ca gātrāṇāṁ jvaramārdavam doṣapravṛttiraṣṭāhānnirāmajvaralakṣaṇam

Hunger, lightness and thinness of the limbs, a softened fever, and the normal elimination of humors within about eight days — these are the signs of fever free of ama.

Verse 9 (garuda.1.147.9)

यथा स्वलिङ्गं संसर्गे ज्वरसंसर्गजोऽपि वा । शिरोर्तिमूर्छावमिदेहदाहकण्ठास्यशोषारुचिपर्वभेदाः । उन्निद्रता संभ्रमरोमहर्षा जृंभातिवाक्त्वं पवनात्सपित्तात्

yathā svaliṅgaṁ saṁsarge jvarasaṁsargajo'pi vā śirortimūrchāvamidehadāhakaṇṭhāsyaśoṣāruciparvabhedāḥ unnidratā saṁbhramaromaharṣā jṛṁbhātivāktvaṁ pavanātsapittāt

In combination, each humor shows its own sign, as does the combined fever. Headache, fainting, vomiting, bodily burning, dryness of throat and mouth, loss of appetite, breaking pain in the joints, sleeplessness, agitation, horripilation, yawning, and excessive talking — these are the signs of fever from Vata combined with Pitta.

Verse 10 (garuda.1.147.10)

तापहान्यरुचिपर्वशिरोरुक्ष्ठीवनश्वसनकासविवर्णाः । शीतजाड्यतिमिरभ्रमितन्द्राश्लेष्मवातजनितज्वरलिङ्गम्

tāpahānyaruciparvaśirorukṣṭhīvanaśvasanakāsavivarṇāḥ śītajāḍyatimirabhramitandrāśleṣmavātajanitajvaraliṅgam

Alternating fever, loss of appetite, joint pain, headache, expectoration, breathlessness, cough, and discoloration; coldness, torpor, dimness of vision, giddiness, and drowsiness — these are the signs of fever from Kapha combined with Vata.

Verse 11 (garuda.1.147.11)

शीतस्तम्भस्वेददाहाव्यवस्थास्तृष्णा कासः श्लेष्मपित्तप्रवृत्तिः । मोहस्तन्द्रालिप्ततिक्तास्यता च ज्ञेयं रूपं श्लेष्मपित्तज्वरस्य

śītastambhasvedadāhāvyavasthāstṛṣṇā kāsaḥ śleṣmapittapravṛttiḥ mohastandrāliptatiktāsyatā ca jñeyaṁ rūpaṁ śleṣmapittajvarasya

Irregular alternation of chill, stiffness, sweating, and burning; thirst, cough, and discharge of kapha mixed with pitta; confusion, drowsiness, a coated and bitter-tasting mouth — this should be known as the form of fever from Kapha combined with Pitta.

Verse 12 (garuda.1.147.12)

सर्वजो लक्षणैः सर्वैर्दाहोऽत्र च मुहुर्मुहुः । तदुच्छीतं महा निद्रा दिवा जागरणं निशि

sarvajo lakṣaṇaiḥ sarvairdāho'tra ca muhurmuhuḥ taducchītaṁ mahā nidrā divā jāgaraṇaṁ niśi

The fever born of all three humors shows all these signs together, with burning occurring again and again; it alternates with cold, deep sleep occurs by day, and wakefulness at night.

Verse 13 (garuda.1.147.13)

सदा वा नैव वा निद्रा महास्वेदो हि नैव वा । गीतनर्तनहास्यादिः प्रकृतेहाप्रवर्तनम्

sadā vā naiva vā nidrā mahāsvedo hi naiva vā gītanartanahāsyādiḥ prakṛtehāpravartanam

Sleep is either constant or entirely absent; profuse sweating either occurs or is entirely absent; there is singing, dancing, laughing and the like, or a complete cessation of one's natural activity.

Verse 14 (garuda.1.147.14)

साश्रुणी कलुषे रक्ते भुग्ने लुलितपक्ष्मणी । अक्षिणी पिण्डिकापार्श्वशिरः पर्वास्थिरुग्भ्रमः

sāśruṇī kaluṣe rakte bhugne lulitapakṣmaṇī akṣiṇī piṇḍikāpārśvaśiraḥ parvāsthirugbhramaḥ

The eyes are tearful, turbid, red, sunken, with disheveled lashes; there is pain in the calves, sides, head, joints, and bones, along with giddiness.

Verse 15 (garuda.1.147.15)

सस्वनौ सरुजौ कर्णौ महाशीतौ हि नैव वा । परिदग्धा खरा जिह्वा गुरुस्त्रस्ताङ्गसन्धिता

sasvanau sarujau karṇau mahāśītau hi naiva vā paridagdhā kharā jihvā gurustrastāṅgasandhitā

The ears ring and ache, either intensely cold or not at all; the tongue feels burnt and rough, the body heavy, and the joints of the limbs tremble.

Verse 16 (garuda.1.147.16)

ष्ठीवनं रक्तपित्तस्य लोठनं शिरसोऽतितृट् । कोष्ठानां श्यावरक्तानां मण्डलानां च दर्शनम्

ṣṭhīvanaṁ raktapittasya loṭhanaṁ śiraso'titṛṭ koṣṭhānāṁ śyāvaraktānāṁ maṇḍalānāṁ ca darśanam

Spitting of blood mixed with bile, the head rolling, excessive thirst, and the appearance of dark-red patches upon the trunk —

Verse 17 (garuda.1.147.17)

हृद्व्यथा मलंससर्गः प्रवृत्तिर्वाल्पशोऽति वा । स्निग्धास्यता बलभ्रंशः स्वरसादः प्रलापितः

hṛdvyathā malaṁsasargaḥ pravṛttirvālpaśo'ti vā snigdhāsyatā balabhraṁśaḥ svarasādaḥ pralāpitaḥ

pain in the heart, obstruction of stool along with its scanty or excessive passage, an oily mouth, loss of strength, weakness of voice, and delirium —

Verse 18 (garuda.1.147.18)

दोषपाकश्चिरं तन्द्रा प्रततं कण्ठकूजनम् । सन्निपातमभिन्यासं तं ब्रूयाच्च हतौजसम्

doṣapākaściraṁ tandrā pratataṁ kaṇṭhakūjanam sannipātamabhinyāsaṁ taṁ brūyācca hataujasam

prolonged, slow ripening of the vitiated humors, persistent drowsiness, and continuous rattling in the throat — this, when the vital energy is destroyed, should be called abhinyasa, the gravest stage of sannipata.

Verse 19 (garuda.1.147.19)

वायुना कण्ठरुद्धेन पित्तमन्तः सुपीडितम् । व्यवायित्वाच्च सौख्याच्च बहिर्मर्गं प्रपद्यते । तेन हारिद्रनेत्रत्वं सन्निपातोद्भवेज्वरे

vāyunā kaṇṭharuddhena pittamantaḥ supīḍitam vyavāyitvācca saukhyācca bahirmargaṁ prapadyate tena hāridranetratvaṁ sannipātodbhavejvare

When the throat is obstructed by Vata, Pitta becomes severely constricted within; because of its pervasive and deceptively soothing nature, it seeks an outward path — hence yellowness of the eyes arises in sannipata-fever.

Verse 20 (garuda.1.147.20)

दोषे विवृद्धे नष्टेऽग्नौ सर्वसंपूर्णलक्षणः । सान्निपातज्वरोऽसाध्यः कृच्छ्रसाध्यस्ततोऽन्यथा

doṣe vivṛddhe naṣṭe'gnau sarvasaṁpūrṇalakṣaṇaḥ sānnipātajvaro'sādhyaḥ kṛcchrasādhyastato'nyathā

When the humors are greatly increased and the digestive fire is destroyed, sannipata-fever showing all its signs is incurable; otherwise it is curable only with great difficulty.

Verse 21 (garuda.1.147.21)

अन्यत्र सन्निपातोत्थं यत्र पित्तं पृथक्स्थितम् । त्वचि कोष्ठे च वा दाहं विदधाति पुरोऽनु वा

anyatra sannipātotthaṁ yatra pittaṁ pṛthaksthitam tvaci koṣṭhe ca vā dāhaṁ vidadhāti puro'nu vā

Elsewhere, where a sannipata-derived fever has Pitta lodged separately, it produces burning in the skin or in the abdomen, before or after the other symptoms.

Verse 22 (garuda.1.147.22)

तद्वद्वातकफे शीतं दाहादिर्दुस्तरस्तयोः । शीतादौ तत्र पित्तेन कफे स्यान्दितशोषिते

tadvadvātakaphe śītaṁ dāhādirdustarastayoḥ śītādau tatra pittena kaphe syānditaśoṣite

Similarly, in fever from Vata and Kapha, coldness predominates, and the resulting burning is hard to overcome; there, coldness comes through Pitta, and when Kapha becomes liquefied or dried —

Verse 23 (garuda.1.147.23)

पित्ते शान्तेऽथ वै मूर्छा मदस्तृष्णा च जायते । दाहादौ पुनरन्तेषु तन्द्रालस्ये वमिः क्रमात्

pitte śānte'tha vai mūrchā madastṛṣṇā ca jāyate dāhādau punaranteṣu tandrālasye vamiḥ kramāt

when Pitta subsides, fainting, an intoxication-like stupor, and thirst arise; and again, at the close of burning and the rest, drowsiness, lassitude, and vomiting follow in order.

Verse 24 (garuda.1.147.24)

आगन्तुरभिगाताभिषङ्गशापाभिचारतः । चतुर्धा तु कृतः स्वेदो दाहाद्यैरभिघातजः

āganturabhigātābhiṣaṅgaśāpābhicārataḥ caturdhā tu kṛtaḥ svedo dāhādyairabhighātajaḥ

The 'incidental' fever is fourfold: from injury, from spirit-possession, from a curse, and from sorcery. In the injury-born type, sweating occurs along with burning and the rest.

Verse 25 (garuda.1.147.25)

श्रमाच्च तस्मिन्पवनः प्रायो रक्तं प्रदूषयन् । सव्यथाशोकवैवर्ण्यं सरुजं कुरुते ज्वरम्

śramācca tasminpavanaḥ prāyo raktaṁ pradūṣayan savyathāśokavaivarṇyaṁ sarujaṁ kurute jvaram

From exertion, in that fever, Vata generally vitiates the blood, producing a fever accompanied by pain, grief, discoloration, and aching.

Verse 26 (garuda.1.147.26)

ग्रहावेशौषधिविषक्रोधभीशोककामजः

grahāveśauṣadhiviṣakrodhabhīśokakāmajaḥ

Fevers born from possession, from poisonous plants, from poison, from anger, from fear, from grief, and from desire also belong to this incidental category.

Verse 27 (garuda.1.147.27)

अभिषङ्गग्रहोऽप्यस्मिन्नकस्माद्वासरोदने । ओषधीगन्धजे मूर्छा शिरोरुग्वमथुः क्षयः

abhiṣaṅgagraho'pyasminnakasmādvāsarodane oṣadhīgandhaje mūrchā śirorugvamathuḥ kṣayaḥ

In this possession-fever, there is causeless weeping. In the fever born of plant-fragrance, there occur fainting, headache, vomiting, and wasting.

Verse 28 (garuda.1.147.28)

विषान्मूर्छातिसारश्च श्यावता दाहकृद्भ्रमः । क्रोधात्कम्पः शिरोरुक्च प्रलापो भयशोकजे

viṣānmūrchātisāraśca śyāvatā dāhakṛdbhramaḥ krodhātkampaḥ śirorukca pralāpo bhayaśokaje

Poison-born fever brings fainting, diarrhea, a dark-bluish hue, burning, and giddiness. Anger-born fever brings trembling and headache; fear- and grief-born fever brings delirium.

Verse 29 (garuda.1.147.29)

कामाद्भ्रमोऽरुचिर्दाहो ह्रीनिद्राधीधृतिक्षयाः । ग्रहादौ सन्निपातस्य रूपादौ मरुतस्तयोः

kāmādbhramo'rucirdāho hrīnidrādhīdhṛtikṣayāḥ grahādau sannipātasya rūpādau marutastayoḥ

Desire-born fever brings giddiness, loss of appetite, burning, and the loss of modesty, sleep, intellect, and fortitude. In possession-fever and the rest, the initial signs resemble those of sannipata combined with Vata.

Verse 30 (garuda.1.147.30)

कोपात्कोपेऽपि पित्तस्य यौ तु शापाभिचारजौ । सन्निपातज्वरौ घोरौ तावसह्यतमौ मतौ

kopātkope'pi pittasya yau tu śāpābhicārajau sannipātajvarau ghorau tāvasahyatamau matau

From wrath, an aggravation of Pitta also arises. But the two fevers born of a curse and of sorcery, resembling sannipata, are terrible and are held to be the most unbearable of all.

Verse 31 (garuda.1.147.31)

तन्त्रा भिचारिकैर्मन्त्रैर्दूयमानञ्च तप्यते । पूर्वञ्चैतस्ततो देहस्ततो विस्फोटदिग्भ्रमैः

tantrā bhicārikairmantrairdūyamānañca tapyate pūrvañcaitastato dehastato visphoṭadigbhramaiḥ

One tormented by sorcery-mantras suffers greatly; first this distress arises, then it attacks the body, then it advances with blisters and disorientation.

Verse 32 (garuda.1.147.32)

सदाहमूर्छाग्रस्तस्य प्रत्यहं वर्धते ज्वरः । इति ज्वरोऽष्टधा दृष्टः समासाद्द्विबिधस्तु सः

sadāhamūrchāgrastasya pratyahaṁ vardhate jvaraḥ iti jvaro'ṣṭadhā dṛṣṭaḥ samāsāddvibidhastu saḥ

In one seized with burning and fainting, the fever increases day by day. Thus fever is seen to be eightfold; but in brief, it is also twofold —

Verse 33 (garuda.1.147.33)

शारीरो मानसः सौम्यस्तीक्ष्णोंन्तर्बहिराश्रयः । प्राकृतो वैकृतः साध्योऽसाध्यः सामो निरामकः

śārīro mānasaḥ saumyastīkṣṇoṁntarbahirāśrayaḥ prākṛto vaikṛtaḥ sādhyo'sādhyaḥ sāmo nirāmakaḥ

bodily and mental; mild and severe; internally or externally located; natural and abnormal; curable and incurable; and with or without ama.

Verse 34 (garuda.1.147.34)

पूर्वं शरिरे शरीरे तापो मनसि मानसे । पवनैर्योगवाहित्वाच्छीतं श्लेष्मयुते भवेत्

pūrvaṁ śarire śarīre tāpo manasi mānase pavanairyogavāhitvācchītaṁ śleṣmayute bhavet

The former, bodily fever, shows heat in the body; the latter, mental fever, in the mind. Because of Vata's carrying quality, coldness occurs when it is combined with Kapha —

Verse 35 (garuda.1.147.35)

दाहः पित्तयुते मिश्रं मिश्रेऽन्तः संश्रये पुनः । ज्वरेऽधिकं विकाराः स्युरन्तः क्षोभो मलग्रहः

dāhaḥ pittayute miśraṁ miśre'ntaḥ saṁśraye punaḥ jvare'dhikaṁ vikārāḥ syurantaḥ kṣobho malagrahaḥ

burning when combined with Pitta, and mixed symptoms when combined with both. When the fever is internally located, the disturbances too are greater internally — inner agitation and retention of waste —

Verse 36 (garuda.1.147.36)

बहिरेव बहिर्वेगे तापोऽपि च स साधितः । वर्षाशरद्वसन्तेषु वाताद्यैः प्रकृतः क्रमात्

bahireva bahirvege tāpo'pi ca sa sādhitaḥ varṣāśaradvasanteṣu vātādyaiḥ prakṛtaḥ kramāt

while, in the externally located type, the heat too manifests outwardly and is more easily treated. Fever caused respectively by Vata and the others in their proper season — rains, autumn, and spring — is called natural, prakrita.

Verse 37 (garuda.1.147.37)

वैकृतोऽन्यः स दुः साध्यः प्रायश्च प्राकृतोऽनिलात् । वर्षासु मारुतो दुष्टः पित्तश्लेष्मान्वितं ज्वरम्

vaikṛto'nyaḥ sa duḥ sādhyaḥ prāyaśca prākṛto'nilāt varṣāsu māruto duṣṭaḥ pittaśleṣmānvitaṁ jvaram

The other, abnormal fever, is difficult to cure; and mostly the natural fever from Vata occurs in the rainy season, where the vitiated Vata, combined with Pitta and Kapha, produces the fever.

Verse 38 (garuda.1.147.38)

कुर्याच्च पित्तं शरदि तस्य चानुचरः कफः । तत्प्रकृत्या विसर्गाच्च तत्र नानशनाद्भयम्

kuryācca pittaṁ śaradi tasya cānucaraḥ kaphaḥ tatprakṛtyā visargācca tatra nānaśanādbhayam

In autumn, Pitta produces the fever, with Kapha following as its companion. By its own nature and proper release, without excessive fasting, there is no danger.

Verse 39 (garuda.1.147.39)

कफो वसन्ते तमपि वातपित्तं भवेदनु । बलवत्स्वल्पदोषेषु ज्वरः साध्योऽनुपद्रवः

kapho vasante tamapi vātapittaṁ bhavedanu balavatsvalpadoṣeṣu jvaraḥ sādhyo'nupadravaḥ

In spring, Kapha produces the fever, followed likewise by Vata and Pitta. In strong persons with mild vitiation, fever without complications is curable.

Verse 40 (garuda.1.147.40)

सर्वथा विकृतिज्ञाने प्रागसाध्य उदाहृतः । ज्वरोपद्रवतीक्ष्णत्वं मन्दाग्निर्बहुमूत्रता

sarvathā vikṛtijñāne prāgasādhya udāhṛtaḥ jvaropadravatīkṣṇatvaṁ mandāgnirbahumūtratā

When the abnormal nature is fully recognized, it has already been declared incurable. Severity of the fever's complications, weak digestive fire, and excessive urination —

Verse 41 (garuda.1.147.41)

न प्रवृत्तिर्न विजीर्णा न क्षुत्सामज्वराकृतिः । ज्वरवेगोऽधिकस्तृष्णा प्रलापः श्वसनं भ्रमः

na pravṛttirna vijīrṇā na kṣutsāmajvarākṛtiḥ jvaravego'dhikastṛṣṇā pralāpaḥ śvasanaṁ bhramaḥ

absence of proper elimination, indigestion, and absence of hunger — this is the form of ama-fever. Excessive intensity of the fever, thirst, delirium, breathlessness, and giddiness —

Verse 42 (garuda.1.147.42)

मलप्रवृत्तिरुत्क्लेशः पच्यमानस्य लक्षणम् । जीर्णतामविपर्यासात्सप्तरात्रं च लङ्घनम्

malapravṛttirutkleśaḥ pacyamānasya lakṣaṇam jīrṇatāmaviparyāsātsaptarātraṁ ca laṅghanam

along with elimination of stool accompanied by nausea — these are the signs of the fever in the process of resolving. Fasting for seven nights, without deviation, results in the state of full resolution.

Verse 43 (garuda.1.147.43)

ज्वरः पञ्चविधः प्रोक्तो मलकालबलाबलात् । प्रायशः सन्निपातेन भूयसामुपदिश्यते

jvaraḥ pañcavidhaḥ prokto malakālabalābalāt prāyaśaḥ sannipātena bhūyasāmupadiśyate

Fever is declared to be of five kinds, according to elimination, timing, and strength or weakness; in most cases it is mostly taught as arising through sannipata.

Verse 44 (garuda.1.147.44)

सन्ततः सततोऽन्येद्युस्तृतीयकचतुर्थकौ । धातुमूत्रशकृद्वाहिस्नोत सां व्यापिनो मलाः

santataḥ satato'nyedyustṛtīyakacaturthakau dhātumūtraśakṛdvāhisnota sāṁ vyāpino malāḥ

Santata, Satata, Anyedyushka, Tritiyaka, and Chaturthaka — these are the five. The vitiated humors, pervading the channels that carry the tissues, urine, and feces —

Verse 45 (garuda.1.147.45)

तापयन्तस्तनुं सर्वां तुल्यदृष्ट्यादिवर्धिताः । बलिनो गुरवस्तस्याविशेषेण रसाश्रिताः

tāpayantastanuṁ sarvāṁ tulyadṛṣṭyādivardhitāḥ balino guravastasyāviśeṣeṇa rasāśritāḥ

heating the entire body, increased through repeated similar exposure, strong and heavy, lodged indiscriminately in the rasa tissue —

Verse 46 (garuda.1.147.46)

सततं निष्प्रतिद्वन्द्वाज्वरं कुर्युः सुदुः सहम् । मलं ज्वरोष्णधातून्वा स शीघ्रं क्षपयेत्ततः

satataṁ niṣpratidvandvājvaraṁ kuryuḥ suduḥ saham malaṁ jvaroṣṇadhātūnvā sa śīghraṁ kṣapayettataḥ

produce, without any remission, a most unbearable fever — this is the Santata type. One should then quickly eliminate the waste-matter and heated tissues caused by that fever.

Verse 47 (garuda.1.147.47)

सर्वाकारं रसादीनां शुद्ध्यासुद्ध्यापि वा क्रमात् । वातपित्तकफैः सप्तद शद्वादशवासरात्

sarvākāraṁ rasādīnāṁ śuddhyāsuddhyāpi vā kramāt vātapittakaphaiḥ saptada śadvādaśavāsarāt

By the purification or non-purification, in due order, of all the states of rasa and the other tissues, through Vata, Pitta, and Kapha, within seven, ten, or twelve days —

Verse 48 (garuda.1.147.48)

प्रायोऽनुयाति मर्यादां मोक्षाय च वधाय च । इत्यग्निवेशस्य मतं हारीतस्य पुनः स्मृतिः

prāyo'nuyāti maryādāṁ mokṣāya ca vadhāya ca ityagniveśasya mataṁ hārītasya punaḥ smṛtiḥ

it generally reaches its limit, whether toward recovery or toward death. This is the view of Agnivesha; but the teaching remembered from Harita differs.

Verse 49 (garuda.1.147.49)

द्विगुणा सप्तमी या च नवम्येकादशी तथा । एषा त्रिदोषमर्यादा मोक्षाय च वधाय च

dviguṇā saptamī yā ca navamyekādaśī tathā eṣā tridoṣamaryādā mokṣāya ca vadhāya ca

Twice the seventh day, that is the fourteenth, and the ninth and the eleventh — this is the tridosha's time-limit, whether for recovery or for death.

Verse 50 (garuda.1.147.50)

शुद्ध्याशुद्ध्या ज्वरः कालं दीर्घमप्यत्र वर्तते । कृशानां व्याधियुक्तानां मिथ्याहारादिसेविनाम्

śuddhyāśuddhyā jvaraḥ kālaṁ dīrghamapyatra vartate kṛśānāṁ vyādhiyuktānāṁ mithyāhārādisevinām

According to purification or its absence, fever may persist here for a long time — in the emaciated, in those already afflicted with disease, and in those who indulge in improper diet and the like.

Verse 51 (garuda.1.147.51)

अल्पोऽपि दोषो दुष्ट्यादेर्लब्ध्वान्यतमतो बलम् । स प्रत्यनीको विषमं यस्माद्वृद्धिक्षयान्वितः

alpo'pi doṣo duṣṭyāderlabdhvānyatamato balam sa pratyanīko viṣamaṁ yasmādvṛddhikṣayānvitaḥ

Even a slight humor, on gaining strength from some other vitiating cause, becomes contrary and produces irregularity, because it is subject to alternating increase and decrease.

Verse 52 (garuda.1.147.52)

सविक्षेपो ज्वरं कुर्याद्विषमक्षयवृद्धिभाक् । दोषः प्रवर्तते तेषां स्वे काले ज्वरयन्बली

savikṣepo jvaraṁ kuryādviṣamakṣayavṛddhibhāk doṣaḥ pravartate teṣāṁ sve kāle jvarayanbalī

Thus displaced, it produces an irregular fever, alternately waning and waxing. The humor becomes active with strength in its own proper time —

Verse 53 (garuda.1.147.53)

निवर्तते पुनश्चैव प्रत्यनीकबलाबलः । क्षीणदोषो ज्वरः सूक्ष्मो रसादिष्वेव लीयते

nivartate punaścaiva pratyanīkabalābalaḥ kṣīṇadoṣo jvaraḥ sūkṣmo rasādiṣveva līyate

and then subsides again, according to the strength or weakness of the opposing humor. When the humor is diminished, the fever becomes subtle and remains dissolved only in the rasa and other tissues.

Verse 54 (garuda.1.147.54)

लीनत्वात्कार्श्यवैवर्ण्यजाड्यादीनां दधाति सः । आसन्नविकृतास्यत्वात्स्रोतसां रसवाहिनाम्

līnatvātkārśyavaivarṇyajāḍyādīnāṁ dadhāti saḥ āsannavikṛtāsyatvātsrotasāṁ rasavāhinām

Because of this dissolved state, it produces emaciation, discoloration, and torpor. Because of the impaired condition of the nearby rasa-carrying channels —

Verse 55 (garuda.1.147.55)

आशु सर्वस्य वपुषो व्याप्तिदोषो न जायते । सन्तः सततस्तेन विपरीतो विपर्ययात्

āśu sarvasya vapuṣo vyāptidoṣo na jāyate santaḥ satatastena viparīto viparyayāt

a swift pervasion of the whole body by the humor does not occur. This describes the Satata, recurring type; the opposite, Anyedyushka, arises through the reverse process.

Verse 56 (garuda.1.147.56)

विषमो विषमारम्भः क्षपाकालेन सङ्गवान् । दोषो रक्ताश्रयः प्रायः करोति सन्ततं ज्वरम्

viṣamo viṣamārambhaḥ kṣapākālena saṅgavān doṣo raktāśrayaḥ prāyaḥ karoti santataṁ jvaram

The irregular fever begins irregularly, associated with the time of night. The humor, generally lodged in the blood, produces the continuous, santata fever.

Verse 57 (garuda.1.147.57)

अहोरात्रस्य सन्धौ स्यात्सकृदन्येद्युराश्रितः । तस्मिन्मांसवहा नाडी मेदोनाडी तृतीयके

ahorātrasya sandhau syātsakṛdanyedyurāśritaḥ tasminmāṁsavahā nāḍī medonāḍī tṛtīyake

It occurs once, at the junction of day and night, in the anyedyushka type. In that, the flesh-carrying vessel is involved; in the tertian type, the fat-carrying vessel —

Verse 58 (garuda.1.147.58)

ग्राही पित्तानिलान्मूर्ध्नस्त्रिकस्य कफपित्ततः । सपृष्ठस्यानिलकफात्स चैकाहान्तरः स्मृतः

grāhī pittānilānmūrdhnastrikasya kaphapittataḥ sapṛṣṭhasyānilakaphātsa caikāhāntaraḥ smṛtaḥ

which grips the humor — in the head from Pitta and Vata, in the sacrum from Kapha and Pitta, and along the spine from Vata and Kapha — this is remembered as occurring with a one-day interval.

Verse 59 (garuda.1.147.59)

चतुर्थको मलैर्मेदोमज्जास्थ्यन्यतरे स्थितः । मज्जास्थ एव ह्यपरः प्रभावमनुदर्शयेत्

caturthako malairmedomajjāsthyanyatare sthitaḥ majjāstha eva hyaparaḥ prabhāvamanudarśayet

The quartan fever, from vitiated humors, is located in one or another of the fat, marrow, or bone tissues; when located in the marrow, its effect appears especially strong.

Verse 60 (garuda.1.147.60)

द्विधा कफोणिजङ्घाभ्यां स पूर्वं शिरसानिलात् । अस्थिमज्जोरुपगतश्चतुर्थकविपर्ययः

dvidhā kaphoṇijaṅghābhyāṁ sa pūrvaṁ śirasānilāt asthimajjorupagataścaturthakaviparyayaḥ

It is twofold: through Kapha in the forearm and calf, and first, through Vata, in the head; when it reaches the bone, marrow, and thighs, it becomes the reverse form of the quartan.

Verse 61 (garuda.1.147.61)

त्रिधा त्र्यहं ज्वरयति दिनमेकन्तु मुञ्चति । बला बलेन दोषणामन्यचेष्टादिजन्मनाम्

tridhā tryahaṁ jvarayati dinamekantu muñcati balā balena doṣaṇāmanyaceṣṭādijanmanām

In its threefold form it produces fever for three days and gives one day's respite — this depends on the strength or weakness of the humors arising from other activities and causes.

Verse 62 (garuda.1.147.62)

पक्रानामविपर्यासात्सप्तरात्रञ्च लङ्घयेत् । ज्वरः स्यान्मनसस्तद्वत्कर्मणश्च तदातदा

pakrānāmaviparyāsātsaptarātrañca laṅghayet jvaraḥ syānmanasastadvatkarmaṇaśca tadātadā

Without deviation from the properly ripened humors, one should fast for seven nights. Fever may likewise arise from the mind, and from time to time from past karma.

Verse 63 (garuda.1.147.63)

गम्भीरधातुचारित्वात्सन्निपातेन सम्भवात् । तुल्योच्छ्रयाच्च दोषाणां दुश्चिकित्स्यश्चतुर्थकः

gambhīradhātucāritvātsannipātena sambhavāt tulyocchrayācca doṣāṇāṁ duścikitsyaścaturthakaḥ

Because of its deep movement through the tissues, its origin in sannipata, and the equal predominance of all three humors, the quartan fever is difficult to treat.

Verse 64 (garuda.1.147.64)

सूक्षामात्सूक्ष्मज्वरेष्वेषु दूरद्दूरतरेषु च । दोषो रक्तादिमार्गेषु शनैरल्पश्चिरेण यत्

sūkṣāmātsūkṣmajvareṣveṣu dūraddūratareṣu ca doṣo raktādimārgeṣu śanairalpaścireṇa yat

In these subtle fevers, through channels farther and farther apart, the humor moves slowly and in small amounts, over a long time, through the pathways of blood and the rest —

Verse 65 (garuda.1.147.65)

याति देहञ्च नाशेषं सन्तापादीन्करोत्यतः । क्रमो यत्नेन विच्छिन्नः सतापो लक्ष्यते ज्वरः

yāti dehañca nāśeṣaṁ santāpādīnkarotyataḥ kramo yatnena vicchinnaḥ satāpo lakṣyate jvaraḥ

and, pervading the entire body, produces burning and other symptoms. When this sequence is interrupted only with effort, the fever, accompanied by heat, becomes clearly visible.

Verse 66 (garuda.1.147.66)

विषमो विषमारम्भः क्षपाकालानुसारवान् । यथोत्तरं मन्दगतिर्मन्दशक्तिर्यथायथम्

viṣamo viṣamārambhaḥ kṣapākālānusāravān yathottaraṁ mandagatirmandaśaktiryathāyatham

The irregular fever begins irregularly, following the timing of night; successively, its progress and strength grow correspondingly weaker.

Verse 67 (garuda.1.147.67)

कालेनाप्नोति सदृशान्स रसादींस्तथातथा । दोषो ज्वरयति क्रुद्धश्चिराच्चिरतरेण च

kālenāpnoti sadṛśānsa rasādīṁstathātathā doṣo jvarayati kruddhaścirācciratareṇa ca

In due time, it repeatedly reaches similar states within the rasa and other tissues. The aggravated humor produces fever sometimes quickly and sometimes over a longer time.

Verse 68 (garuda.1.147.68)

भूमौ स्थितं जलैः सिक्तं कालं नैव प्रतीक्षते । अङ्कुराय यथा बीजं दोषबीजं भवेत्तथा

bhūmau sthitaṁ jalaiḥ siktaṁ kālaṁ naiva pratīkṣate aṅkurāya yathā bījaṁ doṣabījaṁ bhavettathā

Just as a seed placed in the ground and watered does not wait for a fixed time to sprout, so is the seed of the vitiated humor.

Verse 69 (garuda.1.147.69)

वेगं कृत्वाविषं यद्वदाशये नयते बलम् । कुप्यत्याप्तबलं भूयः कालदोषविषन्तथा

vegaṁ kṛtvāviṣaṁ yadvadāśaye nayate balam kupyatyāptabalaṁ bhūyaḥ kāladoṣaviṣantathā

Just as poison, having spent its initial force, gathers strength again within its reservoir, so time, humor, and poison, having regained strength, again become aggravated.

Verse 70 (garuda.1.147.70)

एवं ज्वराः प्रवर्तन्ते विषमाः सततादयः । उत्क्लेशो गौरवं दैन्यं भङ्गोऽङ्गानां विजृम्भणम्

evaṁ jvarāḥ pravartante viṣamāḥ satatādayaḥ utkleśo gauravaṁ dainyaṁ bhaṅgo'ṅgānāṁ vijṛmbhaṇam

Thus arise the irregular fevers, Santata and the rest. Nausea, heaviness, wretchedness, aching of the limbs, and yawning —

Verse 71 (garuda.1.147.71)

अरोचको वमिः श्वासः सर्वस्मिन्रसगे ज्वरे । रक्तनिष्ठीवनं तृष्णा रूक्षोष्णं पीडकोद्यमः

arocako vamiḥ śvāsaḥ sarvasminrasage jvare raktaniṣṭhīvanaṁ tṛṣṇā rūkṣoṣṇaṁ pīḍakodyamaḥ

loss of appetite, vomiting, and breathlessness occur in all fevers located in the rasa. Spitting of blood, thirst, dryness and heat, and the eruption of pustules —

Verse 72 (garuda.1.147.72)

दाहरागभ्रममदप्रलापो रक्तसंश्रिते । तृड्ग्लानिः स्पृष्टवर्चस्कमन्तर्दाहो भ्रमस्तमः

dāharāgabhramamadapralāpo raktasaṁśrite tṛḍglāniḥ spṛṣṭavarcaskamantardāho bhramastamaḥ

burning, redness, giddiness, an intoxication-like stupor, and delirium occur in blood-located fever. Thirst, exhaustion, obstructed stool, internal burning, giddiness, and darkness —

Verse 73 (garuda.1.147.73)

दौर्गन्ध्यं गात्रविक्षेपो मांसस्थे मेदसि स्थिते । स्वेदोऽतितृष्णा वमनं दौर्गन्ध्यं वा सहिष्णुता

daurgandhyaṁ gātravikṣepo māṁsasthe medasi sthite svedo'titṛṣṇā vamanaṁ daurgandhyaṁ vā sahiṣṇutā

foul odor and thrashing of the limbs occur in flesh-located fever; and in fat-located fever, sweating, excessive thirst, vomiting, foul odor, or tolerance of these.

Verse 74 (garuda.1.147.74)

प्रलापो ग्लानिररुचिरस्थिगे त्वस्थिभेदनम् । दोषप्रवृत्तिरुद्बोधः श्वासांगक्षेपकूजनम्

pralāpo glānirarucirasthige tvasthibhedanam doṣapravṛttirudbodhaḥ śvāsāṁgakṣepakūjanam

Delirium, exhaustion, and loss of appetite occur in bone-located fever, along with a splitting pain in the bones; discharge of the humor, restlessness, breathlessness, thrashing of limbs, and groaning —

Verse 75 (garuda.1.147.75)

अन्तर्दाहो बहिः शैत्यं श्वासो हिक्का हि मज्जमे । तमसो दर्शनं मर्मच्छेदनं स्तब्धमेढ्रता

antardāho bahiḥ śaityaṁ śvāso hikkā hi majjame tamaso darśanaṁ marmacchedanaṁ stabdhameḍhratā

internal burning with external coldness, breathlessness, and hiccup occur in marrow-located fever, along with the appearance of darkness before the eyes, pain as if the vital points were being cut, and stiffness of the genitals —

Verse 76 (garuda.1.147.76)

शुक्रप्रवृत्तौ मृत्युस्तु जायते शुक्रसंश्रये । उत्तरोत्तरदुः साध्याः पञ्चान्ये तु विपर्यये

śukrapravṛttau mṛtyustu jāyate śukrasaṁśraye uttarottaraduḥ sādhyāḥ pañcānye tu viparyaye

and in reproductive-tissue-located fever, death comes with the discharge of semen. Each successive location is more difficult to cure than the last; the other five, in reverse order, are correspondingly easier.

Verse 77 (garuda.1.147.77)

प्रलिम्पन्निव गात्राणि श्लेष्मणा गौरवेण च । मन्दज्वरप्रलापस्तु सशीतः स्यात्प्रलेपकः

pralimpanniva gātrāṇi śleṣmaṇā gauraveṇa ca mandajvarapralāpastu saśītaḥ syātpralepakaḥ

As if coating the limbs, with kapha and heaviness; a fever with mild delirium accompanied by chill is called Pralepaka, the coating fever.

Verse 78 (garuda.1.147.78)

नित्यं मन्दज्वरो रूक्षः शीतकृच्छ्रेण गच्छति । स्तब्धाङ्गः श्लेष्मभूयिष्ठो भवेदङ्गबलाशकः

nityaṁ mandajvaro rūkṣaḥ śītakṛcchreṇa gacchati stabdhāṅgaḥ śleṣmabhūyiṣṭho bhavedaṅgabalāśakaḥ

A constantly mild, dry fever that comes with difficulty through cold, with stiff limbs and predominant kapha, weakens the body's strength.

Verse 79 (garuda.1.147.79)

हरिद्राभेदवर्णाभस्तद्वल्लेपं प्रमेहति । स वै हारिद्रको नाम ज्वरभेदोऽन्तकः स्मृतः

haridrābhedavarṇābhastadvallepaṁ pramehati sa vai hāridrako nāma jvarabhedo'ntakaḥ smṛtaḥ

When the color becomes turmeric-hued and a similarly colored coating is passed, this is called Haridraka, the jaundice-fever — it is held to be a deadly form of fever.

Verse 80 (garuda.1.147.80)

कफवातौ समौ यत्र हीनपित्तस्य देहिनः । तीक्ष्णोऽथ वा दिवा मन्दो जायते रात्रिजो ज्वरः

kaphavātau samau yatra hīnapittasya dehinaḥ tīkṣṇo'tha vā divā mando jāyate rātrijo jvaraḥ

Where Kapha and Vata are equal and Pitta is diminished, either an intense fever by day or a mild one by night arises — this is night-arising fever.

Verse 81 (garuda.1.147.81)

दिवाकरार्पितबले व्यायामाच्च विशोषिते । शरीरे नियतं वाताज्ज्वरः स्यात्पौर्वरात्रिकः

divākarārpitabale vyāyāmācca viśoṣite śarīre niyataṁ vātājjvaraḥ syātpaurvarātrikaḥ

When the body's strength is exhausted by sun's heat and by exertion, and thus dried out, fever certainly arises from Vata in the early part of the night.

Verse 82 (garuda.1.147.82)

आमाशये यदात्मस्थे श्लेष्मपित्ते ह्यधः स्थिते । तदर्धं शीतलं देहे ह्यर्धं चोष्णं प्रजायते

āmāśaye yadātmasthe śleṣmapitte hyadhaḥ sthite tadardhaṁ śītalaṁ dehe hyardhaṁ coṣṇaṁ prajāyate

When Kapha remains lodged in the stomach and Pitta is situated below it, half the body becomes cold and half becomes hot.

Verse 83 (garuda.1.147.83)

काये पित्तं यदा न्यस्तं श्लेष्मा चान्ते व्यवस्थितः । उष्णत्वं तेन देहस्य शीतत्वं करपादयोः

kāye pittaṁ yadā nyastaṁ śleṣmā cānte vyavasthitaḥ uṣṇatvaṁ tena dehasya śītatvaṁ karapādayoḥ

When Pitta is lodged in the upper body and Kapha is settled at the extremity, there is heat in the body and coldness in the hands and feet.

Verse 84 (garuda.1.147.84)

रसरक्ताश्रयः साध्यो मांस मेदोगतश्च यः । अस्थिमज्जागतः कृच्छ्रस्तैस्तैः स्वाङ्गैर्हतप्रभः

rasaraktāśrayaḥ sādhyo māṁsa medogataśca yaḥ asthimajjāgataḥ kṛcchrastaistaiḥ svāṅgairhataprabhaḥ

Fever lodged in rasa and blood is curable, and that lodged in flesh and fat as well; that lodged in bone and marrow is difficult to cure — in each, the patient's own luster grows dim.

Verse 85 (garuda.1.147.85)

विसंज्ञो ज्रवेगार्तः सक्रोध इव वीक्षते । सदोषमुष्णञ्च सदा शकृन्मुञ्चति वेगवत्

visaṁjño jravegārtaḥ sakrodha iva vīkṣate sadoṣamuṣṇañca sadā śakṛnmuñcati vegavat

Unconscious, afflicted by the force of the fever, he stares as if in anger; he passes stool that is always hot and mixed with vitiated humor, forcefully.

Verse 86 (garuda.1.147.86)

देहो लघुर्व्यपगतक्लममोहतापः पाको मुखे करणसौष्ठवमव्यथत्वम् । स्वेदः क्षुवः प्रकृतियोगिमनोऽन्नलिप्सा कण्डूश्च मूर्ध्नि विगत्ज्वरलक्षणानि

deho laghurvyapagataklamamohatāpaḥ pāko mukhe karaṇasauṣṭhavamavyathatvam svedaḥ kṣuvaḥ prakṛtiyogimano'nnalipsā kaṇḍūśca mūrdhni vigatjvaralakṣaṇāni

Lightness of the body, the departure of fatigue, confusion, and burning; the return of taste in the mouth; proper functioning of the senses; freedom from pain; sweating; sneezing; the mind returning to its natural state; desire for food; and itching of the scalp — these are the signs that the fever has departed.