The Diagnosis of Cough

Verse 1 (garuda.1.149.1)

धन्वन्तरिरुवाच । आशुकारी यतः कासः स एवातः प्रवक्ष्यते । पञ्च कासाः स्मृता वातपित्तश्लेष्मक्षतक्षयैः

dhanvantariruvāca āśukārī yataḥ kāsaḥ sa evātaḥ pravakṣyate pañca kāsāḥ smṛtā vātapittaśleṣmakṣatakṣayaiḥ

Dhanvantari said: Since cough can bring on serious disease quickly, it shall now be described. Five kinds of cough are remembered: from Vata, Pitta, Kapha, Kshata (traumatic injury), and Kshaya (consumption).

Verse 2 (garuda.1.149.2)

क्षयायोपेक्षिताः सर्वे बलिनश्चोत्तरोत्तरम् । तेषां भविष्यतां रूपं कण्ठे कण्डूररोचकः

kṣayāyopekṣitāḥ sarve balinaścottarottaram teṣāṁ bhaviṣyatāṁ rūpaṁ kaṇṭhe kaṇḍūrarocakaḥ

If neglected, all of these lead toward wasting disease, each successive type more severe than the last. Their premonitory signs are itching in the throat and loss of appetite —

Verse 3 (garuda.1.149.3)

शुष्ककर्णास्यकण्ठत्वं तत्राधोविहितोऽनिलः । ऊर्ध्वं प्रवृत्तः प्राप्यो रस्तस्मिन्कण्ठे च संसृजन्

śuṣkakarṇāsyakaṇṭhatvaṁ tatrādhovihito'nilaḥ ūrdhvaṁ pravṛttaḥ prāpyo rastasminkaṇṭhe ca saṁsṛjan

and dryness of the ears, mouth, and throat. There, Vata, normally situated below, moves upward and mixes with the fluid rasa in that throat —

Verse 4 (garuda.1.149.4)

शिरास्रोतांसि संपूर्य ततोऽङ्गान्युत्क्षिपन्ति च । क्षिपन्निवाक्षिणी क्लिष्टस्वरः पार्श्वे च पीडयन्

śirāsrotāṁsi saṁpūrya tato'ṅgānyutkṣipanti ca kṣipannivākṣiṇī kliṣṭasvaraḥ pārśve ca pīḍayan

filling the vessels and channels, it convulses the limbs; as if striking the eyes, straining the voice, and afflicting the sides with pain —

Verse 5 (garuda.1.149.5)

प्रवर्तते सवक्रेण भिन्नकांस्योपमध्वनिः । हृत्पार्श्वेरुशिरः शूलमोहक्षोभस्वरक्षयान्

pravartate savakreṇa bhinnakāṁsyopamadhvaniḥ hṛtpārśveruśiraḥ śūlamohakṣobhasvarakṣayān

it proceeds with a twisted expression, producing a sound like a cracked bronze bowl; it produces pain in the heart, sides, and thighs, along with confusion, agitation, and loss of voice —

Verse 6 (garuda.1.149.6)

करोति शुष्ककासञ्च महावेगरुजास्वनम् । सोंगहर्षो कफं शुष्कं कृछ्रान्मुक्त्वाल्पतां व्रजेत्

karoti śuṣkakāsañca mahāvegarujāsvanam soṁgaharṣo kaphaṁ śuṣkaṁ kṛchrānmuktvālpatāṁ vrajet

and causes a dry cough of great force, pain, and sound; with horripilation, only a little dry phlegm is expelled, with difficulty — this is Vata-born cough.

Verse 7 (garuda.1.149.7)

पित्तात्पीताक्षिकत्वं च तिक्तास्यत्वं ज्वरो भ्रमः । पित्तासृग्वमनं तृष्णा वैस्वर्यं धूमको मदः

pittātpītākṣikatvaṁ ca tiktāsyatvaṁ jvaro bhramaḥ pittāsṛgvamanaṁ tṛṣṇā vaisvaryaṁ dhūmako madaḥ

From Pitta come yellowness of the eyes, bitterness in the mouth, fever, giddiness, vomiting of bile mixed with blood, thirst, hoarseness, a smoky sensation, and an intoxication-like stupor —

Verse 8 (garuda.1.149.8)

प्रततं कासवेगे च ज्योतिषामिव दर्शनम् । कफादुरोऽल्परुङ्मूर्धि हृदयं स्तिमिते गुरु

pratataṁ kāsavege ca jyotiṣāmiva darśanam kaphāduro'lparuṅmūrdhi hṛdayaṁ stimite guru

and, with each fit of coughing, the appearance of sparks before the eyes — this is Pitta-born cough. From Kapha come slight chest pain, heaviness in the head, and a heavy, congested heart —

Verse 9 (garuda.1.149.9)

कण्ठे प्रलेपमदजं पीनसच्छर्द्यरोचकाः । रोमहर्षो धनस्निग्धंश्लेष्मणाञ्च प्रवर्तनम्

kaṇṭhe pralepamadajaṁ pīnasacchardyarocakāḥ romaharṣo dhanasnigdhaṁśleṣmaṇāñca pravartanam

a coating in the throat, a stupor-like heaviness, catarrh, vomiting, loss of appetite, horripilation, and the discharge of thick, unctuous phlegm — this is Kapha-born cough.

Verse 10 (garuda.1.149.10)

युद्धाद्यैः साहसैस्तैस्तैः सेवितैरयथाबलम् । उपस्यन्तः क्षतो वायुः पित्तेनानुगतो बली

yuddhādyaiḥ sāhasaistaistaiḥ sevitairayathābalam upasyantaḥ kṣato vāyuḥ pittenānugato balī

From reckless exertions such as combat, undertaken beyond one's strength, injury results; the Vata thus lodged internally, joined with Pitta and made strong —

Verse 11 (garuda.1.149.11)

कुपितः कुरुते कासं कफं तेन सशोणितम् । पीतं श्यावञ्च शुष्कञ्च ग्रथितं कुपितं बहु

kupitaḥ kurute kāsaṁ kaphaṁ tena saśoṇitam pītaṁ śyāvañca śuṣkañca grathitaṁ kupitaṁ bahu

becomes aggravated and produces cough; through it, the phlegm becomes mixed with blood — yellow, dark, dry, clotted, and copious.

Verse 12 (garuda.1.149.12)

ष्ठीवेत्कण्ठेन रुजता विभिन्नेनैव चोरसा । सूचीभिरिव तीक्ष्णाभिस्तुद्यमानेन शूलिना

ṣṭhīvetkaṇṭhena rujatā vibhinnenaiva corasā sūcībhiriva tīkṣṇābhistudyamānena śūlinā

He spits it out with a throat that aches and a chest that feels as if torn, as though pierced by sharp needles, afflicted with stabbing pain —

Verse 13 (garuda.1.149.13)

दुः खस्पर्शेन शूलेन भेदपीडाहितापिना । पर्वभेदज्वरश्वासतृष्णावैस्वर्यकम्पवान्

duḥ khasparśena śūlena bhedapīḍāhitāpinā parvabhedajvaraśvāsatṛṣṇāvaisvaryakampavān

with pain unbearable to the touch, causing a splitting, pressing, burning sensation; accompanied by aching joints, fever, breathlessness, thirst, hoarseness, and trembling —

Verse 14 (garuda.1.149.14)

पारावत इवोत्कूजन्पार्श्वशूली ततोऽस्य च । कफाद्यैर्वमनं पक्तिबलवर्णञ्च हीयते

pārāvata ivotkūjanpārśvaśūlī tato'sya ca kaphādyairvamanaṁ paktibalavarṇañca hīyate

cooing like a dove, and afflicted with pain in the sides — in this state, vomiting of phlegm and the like occurs, and digestion, strength, and complexion decline — this is injury-born cough.

Verse 15 (garuda.1.149.15)

क्षीणस्य सासृङ्मूत्रत्वं श्वासपृष्टकटिग्रहः । षायुप्रधानाः कुपिता धावतो राजयक्ष्मणः

kṣīṇasya sāsṛṅmūtratvaṁ śvāsapṛṣṭakaṭigrahaḥ ṣāyupradhānāḥ kupitā dhāvato rājayakṣmaṇaḥ

In the wasted patient, there is blood in the urine, breathlessness, and stiffness of the back and hips. When Vata predominates among the aggravated humors in one afflicted with consumption —

Verse 16 (garuda.1.149.16)

कर्वन्ति यक्ष्मायतने कासं ष्ठीवत्कफं ततः । पूतिपूयोपमं वीतं मिश्रं हरितलोहितम्

karvanti yakṣmāyatane kāsaṁ ṣṭhīvatkaphaṁ tataḥ pūtipūyopamaṁ vītaṁ miśraṁ haritalohitam

cough arises at the seat of consumption, in which phlegm resembling putrid pus, mixed and streaked with greenish-red matter, is expectorated.

Verse 17 (garuda.1.149.17)

सुप्यते तुद्यत इव हृदयं पचतीव च । अकस्मादुष्णशीतेच्छा बह्वाशित्वं बलक्षयः

supyate tudyata iva hṛdayaṁ pacatīva ca akasmāduṣṇaśītecchā bahvāśitvaṁ balakṣayaḥ

The heart feels as if pierced, and as if it is being cooked; there is sudden craving for hot or cold things, excessive appetite, and yet a loss of strength —

Verse 18 (garuda.1.149.18)

स्निग्धप्रसन्नवक्रत्वं श्रीमद्दर्शननेत्रता । ततोऽस्य क्षयरूपाणि सर्वाण्याविर्भवन्ति च

snigdhaprasannavakratvaṁ śrīmaddarśananetratā tato'sya kṣayarūpāṇi sarvāṇyāvirbhavanti ca

an oily, deceptively cheerful face, and eyes with a bright, beautiful appearance — and thereafter all the signs of consumption manifest in the patient.

Verse 19 (garuda.1.149.19)

इत्येष क्षयजः कास क्षीणानां देहनाशनः । याप्यौ वा बलिनां तद्वत्क्षतजोऽपि नवौ तु तौ

ityeṣa kṣayajaḥ kāsa kṣīṇānāṁ dehanāśanaḥ yāpyau vā balināṁ tadvatkṣatajo'pi navau tu tau

This consumption-born cough destroys the body of the already wasted. In strong persons, both it and the injury-born cough are, in the same way, only palliable — but if both are of recent onset —

Verse 20 (garuda.1.149.20)

सिध्येतामपि सामर्थ्यात्साध्यादौ च पृथक्क्रमः । मिश्रा याप्याश्च ये सर्वे जरसः स्थविरस्य च

sidhyetāmapi sāmarthyātsādhyādau ca pṛthakkramaḥ miśrā yāpyāśca ye sarve jarasaḥ sthavirasya ca

they may, with due strength and treatment, become curable, each following its own proper course. All the mixed and merely palliable forms belong to old age and to the aged.

Verse 21 (garuda.1.149.21)

कासश्वासक्षयच्छर्दिस्वरसादादयो गदाः । भवन्त्युपेक्षया यस्मात्तस्मात्तास्त्वरया जयेत्

kāsaśvāsakṣayacchardisvarasādādayo gadāḥ bhavantyupekṣayā yasmāttasmāttāstvarayā jayet

Cough, breathlessness, consumption, vomiting, weakness of voice, and similar diseases become severe through neglect; therefore they should be overcome swiftly.