The Diagnosis of Dyspnea (Shvasa)

Verse 1 (garuda.1.150.1)

धन्वन्तरिरुवाच । अथातः श्वासरोगस्य निदानं प्रवदाम्यहम् । कासवृद्ध्या भवेच्छ्वासः पूर्वैर्वा दोषकोपनैः

dhanvantariruvāca athātaḥ śvāsarogasya nidānaṁ pravadāmyaham kāsavṛddhyā bhavecchvāsaḥ pūrvairvā doṣakopanaiḥ

Dhanvantari said: Now I shall declare the diagnosis of the disease Shvasa, breathlessness. It may arise from the progression of cough, or from the same aggravating causes of the humors described earlier —

Verse 2 (garuda.1.150.2)

आमातिसारवमथुविषपाण्डुज्वरैरपि । रजोधूमानिलैर्मर्मघातादपि हिमाम्बुना

āmātisāravamathuviṣapāṇḍujvarairapi rajodhūmānilairmarmaghātādapi himāmbunā

and also from undigested toxin, diarrhea, vomiting, poisoning, anemia, and fever; from dust, smoke, and wind; from injury to a vital point; and even from very cold water.

Verse 3 (garuda.1.150.3)

क्षुद्रकस्तमकश्छिन्नो महानूर्ध्वश्च पञ्चमः । कफोपरुद्धगमनपवनो विष्वगास्थितः

kṣudrakastamakaśchinno mahānūrdhvaśca pañcamaḥ kaphoparuddhagamanapavano viṣvagāsthitaḥ

Kshudraka, Tamaka, Chhinna, Maha, and the fifth, Urdhva — these are the five kinds of Shvasa. When the movement of Vata, obstructed by kapha, spreads throughout the body —

Verse 4 (garuda.1.150.4)

प्राणोदकान्नवाहीनि दुष्टस्रोतांसि दूषयन् । उरः स्थः कुरुते श्वासमामाशयसमुद्भवम्

prāṇodakānnavāhīni duṣṭasrotāṁsi dūṣayan uraḥ sthaḥ kurute śvāsamāmāśayasamudbhavam

it further vitiates the already-vitiated channels carrying breath, water, and food, and, lodging in the chest, produces the breathlessness that originates in the stomach.

Verse 5 (garuda.1.150.5)

प्राग्रूपं तस्य हृत्पार्श्वशूलं प्राणविलोमता । आनाहः शङ्खभेदश्च तत्रायासोऽतिभोजनैः

prāgrūpaṁ tasya hṛtpārśvaśūlaṁ prāṇavilomatā ānāhaḥ śaṅkhabhedaśca tatrāyāso'tibhojanaiḥ

Its premonitory signs are pain in the heart and sides, reversal of the breath's normal flow, abdominal distension, and a splitting pain in the temples; it is aggravated there by exertion and by overeating —

Verse 6 (garuda.1.150.6)

प्रेरितः प्रेरयन्क्षुद्रं स्वयं स समलं मरुत् । प्रतिलोमं शिरा गच्छेदुदीर्य पवनः कफम्

preritaḥ prerayankṣudraṁ svayaṁ sa samalaṁ marut pratilomaṁ śirā gacchedudīrya pavanaḥ kapham

driven on and itself driving the lesser Vata, that impure wind moves in reverse through the vessels and stirs up kapha —

Verse 7 (garuda.1.150.7)

परिगृह्यशिरोग्रीवमुरः पार्श्वे च पीडयन् । कासं घुर्घुरकं मोहमरुचिम्पीनसं भृशम्

parigṛhyaśirogrīvamuraḥ pārśve ca pīḍayan kāsaṁ ghurghurakaṁ mohamarucimpīnasaṁ bhṛśam

gripping the head, neck, chest, and sides with pain, it produces a rattling, gurgling cough, confusion, loss of appetite, and severe catarrh —

Verse 8 (garuda.1.150.8)

करोति तीव्रवेगञ्च श्वासं प्राणोपतापिनम् । प्रताम्येत्तस्य वेगेनष्ठीवनान्ते क्षणं सुखी

karoti tīvravegañca śvāsaṁ prāṇopatāpinam pratāmyettasya vegenaṣṭhīvanānte kṣaṇaṁ sukhī

and it produces breathlessness of intense force, tormenting the very breath of life. He becomes distressed by its force, finding momentary relief only after expectorating phlegm —

Verse 9 (garuda.1.150.9)

कृच्छ्राच्छयानः श्वसिति निषण्णः स्वास्थ्यमर्हति । उच्छ्रिताक्षो ललाटेन स्विद्यता भृशमार्तिमान्

kṛcchrācchayānaḥ śvasiti niṣaṇṇaḥ svāsthyamarhati ucchritākṣo lalāṭena svidyatā bhṛśamārtimān

lying down he breathes only with great difficulty, and finds relief only when seated; his eyes are raised, his forehead drenched in sweat, and he is in great distress —

Verse 10 (garuda.1.150.10)

विशुष्कास्यो मुहुः श्वासः काङ्क्षत्युष्णं सवेपथुः । मेघाम्बुशीतप्राग्वातैः श्लेष्मलैश्च विवर्धते

viśuṣkāsyo muhuḥ śvāsaḥ kāṅkṣatyuṣṇaṁ savepathuḥ meghāmbuśītaprāgvātaiḥ śleṣmalaiśca vivardhate

his mouth is dry, his breathing labored and repeated, he craves warmth, and he trembles; this is aggravated by clouds, rain, cold, an easterly wind, and kapha-producing foods — this is Tamaka Shvasa.

Verse 11 (garuda.1.150.11)

स याप्यस्तमकः साध्यो नरस्य बलिनो भवेत् । ज्वरमूर्छावतः सीतैर्न शाम्येत्प्रथमस्तु सः

sa yāpyastamakaḥ sādhyo narasya balino bhavet jvaramūrchāvataḥ sītairna śāmyetprathamastu saḥ

In a strong man this Tamaka may be palliable and even curable; but the first attack, when accompanied by fever and fainting, is not relieved by soothing measures — this is severe.

Verse 12 (garuda.1.150.12)

कासश्वसितवच्छीर्णमर्मच्छेदरुजार्दितः । सस्वेदमूर्छः सानाहो बस्तिदाहविबोधवान्

kāsaśvasitavacchīrṇamarmacchedarujārditaḥ sasvedamūrchaḥ sānāho bastidāhavibodhavān

In the Chhinna type, afflicted with pain as if the vital points were being cut, weakened by cough and breathlessness, accompanied by sweating and fainting, abdominal distension, and burning restlessness in the bladder —

Verse 13 (garuda.1.150.13)

अधोदृष्टिः शुताक्षस्तु स्निह्यद्रक्तैकलोचनः । शुष्कास्यः प्रलपन्दीनो नष्टच्छायो विचेतनः

adhodṛṣṭiḥ śutākṣastu snihyadraktaikalocanaḥ śuṣkāsyaḥ pralapandīno naṣṭacchāyo vicetanaḥ

with a downcast gaze, swollen eyes, one eye moist and red, a dry mouth, delirious, wretched, robbed of luster, and unconscious —

Verse 14 (garuda.1.150.14)

महातामहता दीनो नादेन श्वसिति क्रथन् । उद्धूयमानः संरब्धो मत्तर्षभ इवानिशम्

mahātāmahatā dīno nādena śvasiti krathan uddhūyamānaḥ saṁrabdho mattarṣabha ivāniśam

wretched with great distress, breathing with a loud rasping sound, gasping repeatedly, agitated, like a maddened bull without ceasing —

Verse 15 (garuda.1.150.15)

प्रनष्टज्ञानविज्ञानो विभ्रान्तनयनाननः । नेत्रे समाक्षिपन्बद्धमूत्रवर्चा विशीर्णवाक्

pranaṣṭajñānavijñāno vibhrāntanayanānanaḥ netre samākṣipanbaddhamūtravarcā viśīrṇavāk

his knowledge and understanding destroyed, his eyes and face bewildered, his eyes rolling, retention of urine and stool, and speech broken —

Verse 16 (garuda.1.150.16)

शुष्ककण्ठो मुहुश्चैव कर्णशङ्खाशिरोऽतिरुक् । यो दीर्घमुच्छ्वसित्यूर्ध्वं न च प्रत्याहरत्यधः

śuṣkakaṇṭho muhuścaiva karṇaśaṅkhāśiro'tiruk yo dīrghamucchvasityūrdhvaṁ na ca pratyāharatyadhaḥ

his throat repeatedly parched, with severe pain in the ears, temples, and head — he who breathes out for a long time upward but cannot draw the breath back down —

Verse 17 (garuda.1.150.17)

श्लेष्मावृतमुखश्रोत्रः क्रुद्धगन्धवहार्दितः । ऊर्ध्वं समीक्षते भ्रान्तमक्षिणी परितः क्षिपन्

śleṣmāvṛtamukhaśrotraḥ kruddhagandhavahārditaḥ ūrdhvaṁ samīkṣate bhrāntamakṣiṇī paritaḥ kṣipan

his mouth and ears choked with phlegm, afflicted by the aggravated life-breath, gazing fixedly upward, his eyes rolling wildly on all sides —

Verse 18 (garuda.1.150.18)

मर्मसु च्छिद्यमानेषु परिदेवी निरुद्धवाक् । एते सिध्येयुरव्यक्ताः व्यक्ताः प्राणहरा ध्रुवम्

marmasu cchidyamāneṣu paridevī niruddhavāk ete sidhyeyuravyaktāḥ vyaktāḥ prāṇaharā dhruvam

lamenting as if his vital points were being cut, his speech obstructed — these severe conditions may be cured only while their fatal signs remain unmanifest; once fully manifest, they certainly take life.