The Diagnosis of Consumption (Rajayakshma)

Verse 1 (garuda.1.152.1)

धन्वन्तरिरुवाच । अथातो यक्ष्मरोगस्य निदानं प्रवदाम्यहम् । अनेकरोगानुगतो बहुरोगपुरोगमः

dhanvantariruvāca athāto yakṣmarogasya nidānaṁ pravadāmyaham anekarogānugato bahurogapurogamaḥ

Dhanvantari said: Now I shall declare the diagnosis of the disease Yakshma, consumption. It is accompanied by many diseases, and is itself the forerunner of many others.

Verse 2 (garuda.1.152.2)

राजयक्ष्मा क्षयः शोषो रोगराडिति कथ्यते । नक्षत्राणां द्विजानाञ्च राज्ञोऽभूद्यदयं पुरा

rājayakṣmā kṣayaḥ śoṣo rogarāḍiti kathyate nakṣatrāṇāṁ dvijānāñca rājño'bhūdyadayaṁ purā

It is called Rajayakshma, Kshaya, Shosha, and Rogaraj, king of diseases, because in ancient times it afflicted the king of the asterisms, the Moon, and also a king among Brahmins —

Verse 3 (garuda.1.152.3)

यच्च राजा च यक्ष्मा च राजयक्ष्मा ततो मतः । देहौषधक्षयकृतेः क्षयस्तत्सम्भवाच्च सः

yacca rājā ca yakṣmā ca rājayakṣmā tato mataḥ dehauṣadhakṣayakṛteḥ kṣayastatsambhavācca saḥ

and since it afflicted a king and is a form of Yakshma, it is thus called Rajayakshma. It is called Kshaya because it wastes the body's tissues, and also because of its connection to that wasting.

Verse 4 (garuda.1.152.4)

रसादिशोषणाच्छोषो रोगराडिति राजवत् । साहसं वेगसंरोधः शुक्रौजः स्नेहसंक्षयः

rasādiśoṣaṇācchoṣo rogarāḍiti rājavat sāhasaṁ vegasaṁrodhaḥ śukraujaḥ snehasaṁkṣayaḥ

It is called Shosha because it dries up the rasa and other tissues, and, like a king, it is called Rogaraj. Excessive exertion, suppression of the natural urges, and the wasting of semen, vital essence, and unctuous substance —

Verse 5 (garuda.1.152.5)

अन्नपानविधित्यागश्चत्वारस्तस्यहेतवः । तैरुदीर्णोऽनिलः पित्तं व्यर्थं चोदीर्य सर्वतः

annapānavidhityāgaścatvārastasyahetavaḥ tairudīrṇo'nilaḥ pittaṁ vyarthaṁ codīrya sarvataḥ

and the abandonment of proper regimen in food and drink — these are its four causes. Vata, aggravated by these, stirring up Pitta uselessly throughout the body —

Verse 6 (garuda.1.152.6)

शरिरसन्धिमाविश्य ताः शिराः प्रतिपीडयन् । मुखानि स्रोतसां रुद्ध्वा तथैवातिविसृज्य वा

śarirasandhimāviśya tāḥ śirāḥ pratipīḍayan mukhāni srotasāṁ ruddhvā tathaivātivisṛjya vā

enters the joints of the body and afflicts those vessels, obstructing the mouths of the channels, or else releasing them to excess —

Verse 7 (garuda.1.152.7)

मध्यमूर्ध्वमधस्तिर्यगव्यथां सञ्जनयेद्धृदः । रूपं भविष्यतस्तस्य प्रतिश्यायो भृशं ज्वरः

madhyamūrdhvamadhastiryagavyathāṁ sañjanayeddhṛdaḥ rūpaṁ bhaviṣyatastasya pratiśyāyo bhṛśaṁ jvaraḥ

and produces pain radiating from the heart in the middle, upper, lower, and lateral directions. The signs of its coming onset are: persistent catarrh and intense fever —

Verse 8 (garuda.1.152.8)

प्रसेको मुखमाधुर्यं मार्दवं वह्निदे हयोः । लौल्यभावोऽन्नपानादौ शुचावशुचिवीक्षणम्

praseko mukhamādhuryaṁ mārdavaṁ vahnide hayoḥ laulyabhāvo'nnapānādau śucāvaśucivīkṣaṇam

salivation, sweetness in the mouth, weakness of digestion and body, fickleness regarding food and drink, and seeing something unclean even in what is clean —

Verse 9 (garuda.1.152.9)

मक्षिकातृणकेशादिपातः प्रायोऽन्नपानयोः । हृल्लासश्छर्दिररुचिरस्नातेऽपि बलक्षयः

makṣikātṛṇakeśādipātaḥ prāyo'nnapānayoḥ hṛllāsaśchardirarucirasnāte'pi balakṣayaḥ

the frequent falling of flies, straw, hair, and the like into one's food and drink; nausea, vomiting, loss of appetite, and loss of strength even without exertion —

Verse 10 (garuda.1.152.10)

पाण्योरुवक्षः पादास्यकुक्ष्यक्ष्णोरतिशुक्लता । बाह्वोः प्रतोदो जिह्वायाः काये बैभत्स्यदर्शनम्

pāṇyoruvakṣaḥ pādāsyakukṣyakṣṇoratiśuklatā bāhvoḥ pratodo jihvāyāḥ kāye baibhatsyadarśanam

excessive pallor in the hands, thighs, chest, feet, mouth, abdomen, and eyes; a pricking pain in the arms and tongue, and a feeling of revulsion toward one's own body —

Verse 11 (garuda.1.152.11)

स्त्रीमद्यमांसप्रियता घृणिता मूर्धगुण्ठनम् । नखकेशास्थिवृद्धिश्च स्वप्ने चाभिभवो भवेत्

strīmadyamāṁsapriyatā ghṛṇitā mūrdhaguṇṭhanam nakhakeśāsthivṛddhiśca svapne cābhibhavo bhavet

a craving for women, liquor, and meat, a tendency to keep the head covered, a sense of growth in the nails, hair, and bones, and being overpowered in dreams —

Verse 12 (garuda.1.152.12)

पतनं कृकलासाहिकपिश्वापदपक्षिभिः । केशास्थितुषभस्मादितरौ समधिरोहणम्

patanaṁ kṛkalāsāhikapiśvāpadapakṣibhiḥ keśāsthituṣabhasmāditarau samadhirohaṇam

falling, and being attacked in dreams by lizards, snakes, monkeys, wild beasts, and birds; or, conversely, climbing upon hair, bones, chaff, and ashes —

Verse 13 (garuda.1.152.13)

शून्यानां ग्रामदेशानां दर्शनं शुष्यतोऽम्भसः । ज्योतिर्दिवि दवाग्नीनां ज्वलतां च महीरुहाम्

śūnyānāṁ grāmadeśānāṁ darśanaṁ śuṣyato'mbhasaḥ jyotirdivi davāgnīnāṁ jvalatāṁ ca mahīruhām

seeing empty villages and lands, and water drying up; seeing lights in the sky, and seeing forest fires and trees ablaze —

Verse 14 (garuda.1.152.14)

पीनसश्वासकासं च स्वरमूर्धरुजोऽरुचिः । ऊर्ध्वनिः श्वाससंशोषावधश्छर्दिश्च कोष्ठगे

pīnasaśvāsakāsaṁ ca svaramūrdharujo'ruciḥ ūrdhvaniḥ śvāsasaṁśoṣāvadhaśchardiśca koṣṭhage

catarrh, breathlessness, and cough; hoarseness, headache, and loss of appetite; when the disease is located in the abdominal cavity, dryness in breathing above and vomiting below —

Verse 15 (garuda.1.152.15)

स्थिते पार्श्वे च रुग्बोधे सन्धिस्थे भवति ज्वरः । रूपाण्यैकादशैतानि जायन्ते राजयक्ष्मणः

sthite pārśve ca rugbodhe sandhisthe bhavati jvaraḥ rūpāṇyaikādaśaitāni jāyante rājayakṣmaṇaḥ

and, when located in the side, an awareness of pain there, and when located in the joints, fever. These eleven signs are the manifestations of Rajayakshma.

Verse 16 (garuda.1.152.16)

तेषामुपद्रवान्विद्यात्कण्ठध्वंसकरी रुजाः । जृम्भाङ्गमर्दनिष्ठीववह्निमान्द्यास्यपूतिता

teṣāmupadravānvidyātkaṇṭhadhvaṁsakarī rujāḥ jṛmbhāṅgamardaniṣṭhīvavahnimāndyāsyapūtitā

One should know its complications to include throat-destroying pains, yawning, aching of the limbs, spitting, weakness of digestive fire, and foul breath.

Verse 17 (garuda.1.152.17)

तत्र वाताच्छिरः पार्श्वशूलनं सांगमर्दनम् । कण्ठरोधः स्वरभ्रंशः पित्तात्पादांसपाणिषु

tatra vātācchiraḥ pārśvaśūlanaṁ sāṁgamardanam kaṇṭharodhaḥ svarabhraṁśaḥ pittātpādāṁsapāṇiṣu

There, from Vata: pain in the head and sides, aching of the limbs, obstruction of the throat, and loss of voice. From Pitta, in the feet, shoulders, and hands —

Verse 18 (garuda.1.152.18)

दाहोऽतिसारोऽसृक्छर्दिर्मुखगन्धो ज्वरो मदः । कफादरोचकच्छर्दिकासा अर्ध्वां गगौरवम्

dāho'tisāro'sṛkchardirmukhagandho jvaro madaḥ kaphādarocakacchardikāsā ardhvāṁ gagauravam

burning, diarrhea, vomiting of blood, bad breath, fever, and an intoxication-like stupor arise. From Kapha: loss of appetite, vomiting, cough, and heaviness in the upper body —

Verse 19 (garuda.1.152.19)

प्रसेकः पीनसः श्वासः स्वरभेदोऽल्पवह्निता । दोषैर्मन्दानलत्वेन शोथलेपकफोल्बणैः

prasekaḥ pīnasaḥ śvāsaḥ svarabhedo'lpavahnitā doṣairmandānalatvena śothalepakapholbaṇaiḥ

salivation, catarrh, breathlessness, hoarseness, and weak digestive fire. From the humors, together with weak digestion, swelling, coating, and excess kapha —

Verse 20 (garuda.1.152.20)

स्रोतोमुखेषु रुद्धेषु धातुषु स्वल्पकेषु च । विदाहो मनसः स्थाने भवन्त्यन्ये ह्युपद्रवाः

srotomukheṣu ruddheṣu dhātuṣu svalpakeṣu ca vidāho manasaḥ sthāne bhavantyanye hyupadravāḥ

when the mouths of the channels are obstructed and the tissues diminished, burning distress arises in the seat of the mind, the heart; other complications also occur.

Verse 21 (garuda.1.152.21)

पच्यते कोष्ठ एवान्नमम्लयुक्तै रसैर्युतम् । प्रायोऽस्य क्षयभागानां नैवान्नं चाङ्गपुष्टये

pacyate koṣṭha evānnamamlayuktai rasairyutam prāyo'sya kṣayabhāgānāṁ naivānnaṁ cāṅgapuṣṭaye

Food is digested in the abdomen only mixed with sour humors; for the most part, in this consumptive patient, food does not go toward nourishing the body.

Verse 22 (garuda.1.152.22)

रसो ह्यस्य न रक्ताय मांसाय कुरुते तु तत् । उपष्टब्धः समन्ताच्च केवलं वर्तते क्षयी

raso hyasya na raktāya māṁsāya kurute tu tat upaṣṭabdhaḥ samantācca kevalaṁ vartate kṣayī

His rasa does not properly transform into blood, nor into flesh; oppressed on every side, this wasted patient exists only in a diminished state.

Verse 23 (garuda.1.152.23)

लिङ्गेष्वल्पेष्वतिक्षीणं व्याधौ षट्करणक्षयम् । वर्जयेत्साधयेदेव सर्वेष्वपि ततोऽन्यथा

liṅgeṣvalpeṣvatikṣīṇaṁ vyādhau ṣaṭkaraṇakṣayam varjayetsādhayedeva sarveṣvapi tato'nyathā

When the signs are few but the patient is extremely wasted, with the disease having exhausted all six essential factors, treatment should be abandoned; in all other cases, it should indeed be attempted.

Verse 24 (garuda.1.152.24)

दोषैर्व्यस्तैः समस्तैश्च क्षयात्सर्वस्य मेदसः । स्वरभेदो भवेत्तस्य क्षामो रूक्षश्चलः स्वरः

doṣairvyastaiḥ samastaiśca kṣayātsarvasya medasaḥ svarabhedo bhavettasya kṣāmo rūkṣaścalaḥ svaraḥ

From the humors, whether singly or combined, and from the wasting of the entire fat tissue, hoarseness occurs — the voice becomes weak, dry, and unsteady.

Verse 25 (garuda.1.152.25)

शुकवर्णाभकण्ठत्वं स्निग्धोष्णोपशमोऽनिलात् । पित्तात्तालुगले दाहः शोषो भवति सन्ततम्

śukavarṇābhakaṇṭhatvaṁ snigdhoṣṇopaśamo'nilāt pittāttālugale dāhaḥ śoṣo bhavati santatam

A parrot-green coloring of the throat, relieved by unctuous, warm remedies, indicates the Vata form. From Pitta: burning in the palate and throat, and constant dryness —

Verse 26 (garuda.1.152.26)

लिम्पन्निव कफैः कण्ठं मुखं घुरघुरायते । स्वयं विरुद्धैः सर्वैस्तु सर्वालिङ्गैः क्षयो भवेत्

limpanniva kaphaiḥ kaṇṭhaṁ mukhaṁ ghuraghurāyate svayaṁ viruddhaiḥ sarvaistu sarvāliṅgaiḥ kṣayo bhavet

From Kapha, as if coating the throat, a rattling sound arises in the mouth. When all the mutually opposed humors occur together, with every sign present, the consumption becomes the tridoshic, most severe form —

Verse 27 (garuda.1.152.27)

धूमायतीव चात्यर्थमुदेति श्लेष्मलक्षणम् । कृच्छ्रसाध्याः क्षयाश्चात्र सर्वैरल्पञ्च वर्जयेत्

dhūmāyatīva cātyarthamudeti śleṣmalakṣaṇam kṛcchrasādhyāḥ kṣayāścātra sarvairalpañca varjayet

with an intense sensation as if of smoke, and the signs of kapha arising strongly. Such tridoshic wasting diseases are curable only with great difficulty; even when mild, they should be left untreated.