The Compendium of Caraka 5.1: prathamo 'adhyāyaḥ/

Now, therefore, we shall explain the section of the senses [dealing with fatal signs] regarding complexion and voice (Varṇasvarīya Indriya).

Thus spoke the venerable Ātreya.

Here, indeed, complexion, voice, smell, taste, touch, eye, ear, nose, tongue, skin, mind, disposition, cleanliness, conduct, behavior, memory, appearance, constitutional nature, pathological alteration, strength, debility, intellect, exhilaration, dryness, unctuousness, drowsiness, exertion, heaviness, lightness, bodily qualities, diet, regimen, digestion of food, expedient means, harm, disease, premonitory symptoms of disease, pain, complications, shadow, reflection, dreams, messenger's condition, omens on the road, condition and state of affairs in the patient's household, and the response to medicine and application of therapeutics—these are to be examined through direct perception, inference, and authoritative testimony by a physician seeking to know the remaining span of life.

Among these objects of examination, some do not reside in the person, while others do reside in the person.

Among them, those that do not reside in the person should be examined by authoritative instruction and reasoning; those, however, that reside in the person [should be examined] through constitutional nature and pathological alteration.

In that context, constitutional nature is related to caste/species, related to lineage, dependent on region, dependent on season/time, dependent on age, and fixed to the individual.

For specific bodily characteristics belong to those respective individuals as determined by caste/species, lineage, region, season/time, age, and individual uniqueness.

Pathological alteration, moreover, has marks as its cause, has what is to be marked as its cause, and corresponds to a cause.

Among these, that which has marks as its cause is that for which bodily marks themselves become causes by destiny; for certain marks are bound to the body, which, finding their locus there at such and such a time, produce such and such a pathological alteration.

That which has what is to be marked as its cause is that whose cause is observed as stated in the etiology (Nidāna).

That which corresponds to a cause is that which imitates the object of a cause; physicians consider this causeless [alteration] to be a sign for knowing the remaining span of life, and furthermore, being caused by the exhaustion of life, it corresponds to the signs of death, which the wise teach for the sake of knowing the term of life.

And with reference to this, we shall explain the signs residing in the person of those about to die.

Such is the brief statement.

We shall explain it in detail.

In that regard, right at the beginning is the topic of complexion.

Namely: black, dark brown, fair-dark, and fair are the constitutional complexions of the body; and whichever others an observant person may recognize, as handed down by tradition or otherwise pointed out by experts on the subject.

Blue, greyish-black, coppery, green, and white are the pathological complexions of the body; and whichever others an observant person may recognize as having arisen without previously existing as a pathological alteration.

Thus the constitutional and pathological complexions of the body have been stated.

In that regard, having observed the constitutional complexion in half of the body and the pathological complexion in the other half of the body, both complexions being divided by a boundary—whether divided by left and right, whether divided by front and back, whether divided by upper and lower, or whether divided by interior and exterior—one should know it to be a fatal sign (ariṣṭa) for the patient; similarly, a difference in complexion occurring in half of the face or elsewhere leads to death.

By means of the difference in complexion, debility, exhilaration, dryness, and unctuousness are explained.

Likewise, the emergence on the face of a patient of any one of freckles, dark pigmentation, moles, or eruptions should similarly be recognized as inauspicious.

Moreover, the appearance of any of the stated pathological complexions on the nails, eyes, face, urine, feces, hands, feet, lips, and so forth, in persons diminished in strength, complexion, and sensory faculties, is a sign of the exhaustion of life.

And whatever other unnatural change in complexion, never seen before, should arise suddenly without any apparent cause in a patient who is constantly declining, one should know that to be a fatal sign.

Such is the topic of complexion.

The topic of voice, however: voices resembling a swan, a sarus crane, a chariot wheel, a kettle drum, a sparrow, a crow, a dove, or a cracked vessel are constitutional voices; and whichever others an observant person may recognize, as handed down by tradition or otherwise pointed out by experts on the subject.

Those resembling a sheep, sweet, choking, indistinct, stammering, faint, distressed, or disordered are the pathological voices of patients; and whichever others an observant person may recognize as having arisen without previously existing as a pathological alteration.

Thus the constitutional and pathological voices have been explained.

In that regard, the sudden manifestation of constitutional or pathological voices, multiplicity of voices, and one [voice] becoming multiple are inauspicious.

Such is the topic of voice.

Thus the topics of complexion and voice have been properly stated for the purpose of knowing the signs of those about to die.

And here are [the verses]:

In whom a pathological complexion appears on the body, / whether in half or in the whole, and there is no [external] cause for it, he does not survive.

If half the face is blue, or greyish-black, or coppery, or reddish, / and the other half of the face is of another complexion, it is called a fatal sign.

Distinct unctuousness on half the face and extreme dryness on half the face, / likewise debility on half and exhilaration on half the face is a sign of death.

Moles, freckles, dark patches, and lines of various kinds / arising quickly on the face of a patient about to lose his life [indicate death].

White spots on the nails or teeth, or slime adhering to the teeth, / or chalky powder on the teeth—that is a sign of death.

Discoloration on the lips, feet, hands, eyes, urine, feces, / and also on the nails—in one whose strength is depleted, this brings about the end.

A wise man should recognize that a person whose two lips are blue, / resembling a ripe jambu fruit, is about to die, his life having come to an end.

A single or multiple pathological voice that arises suddenly / in a declining living being—he does not survive.

And whatever other unnatural change there may be in voice and complexion / in one devoid of strength and flesh, all of that brings about death.

Here is the summary verse:

Thus complexion and voice have been stated for the sake of the signs of those about to die; / he who understands these two properly is not deluded in the knowledge of the span of life.

Thus ends the first chapter, named Signs Relating to Complexion and Voice, in the Section on Signs of Death, in the treatise composed by Agniveśa and redacted by Caraka. //1