Garudapurana 1.147

The glorious Garuḍapurāṇa — 147 / Dhanvantari said: / I will proclaim the diagnosis of fever for the full understanding of all fevers. / Fever is the king of diseases, evil, the lord of death, the devourer, the end-maker, / born from the upper eye of Rudra when he was angry and destroyed the sacrifice of Dakṣa.

Its heat consists of delusion, having the nature of heat, born of improper conduct. / Fierce under various names, it exists in diverse wombs:

pākala in elephants; abhitāpa in horses; rabies in dogs; / indramada in clouds; nīlikā in water; blighting light in plants; and on earth it is called ūṣara.

Nausea, vomiting, cough, stiffness, coldness in the skin and other parts, / and boils arisen on the limbs occur in the fever born of phlegm.

The onset or increase of all occurs at their own respective time. / What is stated in the aetiology is unwholesome, while the opposite serves as the therapeutic test.

Loss of appetite, indigestion, stiffness, languor, / burning sensation in the chest, improper digestion, drowsiness, sluggishness, / pressing pain in the bladder, and non-elimination of the doṣas,

salivation, nausea, loss of hunger, bad taste in the mouth, / clarity, heat and heaviness of the limbs, excessive urination, / absence of digestion, and lack of exhaustion: these are the signs of raw fever.

Hunger, emaciation, lightness of the limbs, mildness of the fever, / and the movement of the doṣas after eight days: these are the signs of fever free from raw humours.

According to the respective symptoms in combination, fever also arises from a combination [of doshas]: / Headache, fainting, vomiting, burning of the body, dryness of the throat and mouth, anorexia, pain in the joints, / sleeplessness, delirium, horripilation, yawning, and excessive talkativeness arise from wind combined with bile.

Loss of heat, anorexia, joint and head pain, spitting, dyspnea, cough, pallor, / coldness, stiffness, dim vision, giddiness, and torpor are the symptoms of fever caused by phlegm and wind.

Cold, rigidity, sweating, burning, instability, thirst, cough, discharge of phlegm and bile, / confusion, torpor, and a coated, bitter mouth are to be recognized as the form of phlegm-bile fever.

Fever caused by all three [doshas] exhibits all symptoms, and in this case, there is burning again and again; / then intense cold, deep sleep by day, sleeplessness by night,

or constant sleep, or no sleep at all; profuse sweating or none at all; / singing, dancing, laughter, and so forth, or abnormal bodily movements.

The eyes are tearful, turbid, bloodshot, crooked, and have disordered eyelashes; / there is pain in the calves, flanks, head, small joints, and bones, as well as dizziness;

the ears have ringing and pain, or are excessively cold, or not at all; / the tongue is scorched and rough; the joints of the limbs are heavy and lax;

spitting of blood and bile; tossing of the head; excessive thirst; / and the appearance of circular patches on the trunk that are dark and red;

cardiac distress, elimination of feces, or evacuations that are scanty or excessive; / an oily mouth, loss of strength, weakness of voice, and delirium;

slow maturation of the doshas, torpor, continuous rattling in the throat— / one should declare that to be abhinyāsa-type sannipāta, in which the vital energy is destroyed.

When bile is severely compressed inside by wind blocked in the throat, / then, because of its diffusive and relaxing nature, it takes an outward path; / on account of that, yellowness of the eyes occurs in fever arising from sannipāta.

When the doshas are excessively aggravated, the digestive fire is destroyed, and all the symptoms are fully present, / the sannipāta fever is incurable; otherwise, it is curable with difficulty.

In another variety of fever arising from sannipāta where bile resides apart, / it produces burning in the skin or the trunk, either first or afterward.

Similarly, wind and phlegm [produce] cold; among these, the burning-preceded type is difficult to overcome. / In the cold-preceded type, when the phlegm is liquefied and dried up by the bile,

and then the bile subsides, fainting, intoxication, and thirst arise; / but in the burning-preceded type, at the end, torpor, indolence, and vomiting occur in succession.

Exogenous [fever] is of four kinds, resulting from injury, possession, a curse, and black-magic sorcery. / Sweating occurs in all four; that born of injury begins with burning and the like,

and by exertion; in it, wind, mostly vitiating the blood, / produces fever accompanied by distress, sorrow, discolouration, and pain.

[Exogenous fever is] born of spirit possession, herbs, poison, anger, fear, sorrow, and passion.

In that caused by possession, there is seizure, and laughing or crying without cause. / In that caused by the smell of herbs, there is fainting, headache, vomiting, and sneezing.

From poison, there is fainting, diarrhea, darkness of skin, sensation of burning, and dizziness. / From anger, there is trembling and headache; from fear and sorrow, delirium.

From passion, there is dizziness, anorexia, burning, and loss of shame, sleep, intellect, and courage. / In spirit possession and the like, the symptoms of sannipāta appear; in the other two, the signs of wind appear first.

Even when bile is excited by anger, those fevers that arise from curses and sorcery / are considered to be dreadful sannipāta fevers, the most intolerable of all.

Tormented by the sorcery spells of the Tantras, the body is consumed with heat; / first this and that happens, and then from eruptions and spatial disorientation,

and afflicted by burning and fainting, the fever increases day by day. / Thus fever is observed to be of eight kinds, but in brief it is twofold:

bodily and mental, mild and acute, internal and external, / seasonal and unseasonal, curable and incurable, unripe and ripe.

Heat appears first in the body in bodily [fever], and in the mind in mental [fever]. / Because of wind's capability to take on properties, there is cold when it is combined with phlegm;

there is burning when combined with bile; and mixed [symptoms] when combined with both. Furthermore, when fever resides internally, / the abnormalities are intense: internal agitation and retention of waste.

When the force is external, the heat is only external, and that [fever] is easily cured. / In the rainy season, autumn, and spring, it is seasonal from wind and the others, respectively.

The other is unseasonal and difficult to cure; and seasonal fever is mostly from wind. / In the rainy season, the vitiated wind produces fever accompanied by bile and phlegm,

and bile produces it in autumn, with phlegm as its follower; / by that nature and by the natural emission [season], there is no fear from fasting in that case.

Phlegm [produces fever] in spring, and wind and bile follow it. / Fever is curable and devoid of complications in strong patients when the doshas are slight.

When all signs of morbidity are recognized, it was previously stated to be incurable. / Sharpness of complications of fever, sluggish digestive fire, excessive urination,

no evacuation, lack of digestion, and no hunger are the form of unripe fever. / The force of fever is intense, with thirst, delirium, dyspnea, and dizziness;

evacuation of waste and nausea are the symptoms of fever undergoing digestion. / Because of the absence of reversal in chronic stage, fasting for seven nights is prescribed.

Fever is said to be of five types according to the strength and weakness of the wastes and the time; / it is mostly taught to occur through sannipāta among the abundant [doshas]:

continuous, remittent, quotidian, tertian, and quartan. / The wastes pervading the channels carrying tissue-elements, urine, and feces,

tormenting the entire body, aggravated by matching seasons and the like, / strong and heavy, particularly residing in the plasma,

produce a continuous and most intolerable fever without opposition. / It quickly destroys the waste, the fever-heat, or the tissues thereafter.

In every way, by the purification or non-purification of the plasma and other tissues in order, / [the fever] through wind, bile, and phlegm, after seven, ten, and twelve days,

generally reaches the critical period either for release or for death. / Such is the doctrine of Agniveśa; while the traditional view of Hārīta is:

Double the seventh [i.e. the fourteenth], and likewise the ninth and the eleventh; / this is the critical period of the three doshas either for release or for death.

Depending on purification or non-purification, the fever continues here even for a long time. / In emaciated persons, in those afflicted with diseases, and in those who indulge in improper diet and habits,

even a slight dosha, having obtained strength from corruption and the like through one or another cause, / becomes an adversary and, because it is accompanied by waxing and waning, becomes irregular.

With irregular onset, it produces fever characterised by irregular decrease and increase. / The dosha of these patients becomes active at its own time, powerful, causing fever,

and then it subsides again, [its power fluctuating] according to the strength or weakness of the opposing forces. / When its dosha is weakened, the subtle fever merges into the plasma and other tissues.

Because of its merged state, it causes emaciation, discolouration, dullness, and the like, / since the channels carrying plasma have their openings nearly disordered.

The morbidity does not quickly pervade the whole body; / therefore, it is continuous (satata); its opposite is so from the contrary reason.

An irregular fever has an irregular onset and is associated with the period of night. / The morbid humor residing mostly in the blood produces continuous (santata) fever.

It occurs once at the junction of day and night, residing [in the blood] as quotidian (anyedyuṣka); / in the third-day [tertian fever] the channel carrying flesh and the channel carrying fat [are affected].

Seizing the head from bile and wind, the sacrum from phlegm and bile, / and the back from wind and phlegm, it is known as alternate-day [tertian] fever.

The quartan [fever] resides through the wastes in either fat, marrow, or bone; / residing in the marrow alone, another one displays its specific power.

It is twofold: from phlegm through the shanks, and from wind beginning with the head; / when gone to bone and marrow, it is the reverse quartan fever.

It causes fever in three ways for three days, but releases for one day, / by the strength or weakness of the morbid humors arising from other activities and factors.

Due to no inversion of what is digested, one should fast for seven nights; / fever may likewise arise from the mind and from past action at various times.

Because it moves in deep tissues, arises from a combination of all three humors, / and has an equal elevation of the humors, quartan fever is difficult to cure.

Because the humor moves from subtle to subtler fevers, far and further still, / in the channels of blood and so forth, slowly, slightly, and over a long time,

it pervades the entire body and therefore produces burning heat and the like; / its course broken with effort, the fever is observed with burning heat.

Irregular [fever] has an irregular onset and follows the time of night; / it has a progressively slower motion and weaker power according to circumstances.

In time it reaches similar [tissues] such as the chyle and so forth in various manners; / the provoked humor produces fever after a long time and after an even longer time.

Just as a seed resting in the soil and watered with water / does not wait long to sprout, so it is with the seed of the morbid humor.

Just as poison, after having produced an impulse, brings its strength into its receptacle, / and having attained strength is provoked again, so it is with the poison of the humor and time.

Thus the irregular fevers, continuous (satata) and the rest, proceed. / Nausea, heaviness, dejection, breaking pain in the limbs, yawning,

anorexia, vomiting, and breathlessness occur in all fevers residing in the chyle. / Spitting of blood, thirst, dryness and heat, and the eruption of boils,

burning sensation, redness, giddiness, intoxication, and delirium occur when it resides in the blood. / Thirst, languor, passed stool, internal burning, giddiness, fainting,

foul odor, and tossing of the limbs occur when residing in the flesh; when residing in the fat, / sweating, excessive thirst, vomiting, foul odor, or forbearance [occur].

Delirium, languor, and anorexia occur; but when residing in the bone, breaking pain in the bones, / movement of morbid humors, waking, breathlessness, tossing of limbs, and groaning.

Internal burning, external coldness, breathlessness, and hiccup occur when residing in the marrow; / vision of darkness, cutting pain in vital spots, and rigidity of the penis.

Upon the emission of semen, death surely occurs when it resides in semen; / the other five are progressively difficult to cure, and in the reverse case [incurable].

Smearing the limbs as it were with phlegm and heaviness, / with mild fever, delirium, and chills, it is the smearing fever (pralepaka).

Always accompanied by mild fever, dryness, and chills, passing with difficulty, / with stiffened limbs and an abundance of phlegm, it is the limb-destroying fever (aṅgabalāśaka).

Possessing the luster and color of a variety of turmeric, and urinating a similar coating, / that indeed is called the turmeric fever (hāridraka), a variety of fever known as the bringer of death.

Where phlegm and wind are equal in a person whose bile is deficient, / a nocturnal fever arises, sharp or mild during the day.

When the body has had its strength depleted by the sun and has been dried out by exercise, / fever in the first part of the night surely arises from wind.

When wind resides in the stomach, and phlegm and bile reside below, / then half of the body becomes cold and half becomes hot.

When bile is situated in the body and phlegm is settled at the extremities, / thereby heat of the body and coldness of the hands and feet occur.

Residing in the chyle and blood it is curable, as well as that gone to the flesh and fat; / gone to the bone and marrow it is difficult to cure, its luster destroyed in those various bodily limbs.

Senseless, afflicted by the force of fever, he looks as if in anger; / he constantly and forcefully expels hot stool accompanied by morbidity.

A light body, fatigue, delusion, and burning heat departed, suppurating in the mouth, fitness of the sense organs, freedom from distress, / sweating, sneezing, mind returning to its normal state, desire for food, and itching on the head: these are the signs of a departed fever.

Thus ends the one hundred and forty-seventh chapter, named “Diagnosis of Fever and the Like,” in the Ācārakāṇḍa of the first part in the first section of the glorious Garuḍa Mahāpurāṇa.