Listen, as the sage Dhanvantari imparts the sacred knowledge of ailments and their remedies, speaking first of the subtle disturbances of bile. When bile is weak, he says, forceful emesis is not the best remedy. But where strength is present, and in those whose bile has already been pacified, such measures may be appropriate. For such a person, astringent and sweet substances are beneficial. Yet, when phlegm and wind join the disorder, the condition becomes incurable and is named according to its dominant cause. When the affliction is intolerable, moving in a contrary direction, and medicines prove ineffective, no purification is possible, for nature resists the remedy. However, in disorders where blood and bile are both involved, purification in the reverse direction is prescribed; here, both pacification and purification must be sought. When the faults are mixed together, expulsion by every means is beneficial, for any remnant of the fault is regarded as perilous as a missile of Shiva. Complications, too, distort the body, and their results are firmly established. With gentle authority, Dhanvantari continues: “Since cough arises swiftly, let me now describe its forms. There are five types, born of wind, bile, phlegm, injury, and wasting. Of these, those associated with wasting, if neglected, grow ever stronger. Their signs are itching and loss of taste in the throat, followed by dryness of the ears, mouth, and throat, caused by the downward-moving wind. When this wind turns upward, it accumulates in the throat, filling the veins and channels, lifting the limbs as if throwing them, causing pain in the eyes, a strained voice, and pressure on the side. The cough emerges with a crooked, metallic sound, like broken bronze. It brings pain to the heart, side, and head, confusion, agitation, and loss of voice. A dry cough follows, with severe pain and harsh sound; horripilation arises, and dry phlegm is expelled only with difficulty, after which the symptoms subside. When bile is the cause, the eyes turn yellow, the mouth tastes bitter, fever and dizziness follow, and vomiting of bile and blood occurs. Thirst, hoarseness, a smoky feeling, and intoxication appear. With persistent cough, vision is disturbed, as if seeing lights. Phlegm-induced cough brings little pain to the head, but the heart feels heavy and dull. The throat becomes coated, appetite is lost, nasal discharge and vomiting ensue, and taste disappears. Horripilation arises again, with thick, oily phlegm produced in abundance. Engaging in strenuous acts—such as battle—beyond one’s strength, disturbs the wind, which, joined by bile, becomes powerful. When this happens, a cough arises with phlegm mixed with blood, yellow, dark, dry, clotted, abundant, and aggravated. The patient spits painfully from the throat, feeling as if the chest is split open, pierced by sharp needles or struck by a spear. Touch brings pain, piercing and splitting sensations oppress him, the joints feel broken, fever and shortness of breath set in, thirst, hoarseness, and trembling follow. He coos like a pigeon, feels pain in the side, and, due to phlegm and other causes, vomiting occurs, while strength, complexion, and digestion are diminished. In the emaciated, blood appears in the urine, breathing becomes difficult, and stiffness arises in the back and loins—these are the main signs of consumption when aggravated. In the seat of consumption, cough and phlegm appear, with spitting of matter resembling putrid pus, mixed yellow and red. Sleep is disturbed, as if struck; the heart burns; sudden desires for heat or cold arise, excessive hunger appears, and strength is lost. The face becomes oily, clear, and curved, the eyes radiant and lustrous—then all the signs of wasting disease manifest. Thus, cough arising from wasting destroys the bodies of the weak. In the strong, wasting and injury may also appear, but in them, these are new afflictions. Both can be cured if addressed with capability, but in the early stages of curable diseases, their progression is distinct. All mixed and chronic types belong to old age and the elderly. Cough, breathlessness, wasting, vomiting, hoarseness, and other such diseases arise from neglect—therefore, one should conquer them swiftly. Dhanvantari then speaks of breathlessness, explaining its causes. It may arise from the increase of cough, or from the prior aggravation of the bodily humors. Other causes include indigestion, diarrhea, vomiting, poisoning, anemia, fever, dust, smoke, wind, injury to vital spots, or the use of cold water. There are five types of breathlessness: minor, darkness, broken, great, and upward. Here, wind, obstructed by phlegm, moves erratically and becomes established throughout the body. Corrupting the channels that carry breath, water, and food, the vitiated wind, residing in the chest, produces breathlessness, especially when undigested food remains in the stomach. Early symptoms include pain in the heart and sides, irregular breathing, abdominal distension, and splitting pain in the temples; exertion and overeating worsen the condition. The impure wind, both driven and driving, moves in reverse, ascending the channels and expelling phlegm. It seizes the head, neck, chest, and sides, causing cough, rattling sounds, fainting, loss of appetite, and severe nasal congestion. Intense, rapid breathlessness follows, tormenting the life-breath; the patient may faint from its force, but after spitting, relief comes for a moment. Lying down is difficult, breathing is labored, but sitting brings some comfort. The eyes are wide, sweat appears on the forehead, and suffering is great. The mouth is dry, breath is frequent, warmth is desired, and the patient trembles. The condition worsens with cold clouds, water, east wind, and phlegmatic states. Chronic darkness-type breathlessness is curable in a strong man, but in one with fever, fainting, or cold, it does not subside at first. Afflicted like those with cough and breathlessness, the patient suffers pain from injury to vital spots, sweats, faints, has abdominal distension, burning in the bladder, and disturbed sleep. His gaze is downward, his eyes are sunken, the whites tinged with red, his mouth is dry, he babbles incoherently, his complexion is lost, and he falls into unconsciousness. Thus, with deep compassion and wisdom, Dhanvantari reveals the nature and signs of these disorders, urging swift recognition and treatment, so that health and harmony may be restored.