In the teachings of Dhanvantari, the nature of cough and its related afflictions are revealed with clarity. The onset of a particular cough is marked by a harsh, crooked sound, reminiscent of broken bronze, which brings pain to the heart, sides, and head. This cough causes confusion and agitation, sometimes robbing one of their voice. It is often accompanied by a dry, grating cough, severe pain, and a rough sound, with horripilation and the difficult expulsion of dry phlegm. Gradually, the cough subsides. When bile is disturbed, new symptoms arise: the eyes turn yellow, the mouth tastes bitter, fever sets in, dizziness follows, and there may be vomiting of bile and blood. Thirst becomes unquenchable, the voice grows hoarse, a smoky sensation pervades, and a sense of intoxication clouds the mind. Persistent coughing may cause one’s vision to flicker with lights, and when phlegm predominates, pain in the head is mild but the heart feels heavy and dull. A coating forms in the throat, appetite diminishes, nasal discharge and vomiting occur, and food loses its taste. Horripilation returns, the phlegm is thick and oily, and its production increases. When a person exerts themselves in strenuous acts—such as battle—beyond their strength, the wind within is disturbed, especially when joined by bile, and becomes overpowering. This agitated wind triggers a cough that brings up phlegm mixed with blood: yellow, dark, dry, clotted, and abundant. The act of spitting is painful, as if the chest is being split open, pierced by needles or struck by a spear. The suffering is sharp and oppressive, with joints feeling as if they are breaking, fever, shortness of breath, thirst, hoarseness, and trembling all following. At times, the afflicted person makes a sound like a cooing pigeon, with pain in the sides; vomiting occurs due to phlegm and other causes, and strength, complexion, and digestion all wane. In those who are emaciated, blood may appear in the urine, breathing becomes difficult, and the back and loins grow stiff. These are the main symptoms when consumption is aggravated. At the seat of consumption, coughing is first, then the expulsion of phlegm, which appears like putrid pus, streaked with yellow and red. The patient sleeps as if struck, the heart burns, and there are sudden desires for heat or cold, excessive eating, and a loss of strength. The face may become oily, clear, and curved, and the eyes shine brightly; then, all the signs of wasting disease manifest. This cough, arising from wasting, destroys the bodies of the weak. In the strong, both wasting and injury may be present, but they are new and less severe. Both forms can be cured if treated early and with care, for at the onset, their progression is distinct. However, mixed and chronic types are found especially among the aged and elderly. Cough, breathlessness, wasting, vomiting, hoarseness, and other diseases arise from neglect, and thus, one should strive to overcome them quickly. Dhanvantari then explains the causes of breathlessness. It may arise from an 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 drinking cold water. There are five types of breathlessness: minor, darkness, broken, great, and upward. Here, the wind, obstructed by phlegm, moves erratically and becomes established throughout the body. The vitiated wind corrupts the channels that carry breath, water, and food, and, residing in the chest, produces breathlessness, especially when undigested food lingers in the stomach. Early signs include pain in the heart and sides, irregular breathing, abdominal distension, and splitting pain in the temples. Exertion and overeating make it worse. 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. Breathlessness becomes intense, rapid, and torments the very life-breath; the patient may faint, but after spitting, finds momentary relief. Lying down becomes difficult, breathing is heavy; sitting brings some comfort. The eyes are wide, the forehead sweats, and the affliction is great. The mouth is dry, breathing is frequent, warmth is desired, and trembling occurs. Cold clouds, water, the east wind, and phlegmatic conditions worsen the state. The chronic darkness type of breathlessness can be cured in a strong person, but in one suffering from fever, fainting, or cold, it does not subside quickly. The afflicted suffer pain from injury to vital spots, sweat, faint, have abdominal distension, burning in the bladder, and disturbed sleep. The gaze is downward, the eyes are sunken and red, the mouth is dry, speech becomes incoherent, complexion is lost, and unconsciousness follows. Breath comes with a great, deep, pitiable sound, snorting and gasping, the patient agitated like a maddened bull, ceaselessly. Knowledge and discernment are lost, the eyes and face bewildered; the eyes draw together, urine and stool are retained, and speech is broken. The throat dries repeatedly, and there is severe pain in the ears, temples, and head. Breathing is long and upward, but the breath does not return downward. The mouth and ears are blocked with phlegm, and the sense of smell is disturbed; the patient looks upward, the eyes wandering, glancing about. When the vital spots are injured, he laments, his speech suppressed; these hidden symptoms may become manifest, and they surely bring death. Dhanvantari then turns to the origin of hiccup, addressing Suśruta. Hiccup, he says, has a single cause, but its preliminary signs, types, and dependence on constitution are many. Hiccups arise from food, and may be minor, paired, or great; there is also a deep type, caused by improper, hurried, or excessive eating and drinking. When one consumes dry, sharp, rough, or excessive food and drink, the breath produces a mild hiccup, with a soft sound, often following hunger. The hiccup that arises together with food and drink at twilight is called ‘paired’; when the wind is disturbed by exertion, it produces a minor hiccup. That type which spreads from the root of the neck, moving slowly, increases with exertion and becomes mild immediately after eating. Thus, Dhanvantari reveals the nature, causes, and progression of cough, breathlessness, and hiccup, guiding the attentive towards understanding and healing.