In the ancient discourse, the sage described a grave and wasting illness known as rājayakṣma, painting a vivid picture of its many signs and symptoms. Those afflicted become drawn to women, wine, and meat, yet also develop strange aversions and find themselves compelled to cover their heads. Their nails, hair, and bones grow excessively, and even their dreams become troubled—haunted by oppression, visions of falling, jackals, snakes, demons, wild animals, and birds. They dream of climbing heaps of hair, bones, husks, and ashes, and see deserted villages and lands, drying rivers, mysterious lights in the sky, wildfires, and burning trees. The body, too, suffers: nasal congestion, breathlessness, cough, hoarseness, headaches, loss of appetite, and a drying up of the upward breath. Vomiting arises from the stomach. Pain is felt in the sides, and fever appears in the joints—these eleven symptoms mark the presence of rājayakṣma. Further complications emerge: pain that destroys the throat, yawning, body aches, spitting, weakness of the digestive fire, and a foul taste in the mouth. The causes are rooted in the three humors: when wind (vāta) predominates, there is pain in the head and sides, aches throughout the body, obstruction of the throat, and loss of voice. When bile (pitta) is disturbed, pain arises in the feet, shoulders, and hands, with burning, diarrhea, vomiting of blood, foul breath, fever, and delirium. If phlegm (kapha) is at fault, appetite is lost, vomiting and cough occur, the chest feels heavy, and there is a sense of weight pressing down. Excessive salivation, nasal discharge, shortness of breath, hoarseness, and weak digestion follow. The digestive fire is diminished, and swelling, coating, and excess phlegm appear. When the body’s channels are blocked and tissues depleted, burning sensations arise in the mind, and other complications ensue. Food, instead of nourishing the body, is digested only in the gut, mixed with sour juices, and fails to strengthen the limbs. The very essence of nourishment (rasa) does not become blood or flesh; it is obstructed, and wasting prevails. If the signs are few, the disease mild, and the six senses are not exhausted, one should avoid treatment; otherwise, treatment is necessary. When all the humors are disturbed and the body’s fat is wasted, the voice grows hoarse, thin, dry, and unsteady. The throat turns white, and relief comes from oily and warm substances if wind is the cause; with bile, there is constant burning and dryness in the palate and throat. If phlegm predominates, the throat feels smeared, the mouth gurgles, and when all these signs are present together, wasting is certain. The disease then rises greatly, as if the body is filled with smoke, showing phlegmatic symptoms. Such wasting, especially when all signs are present, is difficult to cure and should be avoided. Thus ends the Śrī Garuḍa Mahāpurāṇa. Then Dhanvantari spoke: “Now I will explain the causes of loss of appetite, as taught by Suśruta. Loss of appetite arises when the humors disturb the tongue and heart. Sometimes, by the combination of all humors and mental distress, a fifth type occurs. In wind and other disorders, the mouth tastes astringent, bitter, and sweet in succession. Just as the mind loses all taste in grief or anger, so too does this fifth type arise from humoral imbalance and other corruptions. “When the upward-moving air is afflicted by all the humors, it expels everything fit for digestion. Quickly, distress follows, the complexion fades, excessive salivation occurs, and appetite is lost. Pain arises in the navel and back, and food is expelled to the side; then, in fits and starts, astringent, frothy matter is vomited. Noisy belching follows, difficult and forceful. Wind causes cough, dryness of mouth, and affliction of the voice. Bile makes the vomit saline, smoky, greenish-yellow, sometimes mixed with blood, sour, sharp, bitter, smelling of grass, causing burning and ripening. Phlegm makes it unctuous, thick, yellow, or honey-like—sweet, salty, abundant, excessive, and causing horripilation. “When vomiting comes with swelling, sweetness, drowsiness, nausea, exhilaration, and cough, and all these signs are present together, it must be discarded as hopeless. When everything about a person becomes repulsive—to sight, hearing, and so on—due to humoral disturbance or food corrupted by worms, the disease manifests with pain, trembling, and exhilaration, especially in worm-induced cases. “Now, O learned one, I will explain the causes of heart disease and related conditions, including those caused by worms. Five types located in the heart are recognized by their signs. When wind is disturbed, there is excessive emptiness; the person eats and cries out, the heart feels broken, dried, stiff, empty, and there is dizziness. Sudden dejection, sorrow, fear, intolerance of sound, trembling, shivering, confusion, difficulty breathing, and little sleep arise. “From bile, there is thirst, fatigue, burning, sweating, and a sequence of sour and phlegmatic symptoms; vomiting occurs in sour-bile conditions, and fever arises with a smoky sensation. From phlegm, the heart feels stiff and heavy, as if containing a stone; cough, weakness of bones, spitting, drowsiness, laziness, loss of appetite, and fever occur. “In heart disease caused by all three humors and by worms, there is darkening of the eyes, entry into darkness, exhilaration, swelling, itching, and discharge of phlegm. Here, the heart feels as if torn by a saw—this terrible disease must be treated quickly, very quickly. “From wind, bile, and phlegm comes thirst; from the combination of all three, loss of strength. The sixth type arises from complications, with wind and bile as causes. When all these are aggravated, they thoroughly dry up the body’s tissues, causing confusion, trembling, heat, burning in the heart, and loss of consciousness. When the veins that carry fluids to the root of the tongue, throat, palate, and uvula are dried up, thirst arises—this is their common sign. “Dryness of the mouth, satisfaction from water, aversion to food, loss of voice, burning in the throat, lips, and palate, and fatigue when sticking out the tongue are seen. Delirium, confusion of mind, and disease with frequent belching appear. From wind, there is emaciation, dejection, pain in the temples, and dizziness in the head.” Thus, the sage revealed the nature of these devastating diseases, their causes, signs, and the suffering they bring—so that one might recognize them, understand their roots, and seek the proper path to healing.