Garuda Purana

चतुर्थको मलैर्मेदोमज्जास्थ्यन्यतरे स्थितः । मज्जास्थ एव ह्यपरः प्रभावमनुदर्शयेत् ॥ १,१४७.

The fourth type, situated in the impurities, fat, marrow, or bone; another is only in the marrow and bone, showing its effect.

द्विधा कफोणिजङ्घाभ्यां स पूर्वं शिरसानिलात् । अस्थिमज्जोरुपगतश्चतुर्थकविपर्ययः ॥ १,१४७.

Phlegm is twofold, in the calves, first from wind in the head; when it reaches bone and marrow, it is the reverse of the fourth type.

त्रिधा त्र्यहं ज्वरयति दिनमेकन्तु मुञ्चति । बला बलेन दोषणामन्यचेष्टादिजन्मनाम् ॥ १,१४७.

Threefold, it causes fever for three days, but releases for one day; by the strength of the doshas, and the origin of other actions.

पक्रानामविपर्यासात्सप्तरात्रञ्च लङ्घयेत् । ज्वरः स्यान्मनसस्तद्वत्कर्मणश्च तदातदा ॥ १,१४७.

Due to the absence of reversal in the fevers, it fasts for seven nights; fever affects the mind similarly, and also actions, at that time and otherwise.

गम्भीरधातुचारित्वात्सन्निपातेन सम्भवात् । तुल्योच्छ्रयाच्च दोषाणां दुश्चिकित्स्यश्चतुर्थकः ॥ १,१४७.

Because of deep-seated behavior in the tissues, and arising from combination, and equal increase of the doshas, the fourth type is difficult to treat.

सूक्षामात्सूक्ष्मज्वरेष्वेषु दूरद्दूरतरेषु च । दोषो रक्तादिमार्गेषु शनैरल्पश्चिरेण यत् ॥ १,१४७.

From subtlety, in subtle fevers, and in those farther and farther away; the dosha, in the path of blood and so forth, slowly, slightly, over a long time.

याति देहञ्च नाशेषं सन्तापादीन्करोत्यतः । क्रमो यत्नेन विच्छिन्नः सतापो लक्ष्यते ज्वरः ॥ १,१४७.

It goes to the body and does not leave anything, causing burning and so forth; when the sequence is interrupted by effort, fever with burning is observed.

विषमो विषमारम्भः क्षपाकालानुसारवान् । यथोत्तरं मन्दगतिर्मन्दशक्तिर्यथायथम् ॥ १,१४७.

Uneven, with a difficult onset, following the course of the night; each successive stage is slower and weaker, as is appropriate.

कालेनाप्नोति सदृशान्स रसादींस्तथातथा । दोषो ज्वरयति क्रुद्धश्चिराच्चिरतरेण च ॥ १,१४७.

Over time, it acquires corresponding tastes and qualities; the disorder burns fiercely when provoked, sometimes after a long delay.

भूमौ स्थितं जलैः सिक्तं कालं नैव प्रतीक्षते । अङ्कुराय यथा बीजं दोषबीजं भवेत्तथा ॥ १,१४७.

A seed placed in the earth and moistened with water does not wait for time to sprout; so too, the seed of disorder acts likewise.

वेगं कृत्वाविषं यद्वदाशये नयते बलम् । कुप्यत्याप्तबलं भूयः कालदोषविषन्तथा ॥ १,१४७.

Just as poison, having gained momentum, brings its force into the body, so too, the disorder and poison, empowered by time, become agitated.

एवं ज्वराः प्रवर्तन्ते विषमाः सततादयः । उत्क्लेशो गौरवं दैन्यं भङ्गोऽङ्गानां विजृम्भणम् ॥ १,१४७.

Thus fevers arise, irregular and persistent, causing agitation, heaviness, dejection, collapse of limbs, and stretching.

अरोचको वमिः श्वासः सर्वस्मिन्रसगे ज्वरे । रक्तनिष्ठीवनं तृष्णा रूक्षोष्णं पीडकोद्यमः ॥ १,१४७.

Loss of appetite, vomiting, breathlessness occur in every type of fever; spitting blood, thirst, dryness, heat, and painful effort.

दाहरागभ्रममदप्रलापो रक्तसंश्रिते । तृड्ग्लानिः स्पृष्टवर्चस्कमन्तर्दाहो भ्रमस्तमः ॥ १,१४७.

Burning, redness, confusion, delirium, and babbling in those with blood involvement; thirst, fatigue, altered complexion, internal burning, dizziness, and darkness.

दौर्गन्ध्यं गात्रविक्षेपो मांसस्थे मेदसि स्थिते । स्वेदोऽतितृष्णा वमनं दौर्गन्ध्यं वा सहिष्णुता ॥ १,१४७.

Foul smell, twitching of limbs, when the disorder is in the flesh or fat; sweating, excessive thirst, vomiting, foul odor, or endurance.

प्रलापो ग्लानिररुचिरस्थिगे त्वस्थिभेदनम् । दोषप्रवृत्तिरुद्बोधः श्वासांगक्षेपकूजनम् ॥ १,१४७.

Delirium, fatigue, loss of appetite, pain in the bones and their splitting; activation of disorder, awakening, breathlessness, spasms, and groaning.

अन्तर्दाहो बहिः शैत्यं श्वासो हिक्का हि मज्जमे । तमसो दर्शनं मर्मच्छेदनं स्तब्धमेढ्रता ॥ १,१४७.

Internal burning, external coldness, breathlessness, hiccups in the marrow; darkness of vision, cutting pain in vital spots, stiffness of the genitals.

शुक्रप्रवृत्तौ मृत्युस्तु जायते शुक्रसंश्रये । उत्तरोत्तरदुः साध्याः पञ्चान्ये तु विपर्यये ॥ १,१४७.

When the disorder reaches the semen, death arises in those with semen involvement; the five that follow are increasingly difficult to cure in reverse order.

प्रलिम्पन्निव गात्राणि श्लेष्मणा गौरवेण च । मन्दज्वरप्रलापस्तु सशीतः स्यात्प्रलेपकः ॥ १,१४७.

As if smeared over the limbs, heaviness from phlegm; in mild fever, delirium occurs with coldness and a covering sensation.

नित्यं मन्दज्वरो रूक्षः शीतकृच्छ्रेण गच्छति । स्तब्धाङ्गः श्लेष्मभूयिष्ठो भवेदङ्गबलाशकः ॥ १,१४७.

The mild fever is always dry and passes with difficulty in cold; the limbs become stiff, dominated by phlegm, and there is weakness of the limbs.

हरिद्राभेदवर्णाभस्तद्वल्लेपं प्रमेहति । स वै हारिद्रको नाम ज्वरभेदोऽन्तकः स्मृतः ॥ १,१४७.

With a turmeric-like color and similar coating in diabetes, this is called 'haridraka', a fatal type of fever.

कफवातौ समौ यत्र हीनपित्तस्य देहिनः । तीक्ष्णोऽथ वा दिवा मन्दो जायते रात्रिजो ज्वरः ॥ १,१४७.

Where phlegm and wind are both present and bile is deficient in the body, the fever is sharp by day or mild, but arises at night.

दिवाकरार्पितबले व्यायामाच्च विशोषिते । शरीरे नियतं वाताज्ज्वरः स्यात्पौर्वरात्रिकः ॥ १,१४७.

When the body's strength is given to the sun and exhausted by exertion, fever from wind surely arises in the early part of the night.

आमाशये यदात्मस्थे श्लेष्मपित्ते ह्यधः स्थिते । तदर्धं शीतलं देहे ह्यर्धं चोष्णं प्रजायते ॥ १,१४७.

When the self is in the stomach and phlegm and bile are situated below, half the body becomes cold and the other half hot.

काये पित्तं यदा न्यस्तं श्लेष्मा चान्ते व्यवस्थितः । उष्णत्वं तेन देहस्य शीतत्वं करपादयोः ॥ १,१४७.

When bile is placed in the body and phlegm is settled at the extremities, the body becomes hot, while the hands and feet are cold.

रसरक्ताश्रयः साध्यो मांस मेदोगतश्च यः । अस्थिमज्जागतः कृच्छ्रस्तैस्तैः स्वाङ्गैर्हतप्रभः ॥ १,१४७.

That which is situated in the fluids, blood, flesh, and fat, and that which is in the bone and marrow—when afflicted in these respective parts, the body loses its luster.

विसंज्ञो ज्रवेगार्तः सक्रोध इव वीक्षते । सदोषमुष्णञ्च सदा शकृन्मुञ्चति वेगवत् ॥ १,१४७.

He becomes unconscious, distressed by the urge to evacuate, and looks around as if angry; he constantly passes foul, hot stool with force.

देहो लघुर्व्यपगतक्लममोहतापः पाको मुखे करणसौष्ठवमव्यथत्वम् । स्वेदः क्षुवः प्रकृतियोगिमनोऽन्नलिप्सा कण्डूश्च मूर्ध्नि विगत्ज्वरलक्षणानि ॥ १,१४७.

The body is light, free from fatigue, delusion, and heat; digestion is in the mouth, the senses function well, there is no pain; sweating, sneezing, the mind united with its nature, desire for food, and itching on the head are signs of absence of fever.

श्रीगरुडमहापुराणम् १४८ धन्वन्तरिरुवाच । अथातो रक्तपित्तस्य निदानं प्रवदाम्यहम् । भृशोष्णतिक्तकट्वम्ललवणादिविदाहिभिः ॥ १,१४८.

Dhanvantari said: Now, therefore, I will explain the causes of blood-bile disorder—by consuming excessively hot, bitter, pungent, sour, salty, and burning substances.