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Charak Samhita

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यस्यनीलावुभावोष्ठौपक्वजाम्बवसन्निभौ। मुमूर्षुरिति तं विद्यान्नरो धीरो गतायुषम् ॥२३॥

In a patient who is very much weak, due to Ojokshaya (immune depletion) along with any changes occur in voice either as single problem or multiple issues, that indicates death.

english translation