Muslim prayer involves bowing, kneeling and prostration. Tartar emetic causes intense nausea, prostration and vomiting by irritating the gastrointestinal mucosa. The takbir is said again and the worshipper moves into prostration. Devotional practices include ritual prayer, prostration, offerings, pilgrimage, and chanting. Additionally, there is risk of heat prostration, hyperthermia, heat stroke and even death. Often, the chanting of this hymn is followed by either a metania or a prostration. Sikhs call the prostration "mutha tekna" ("lowering the forehead"). In general, dogeza is translated into English as "prostration" or "kowtow". Infected birds may suffer from reluctance to move, ruffled appearance, prostration and death. Officially, it was announced as heat prostration, but in fact it was a heart seizure. This limbo is the threshold for mental prostration. The subordinates find the performance of prostration a harsh physical practice. The bacteria infect the brain, causing prostration. It spelled almost absolute ruin and prostration for the Puyallup Indians. "Sigd" comes from a root word meaning prostration in Amharic, Aramaic, and Arabic.