The end of life, it is said, can come from the highest degree of poison; and wine, possessing sharp and penetrating qualities akin to poison, steadily diminishes the strength and virtues of the body. Wine acts with ten distinct qualities, contracting and dulling the activity of the mind, so that even in the early stages of intoxication—whether the first or the second—confusion firmly takes hold. In this bewildered state, indecision strikes, and a person mistakes what is merely pleasant for true happiness. As intoxication deepens, reaching the threshold between moderate and extreme, it seizes control like a king enthroning itself. Thereafter, the person, like a wild beast without a goad, becomes incapable of any purposeful action. The earth then becomes the dwelling place of those whose conduct is unspeakable, whose character is poor. This, indeed, is the chief sign of a perilous path, one with many misleading turns. When all movement ceases and speech is lost, intoxication has entered its third and final stage. At this point, the sinful soul falls into a state even more dreadful than death itself, unable to distinguish between righteousness and unrighteousness, happiness and sorrow, honor and dishonor, benefit and harm. Afflicted by delusion and confusion, joined by dryness and other symptoms, the person is beset by madness, delirium, fainting, and even epilepsy—falling helplessly to the ground. Yet, those who are strong, well-fed, or given to gluttony do not succumb so easily to excessive intoxication. The disease of intoxication arises from the combined forces of wind, bile, and phlegm within the body. The common symptoms are many: confusion, pain in the heart, splitting headaches, intense thirst, mild fatigue, fever, and loss of appetite. There may be obstruction in the chest, darkness before the eyes, cough, breathlessness, sleeplessness, excessive sweating, bloating, swelling, and disturbance of mind. The person feels as if dreaming, unable to respond even when spoken to. When bile predominates, burning sensations, fever, sweating, confusion, and constant dizziness arise. If phlegm is the cause, there is vomiting, nausea, drowsiness, and heaviness in the abdomen. Whoever drinks liquor, knowing all these signs and symptoms, must be aware that sudden pleasantness may be followed by destruction and dryness, especially if wind is involved, which brings severe suffering. Destruction manifests as spitting of phlegm, dryness of the throat, excessive sleepiness, intolerance to sound, and distraction of the mind—these are the torments caused by wind in the body. Heart and throat diseases, confusion, breathlessness, thirst, and intermittent fever may also arise. But one who abstains from liquor, practicing self-control and discernment, is freed from these afflictions. Such a person is never troubled in body or mind by these disorders. However, for one whose food is impure, tainted by passion and delusion, three diseases arise: obstruction of the channels carrying fat, blood, and moisture, and the onset of intoxication, fainting, and loss of consciousness in increasing severity. Intoxication may arise from all the bodily humors, as well as from blood, wine, and poisons. Due to its boundless power, its manifestation is unstable and deceptive. When wind predominates, the body becomes dry, dark, and reddish; with bile, irritability, a reddish-yellow hue, and a fondness for quarrels appear. In intoxication from phlegm, one speaks incoherently in dreams and becomes absorbed in meditation. When all three humors are disturbed, there is stiffness in the blood and corruption of the limbs. If bile is the first symptom, there is confusion about one’s own voice, trembling, excessive sleep, and above all, great fatigue from the disturbance of all humors. By observing the prominence of symptoms, one should recognize which humor is at fault. When the body is overtaken by red, blue, or black hues, one falls into darkness. Recovery from such states may come quickly, but is accompanied by pain in the heart, trembling, dizziness, coughing, and a dusky or reddish complexion—these mark fainting due to wind. When bile is the cause, the person sees blood or yellow in the sky and falls into darkness, regaining consciousness sweating, tormented by burning and thirst. With phlegm, the sky appears cloud-like, broken, yellowish-blue, and the eyes are bloodshot and tinged with blue. Consciousness returns after a long time, with much salivation from the heart and chest; the limbs are heavy and dull, and the person is bound by the law of the king. When all forms and all three humors are involved, the person falls suddenly and motionless, as if possessed, without any repulsive movement. In intoxication and fainting caused by the humors, when their force is spent in the body, they subside on their own, or through abstinence and medicines. The actions of speech, body, and mind are seized, whether the force is strong or weak; together with loss of consciousness, all collapse, leading toward the destruction of life. Because of this, people become like wood, resembling the dead, and perish quickly if not treated promptly. Just as one would swiftly rescue a person sinking into the deep ocean, filled with crocodiles and torrents, so too must one hasten to aid a person sinking into unconsciousness. Driven by intoxication, pride, anger, and pleasure, a person acts in many ways; but under the influence of wine, he cannot reason properly about right or wrong. Therefore, considering one’s own strength, cough, place, vessel, natural constitution, and age, one should drink only in accordance with one’s capacity. In this way, drinking becomes like nectar. Then, Dhanvantari said: “Now, O Suśruta, I will explain the causes of hemorrhoids—those growths which arise in the flesh of living beings like stakes. They are called ‘arśas’ because they obstruct the anal passage; the fault, having corrupted the skin, flesh, and fat, produces them in various forms. Hemorrhoids are said to be produced by the sprouting of flesh, by drinking, and other causes. In summary, they are divided into two types: those present from birth and those that arise later. Dry, pointed, and unbroken, they are located in the anal region. Among them, three are situated at one and a half finger-breadths, and the rest at half a finger-breadth from the anal opening. Of these, the one that flows since childhood is found in the middle, discharging; when the outer covering is absent, it is found at the beginning of the anus, externally, at a finger’s breadth. Measuring half a finger, and with hair growing there, their cause, when arising together, is the heating of the seed in childhood. The origin of hemorrhoids, then, is from the seed, due to the ‘cooking’ by mother and father; also, from the anger of deities, and otherwise from the disturbance of all three doṣas.