In the ancient teachings, it is declared that diseases arising from one’s family lineage, especially those that are congenital—dry and difficult to perceive—are deemed incurable. These ailments are subtle, inward-facing, and pale, often accompanied by severe complications. When such diseases result from the combination or accumulation of the individual doṣas—vāta, pitta, and śleṣman—they must be treated according to their specific nature. The dry conditions are attributed to vāta and śleṣman, while moist ones arise from pitta. The causes for the aggravation of these doṣas have already been explained in the section dedicated to wounds. When fire and bodily wastes accumulate excessively, and when there is delay caused by excessive drinking, irritation, consumption of unwholesome or hard foods, and persistent coughing, the seeds of disease are sown. Injury to the bladder, rectum, throat, lips, palate, and similar organs; frequent contact with very cold water; and continuous excessive straining further contribute to the disturbance. Holding back or forcibly expelling urine or stool, feelings of disgust, diarrhea, and the complication known as grahaṇī also play a role. For women, pulling, uneven movements, and exertion—especially during the descent of an unripe embryo or the distress caused by its growth—are significant causes. Through these or other factors, the apāna wind becomes disturbed, producing wastes in the folds of the anus, particularly in those with liquid stools or a full body. Before the symptoms manifest, there is a decrease in digestive fire, obstruction, pain in the seat of the bones, cramping of the limbs, twisting, and dizziness. Dense swelling appears in the eyes, and constipation or retention of stool may follow. The wind, blocked in its path, tends to move below the navel. Mixed with blood and cut off, breathing becomes difficult and contracted. Rumbling in the intestines, bloating, excessive belching, and frequent expulsion occur. Urine is abundant, stool scanty, appetite weak, and the abdomen dusky; pain is felt in the head, back, and chest, accompanied by fatigue and altered feces. Restlessness toward sense objects develops, and anger arises from distress, leading to suspicion, retention, swelling, and pallor in the abdomen. These symptoms intensify in those whose digestion is impaired. As the wind turns back, it is obstructed in the lower path, agitating the other winds, all the senses, and the body. It dries up urine, stool, bile, phlegm, and wind, destroying the digestive fire. The body becomes emaciated—thin, lacking enthusiasm, dejected, wasted, and dull. Without essence or luster, the afflicted appear like trees scorched by insects. They are tormented by severe, fast-flowing humors and pains described as consumption, which attack the vital points. Cough, thirst, dryness of mouth, tastelessness, breathlessness, nasal congestion, fatigue, breaking of limbs, grinding, sneezing, swelling, and fever beset them. Impotence, deafness, stiffness, gravel, wasting, altered voice, meditative states, repeated spitting, and lack of appetite further afflict them. Pain spreads through all joints, bones, heart, navel, anus, and groin. Bile flows from the rectum, resembling the belly of a crane. It is dry, expelled at the tip, ripe or unripe in between; pale bile colored like turmeric, sticky, and passed while seated. Rectal sprouts appear, accompanied by many winds—dry, itchy, fat, dark red, stiff, uneven, and rough to the touch. These masses are mutually dissimilar, crooked, sharp, with split faces, resembling the fruits of jujube, date, karkandhu, and cotton. Some are like kadamba flowers, others like siddhartha seeds. Excessive pain is felt in the head, sides, calves, thighs, groin, and other areas. Sneezing, belching, obstruction, heart pain, nausea, coughing, shortness of breath, irregular digestion, ringing in the ears, and dizziness are common. Afflicted by these, the person passes stool that is lumpy, scanty, noisy, and comes out in a stream, accompanied by pain and mucus, and is difficult to expel. The skin darkens, urine and stool are retained, and the eyes and mouth become discolored. From these arise tumors, spleen disorders, abdominal swelling, and hard masses. When bile predominates, the mouth turns blue, and the masses appear red, yellow, or black. They are thin, sharp, oozing, foul-smelling, slender, soft, and loose. Their tongues resemble that of a parrot, their mouths like a piece of liver or the mouth of a leech. Burning, fever, sweating, thirst, fainting, loss of appetite, and confusion ensue. The masses are hot, fluid, blue, warm, yellow, or red in color; their middles resemble barley, and their skin, nails, and other parts are greenish-yellow. When phlegm predominates, the masses are large, dense, slightly painful, white, elevated, swollen, oily, stiff, round, heavy, and firm. They are slimy, still, smooth, rich in itching, pleasant to the touch, resembling the stem of the karira or jackfruit, and like the udder of a cow. Located in the groin, they are snake-like, with pus, causing pain in the bladder and navel. Shortness of breath, palpitations, excessive saliva, loss of appetite, and nasal congestion accompany these masses. Severe difficulty, heaviness of the head, coldness, and astringency arise; impotence, weak digestion, softness, vomiting, diarrhea, and other disorders follow. The stools are rich in fat, mucus, and phlegm, and there is a flow of blood. They neither flow freely nor break apart, and the skin and other parts are pale and oily. When all symptoms are mixed together, all features appear. When blood predominates, the masses in the anus are yellowish in appearance, resembling the fruit of the banyan tree, or like gunja or coral. They are extremely foul, hot, and severely obstructed and painful. Suddenly, these masses discharge blood, and due to excessive flow, the person suffers with a cry like a peacock, afflicted by the consequences of blood loss. He becomes deficient in color, strength, enthusiasm, and vitality, with impaired senses, especially after consuming foods such as mudga, kodrava, jambira, karira, chanaka, and similar items. When wind is aggravated by dry, binding foods, it becomes strong in the rectum, obstructs the downward channels, and dries out the lower parts. Thus, the scripture describes the progression, manifestations, and consequences of these complex diseases, revealing their roots in the disturbance of the doṣas and the intricate interplay of bodily humors, symptoms, and suffering.