When phlegm becomes the dominant force within the body, unusual growths begin to appear—large, dense, and slightly painful. These masses are white in color, raised above the skin, swollen, oily to the touch, stiff, round, heavy, and firm. Their surface feels slimy and smooth, and they tend to itch, yet their touch is oddly pleasant. Their appearance can be likened to the stem of the karira plant or the jackfruit, and sometimes even to the udder of a cow. These masses often settle in the groin. There, they may take on a serpentine shape, filled with pus, and cause pain that radiates to the bladder and navel. Alongside these symptoms, a person may experience shortness of breath, palpitations, excessive salivation, loss of appetite, and nasal congestion. The afflictions do not end here. Severe discomfort arises, accompanied by heaviness in the head, a sensation of coldness, and an astringent feeling throughout the body. These conditions can lead to impotence, weak digestion, a general softness or laxity in tissues, vomiting, diarrhea, and other related disorders. The stools in such cases are rich in fat, mucus, and phlegm, sometimes streaked with blood. They neither pass easily nor break apart, and the skin and other tissues appear pale and oily. When all these symptoms are present together, the full spectrum of the disorder is seen. If blood becomes the predominant factor, the masses at the anus take on a yellowish hue. Their appearance may resemble the fruit of the banyan tree, or the small red seeds of gunja, or even coral. These are extremely foul-smelling, hot to the touch, and cause severe pain and obstruction. At times, these masses suddenly discharge blood. The excessive bleeding is so distressing that the sufferer may cry out in agony, much like a peacock’s call, tormented by the consequences of blood loss. This leads to a marked loss of color, strength, enthusiasm, and vitality. The senses become impaired, especially after consuming foods such as mudga, kodrava, jambira, karira, and chanaka. When the wind (vāta) is aggravated—especially by eating dry, binding foods—it gathers strength in the rectum, obstructing the downward channels and drying out the lower parts of the body. As a result, the stool becomes hard, dry, and mixed with wind, causing severe pain in the abdomen, back, heart, and sides. Bloating of the abdomen ensues, with the stool remaining hard and difficult to pass. Nausea, cutting pain, and particularly severe pain in the bladder are common, often accompanied by swelling of the cheeks. The upward movement of wind can then give rise to vomiting, loss of appetite, fever, heart disease, digestive disorders, retention of urine, and diarrhea. Other symptoms include deafness, severe headaches, breathlessness, pain in the head, cough, nasal congestion, mental disturbances, thirst, difficulty breathing, disorders of bile, abdominal tumors, and similar conditions. These are the diseases caused by wind, and they can arise suddenly and with great intensity. Among them, the most dangerous are those with fearsome names, capable of leading to death and severe complications. Even without such dramatic symptoms, those whose bowels are afflicted by wind develop inherent disorders, as well as those that are internal and associated with the body’s channels. Once established, these conditions are considered incurable, though some relief may be found through the strength of the digestive fire and other treatments. Cases arising from the combination of two humors, or those affecting the secondary channels, are also described and are known to be difficult to cure, often lingering for years. However, hemorrhoids that arise in the external channel and are dominated by a single humor are more easily managed and do not take long to develop. There are also those that arise in the genitals and similar areas, each with their own characteristics, though congenital forms are not discussed here. Worm infestations present yet another form of disorder, characterized by slimy and soft growths. When the circulating wind picks up phlegm, it produces external hemorrhoids on the skin. These may be hard, immovable, and wart-like. Pain and roughness are caused by wind, while blackening of the mouth points to the involvement of bile. An oily texture, knotting, and normal coloration are signs of phlegm. The wise should act quickly to relieve hemorrhoids, for these diseases can soon cause dangerous obstructions of the anus and abdomen. At this point, Dhanvantari spoke to Suśruta: “Now, I will explain to you the causes of diarrhea and digestive disorders. There are six types, arising from the disturbance of the humors—singly or in combination—as well as from fear and grief. Diarrhea most commonly arises from excessive drinking of water, as well as from eating dry foods, raw meat, unctuous substances, sesame flour, and improperly cooked grains. It may also result from excessive consumption of alcohol, overeating, confusion of tastes and unctuousness, opposition of worms, and improper food combinations, all of which provoke wind. When wind is disturbed, it moves downward, destroying the digestive fire. This affects the food, feces, and bowels, resulting in looseness of stool and a variety of other symptoms. The signs that foretell impending diarrhea include disturbances in the heart, anus, and bowels, sweating of the limbs, and retention of impurities. In such a condition, bloating and indigestion occur without fever. The stool is scanty, silent, and difficult to pass. It may be dry, frothy, and clear, passed either repeatedly or at intervals. Sometimes, it appears burnt or poisoned, slimy, and causes cutting pain. The anus may become dried and contracted, the hair on the body stands on end, and the sufferer may sigh frequently. When bile is involved, the stool turns yellow, resembling turmeric or green grass. It may be blood-stained, extremely foul-smelling, mixed with undigested grass, and accompanied by sweating and burning sensations. There is pain, heat in the rectum, a craving for pungent tastes, and thick phlegm. The discharge in these cases is slimy, scanty, and flowing. It can cause hair loss, severe discomfort, and a feeling of heaviness in the bladder, anus, and abdomen. Even if the process of digestion seems complete, if the food is not properly assimilated, the entire being is affected by these signs. When the mind is disturbed by fear and the person lies down, the bowels may be suddenly emptied. In such cases, wind should be quickly restrained using warm, liquid, and light substances. The signs are similar in both wind and bile disorders, and likewise in cases arising from grief. In summary, diarrhea is of two main types: with impurity and without impurity. When mixed with blood, it is considered a disorder of the bodily fluids, and due to the heaviness, it sinks in water; the stool is foul-smelling, noisy, obstructed, and painful. The opposite, without impurity, is caused by phlegm and does not sink. Among those afflicted with diarrhea, one who is not careful may soon develop grahani disease. For such a person, due to the excessive accumulation of factors that extinguish the digestive fire, whether the stool is impure or pure, it is digested and then expelled as diarrhea. This diarrhea, by its very nature, causes excessive discharge. When mixed with impurity, it remains undigested, but when digested, it is not so. Long-standing grahani disorder leads to accumulation and compels fasting; at times, there may be sudden trembling or sudden joint pain. This disorder arises in four ways, according to the different humors, and also from their combinations. The early symptoms include weakness of the limbs, persistent wind, slight salivation, a bad taste in the mouth, loss of appetite, thirst, fatigue, and dizziness. Thus, the intricate interplay of the body’s humors gives rise to a multitude of ailments, each with its own signs and challenges, and each requiring careful attention and wise management.