Those who are learned in the ways of the body recognize the hard, immovable, wart-like growths that may appear—these are often brought about by the influence of wind, which causes pain and roughness, or by bile, which can darken the mouth. When the condition is oily, knotted, and maintains a normal color, it is due to phlegm. Wise individuals understand the urgency of treating hemorrhoids, for such ailments can swiftly block the passage of the anus and abdomen, leading to grave consequences. Dhanvantari, the divine physician, addressed Suśruta, saying, “Now I will explain to you the causes of diarrhea and digestive disorders. These disturbances are of six kinds, arising from the imbalance of the three humors—wind, bile, and phlegm—either individually, in combination, or from the effects of fear and grief. Diarrhea most often emerges from excessive drinking of water, as well as from consuming dry food, raw meat, oily substances, sesame flour, and improperly cooked grains. It may also result from overindulgence in alcohol, dry and heavy foods, a confusion of tastes and textures, the presence of worms, and improper food combinations that disturb the wind. When the wind is thus agitated, it moves downward, extinguishing the digestive fire. As a result, the food, feces, and bowels are disrupted, leading to looseness of stool and other symptoms. Signs foretelling the onset of diarrhea include disturbances in the heart, anus, and bowels, sweating of the limbs, and the retention of impurities. In this state, one experiences bloating and indigestion without fever; the stool becomes scant, silent, and difficult to pass. The stool may be dry, frothy, and clear, passed repeatedly or at intervals, sometimes appearing burnt or poisoned, or slimy and causing sharp pain. When the anus becomes dried and contracted, and the hair stands on end with sighing, it is a sign of wind involvement. If bile is disturbed, the stool turns yellow, like turmeric or green grass. Such stools may be stained with blood, emit a foul odor, contain undigested grass, and are accompanied by sweating and burning sensations. There is pain, heat in the rectum, a craving for pungent tastes, and thick phlegm. The discharge is slimy, scanty, and flowing, causing hair loss, severe discomfort, and a feeling of heaviness in the bladder, anus, and abdomen. Even when the body attempts to expel waste, if digestion is weak, all these symptoms persist throughout the being. When the mind is troubled by fear and the person lies down, the body expels waste. In such cases, wind should be quickly pacified with warm, liquid, and light foods. The signs of wind and bile disorders are similar, and grief may produce the same effects. In summary, diarrhea is of two types: with impurity and without impurity. When mixed with blood, it is a disorder of the bodily fluids; when heavy, it sinks in water, and the stool is foul-smelling, noisy, obstructed, and painful. The opposite type, without impurity, is caused by phlegm and does not sink. If one is careless, they may become afflicted with grahaṇī disease, a chronic digestive disorder. In such cases, due to the accumulation of factors that suppress the digestive fire, whether the stool is impure or pure, it is digested and then expelled as diarrhea. This type of diarrhea is characterized by excessive discharge; when mixed with impurity, the stool is undigested, but when digestion is complete, it is not so. Long-standing grahaṇī leads to accumulation and necessitates fasting; at times, there may be sudden trembling or joint pain. This disorder arises in four ways, according to the humors, and may also result from their combination. Early signs include weakness of the limbs, persistent wind, slight salivation, bad taste in the mouth, loss of appetite, thirst, fatigue, and dizziness. Abdominal distension, vomiting, and sometimes ringing in the ears may follow. General symptoms are emaciation, nausea, fainting, and fever. There may also be fainting, heaviness in the head and thighs, swelling of the hands and feet, drowsiness from wind, dryness of the palate, darkness before the eyes, and ringing in the ears. Pain may arise in the sides, groin, and neck, with severe colic, and in the afflicted, all symptoms intensify, with hunger and thirst that cannot be satisfied. When food is digested, flatulence occurs, but after eating, well-being returns. Yet, when wind predominates, there is risk of heart disease, abdominal tumors, hemorrhoids, spleen disorders, and anemia. Over time, the stool becomes thin, liquid, dry, hard, noisy, and frothy; the person passes stool repeatedly, with difficulty in the anus, and suffers from breathlessness and cough. If the stool is yellow or tinged with blue, it is liquid; there may be putrid, sour belching, burning in the heart and throat, loss of appetite, thirst, and pain. When phlegm is the cause, digestion is painful, the mind feels nauseated, there is vomiting, loss of appetite, sticky saliva, spitting, cough, palpitations, and nasal discharge. The heart feels stiff, the abdomen is numb and heavy, belching is foul and sweet, and there is weakness or, at times, exhilaration. When the feces are mixed, sticky, heavy, or sour, even those not emaciated experience weakness, and all diseases and symptoms may manifest. The three impurities—such as thirst—described in the division of the body, are also caused by disorders of the grahaṇī, and are found everywhere as their cause. The eight great diseases—those of wind, urinary stones, leprosy, diabetes, abdominal swelling, foul odor, hemorrhoids, and grahaṇī—are extremely difficult to overcome. Dhanvantari continued, “Now, O Suśruta, listen to the causes of urinary retention. The bladder, its neck, the penis, loins, testicles, and anus are all supported by single channels, situated in the cavities of the rectum and bones. The bladder faces downward, with the openings of the urinary veins. From the sides, fine streams constantly fill it, and entering through these, they produce twenty kinds of disorders. Urinary retention and diabetes, both severe, affect the vital spots, causing pain in the bladder, groin, and penis—pain that is mild but frequent. In the wind type, urine is scanty; in the bile type, it is yellow and always burning; in the phlegm type, it is bloody, with heaviness and swelling of the bladder and penis. The urine is slimy, obstructed, and affected by all impurities. When wind blocks the opening of the bladder and dries it out, the urine, mixed with bile, phlegm, or semen, gradually forms a dreadful stone, yellow like cow’s bile. All these conditions are rooted in phlegm. The earliest sign is swelling of the bladder and intense pain around the affected area. There is retention of urine in the bladder, painful urination, fever, and loss of appetite. Common symptoms include pain in the navel, perineum, bladder, and head.” Thus did Dhanvantari impart the profound knowledge of these bodily afflictions, their causes, signs, and the importance of timely understanding and treatment.