In the teachings of Dhanvantari, the sage describes the ailments arising in the urinary tract with great detail. He explains that when the passage for urine is open, the flow is abundant; but when the channel is blocked, urine is expelled with difficulty, appearing clear like the gomedaka gemstone. Agitation in the tract brings pain, and blood and flesh may be found in the urine. Afflicted by wind, the patient grits his teeth and trembles, suffering intensely. He often grasps his penis and navel, struggling with great discomfort. The wind causes frequent passage of stool and urination, but only drop by drop. Sometimes, the stone formed within is dark and rough, sharp like thorns, and the bladder burns as if scorched by heat from bile. In other cases, the stone resembles the seed of bhallātaka—red, yellow, or white in color—and the bladder, burdened by phlegm, feels cold and heavy. Among children, large, smooth stones, honey-colored or white, are more common. When the urinary channel is narrow, and the stone is easy to grasp and expel, the person feels comfortable. However, if semen is retained, a large calculus forms from the accumulated semen. If semen is displaced or not expelled, wind enters between the two testicles, dries up the semen, and this dried semen becomes a stone. This causes pain in the bladder, difficulty in urination, and swelling. As soon as the stone arises, it dries up and dissolves. When afflicted, fever and cough may occur, and the stone becomes like gravel. Sometimes, broken by wind, it moves in the reverse direction. It may be expelled with urine, or, moving against the flow, it is digested. If wind is agitated at the mouth of the bladder, urine is retained. Retention brings pain, itching, and sometimes swelling. The stone covers the bladder, rising up, large and displaced, toward the region near the anus. There, it causes pain, burning, throbbing, and twisting. When the bladder is pressed, urine is passed only drop by drop. This obstruction is known as "wind in the bladder," difficult to overcome, and the second, stronger wind is even more challenging. When wind occupies the space between the rectum and bladder, it produces a hard, knotty, elevated mass like a pestle. This is called "wind-pestle," produced by the wind of Vishnu's channel. Defective, coiled, and intense, the wind in the bladder causes severe pain. Binding up the urine, it moves about, causing stiffness, twisting, and heaviness. The urine is passed little by little, or only occasionally. This is called "wind-coil." When urine is retained for a short time, it does not come out, or is obstructed, and after urination, there is little pain. When, due to retention, the wind is obstructed and whirls about, the lower abdomen below the navel fills with urine. This causes intense pain, distension, inability, and accumulation of waste. Such urine arises from a defect in the opening of the stomach or by wind. When little urine is forcibly retained in the bladder or at the navel, it remains there, floating with the desire to pass, and later is expelled with or without pain. The passage of urine is interrupted; this is less troublesome for those with larger genitals. At the mouth of the inner bladder, there is thirst, and the flow of urine is steady but scanty and sudden. A knot with pain like a stone is called a "urinary knot." In one who has urinated or had intercourse with a woman, the wind draws up the semen. When, after urination, the semen is displaced, it may come out before or after; this semen in the urine resembles ash-water. If wind acts upon the rough and weak, causing a reversal in the feces and obstructing the urinary channel, the feces become mixed together. Obstruction should be recognized when the urine drop has a similar odor, caused by bile, exertion, sharp and sour foods, bloating, and similar factors. When wind increases, it produces burning in the bladder and urine, and the urine first appears bloody or entirely blood-colored. Repeatedly, the urine is hot and difficult to pass. This is called "hot wind," occurring when bile and wind reside in the bladder of a body exhausted and rough. They cause depletion of urine and severe burning, which is known by that name. Whether caused by bile, phlegm, or both, they are overcome by wind. Then, with difficulty, the urine is passed yellow, red, white, or thick, always with burning, and its color resembles rocanā, conch, or powder. When the urine is dry or of all colors, it is called "urinary weakness." Thus, diseases arising from urine have been described in detail. Dhanvantari then addresses Suśruta, saying, "Now I will explain the causes of prameha. Listen well! There are twenty types of prameha: ten arise from phlegm, and others from bile. Four and six arise from wind, and some are caused by fat, marrow, and phlegm. Haridramehī is pungent, resembling turmeric, and the feces are similar. Vistraṃ and mañjiṣṭhamehe: Mañjiṣṭhā is like water; vistra is hot, salty, and reddish, and raktamehataḥ is urine with a blood-like hue. Vasāmehī passes urine mixed with fat, resembling fat, repeatedly; majjāmehī passes urine mixed with marrow, resembling marrow, again and again. Hastī matta: The urine flows without force, thick and sticky, and the elephant-like prameha is so named. Madhumehī: The urine becomes like honey, and it is of two kinds, arising from the anger of the elements, depletion of tissues, or when wind obstructs the channels. When obstructed, the signs of the doshas appear without cause; sometimes depleted, sometimes full, it becomes difficult and slow to cure. When neglected over time, all become madhumeha; among the pramehas, the urine is generally sweet, like honey. All these are called madhumeha because of the sweetness in the body. Indigestion, loss of taste, vomiting, insomnia, cough, and nasal congestion arise as consequences." Thus, Dhanvantari revealed the nature and causes of urinary diseases and prameha, guiding the wise in understanding their signs and origins.