In the ancient teachings, the sages described the many forms and signs of disease that afflict the body, their origins, and their manifestations. Among these, certain pustules and swellings were observed and carefully detailed. There is a condition known as masūrikā, whose appearance is striking: the eruptions are red or white, with blisters that burst and cause severe discomfort, each pustule shaped like a lentil. Another affliction, called putriṇī, takes the form and size of mustard seeds. It brings intense pain and ulceration, especially upon the tongue, and may appear large, small, or barely visible to the eye. Then there is vidradhikā, which is round like the root of the vidārī plant, hard to the touch, and bears the characteristics of an abscess. Of these, putriṇī and vidārī are particularly hard to endure, often seen in those whose bodies contain much fat. The other pustules, dominated by the pitta doṣa, tend to arise in those with little fat. All such eruptions, however, manifest according to the disturbance of the fundamental doṣas within the body, and may even arise from corrupted fat, regardless of the presence of diabetes. These pustules often go unnoticed unless there is a change in their color—such as a yellow or red hue—or when the early signs of diabetes are absent. When a person passes urine of a certain kind, it is said to be raktapitta. This is accompanied by symptoms such as excessive sweating, a strong body odor, looseness of the limbs, drowsiness, a craving for food and sleep, burning sensations in the heart, eyes, tongue, and ears, a feeling of heaviness, and excessive growth of hair and nails. There are other warning signs of approaching diabetes: a fondness for cold, dryness of the throat and palate, a sweet taste in the mouth, burning in the hands and feet, and even the curious sight of ants gathering around the urine. In diabetes, thirst is constant, the mouth feels sweet and sticky, and various disorders arise. When the body is full and heavy, the disease is of kapha origin; when the doṣas are depleted, it is of vāta nature. Diabetes caused by kapha and pitta develops gradually and is more enduring, as is that which arises from excessive sexual activity; when pitta predominates, it tends to become chronic. Yet, if not destined by fate, diabetes can be cured. Then Dhanvantari, the divine physician, spoke to Suśruta, promising to explain the cause of abscess, and the disease called gulma. He taught that abscess arises when one consumes food that is stale, excessively hot, dry, rough, or burning. Lying on uneven beds, improper movements, and various forms of blood impurity further corrupt the flesh, fat, marrow, and bone, creating a seat of disease within the abdomen. Such swelling, whether external or internal, brings severe pain and suffering. It may be round or elongated and is known as an abscess. It is formed by the action—either separate or combined—of the doṣas and blood, and may move throughout the body, remaining hard, knotted, and not discharging. Internally, it is deep and severe, growing like a tumor, sometimes discharging like an anthill, and causing weakness of digestion. Abscesses may arise in the navel, bladder, liver, spleen, heart, abdomen, or groin. When present in the heart, there is trembling and intense pain in those regions. The head of the abscess may appear dark-red, with irregular maturation and uneven shape. Loss of consciousness, confusion, distension, oozing, creeping sensations, and even strange noises may accompany it. If pitta is dominant, the abscess appears red, coppery, or blackish, and is accompanied by delirium, fever, and burning. When it arises swiftly and matures quickly, it is pale and itchy from kapha. Mixed symptoms—such as distress, chills, stiffness, yawning, loss of appetite, heaviness, delayed onset, and poor digestion—arise from the combined disturbance of all three doṣas. In severe cases, abnormal stool is seen, along with both external and internal signs: black eruptions, dark discoloration, intense burning, pain, and fever. The signs of pitta may also be observed in external bleeding, especially in women, and disease can arise from blood lost to injuries from weapons or similar causes. When a wound is agitated by wind, the blood provokes pitta, leading to symptoms of both pitta and blood, and causing abscesses with many complications. The complications themselves vary according to the site of affliction. For example, swelling at the navel or bladder can cause difficulty in urination. Obstruction of breathing and exhalation, disorders of the spleen, excessive thirst, and throat blockage occur when the kloma is affected, along with pain throughout the body and in the heart. Fainting, darkness before the eyes, cough, palpitations, pain in the sides of the abdomen, and the generation of doṣas within the abdomen may also arise. Pain may spread to the thigh joints, groin, hips, back, and sides, and there may be pain in the anus and obstruction of wind. In these cases, one should recognize the presence of swelling—whether raw, ripe, or suppurated. Some swellings, when ripe, discharge upward from the navel; others, downward from the anus. Abscesses that arise from the anus, breast, or navel are due to the moistening of the doṣas, and when all the doṣas are disturbed together, they cause changes at their respective sites. When mature, if located at the navel or bladder, the abscess may rupture internally or externally. If the abscess is depleted and complications arise, suppuration occurs within. Such abscesses may also develop in women of wicked conduct or those considered sinners; if a fetus dies in the womb, a hard swelling may also arise. Pain in the breast, whether present or not, is a sign of external abscess; yet, due to the subtlety of blood in maidens, it does not occur in them. When the wind is enraged or its movement obstructed, it produces swelling at the root of the penis. Reaching the scrotum and groin, it causes excessive swelling of the testicular sac. By compression, it enlarges the veins there, and the dosha accumulates in the fat, manifesting the disease in seven forms, each with swelling. Due to wind, swelling may occur at the ends of the urinary tract, either externally or internally. It is filled with air, rough to the touch, dry, and causes burning. When ripe and due to pitta, the swelling resembles a fig, with burning, heat, and suppuration. When kapha is the cause, it is severe, heavy, oily, itchy, hard, and causes little pain. Swelling may be black, covered with eruptions, and show signs of growth due to blood. With kapha and fat, the swelling increases, becoming soft and resembling a ripe palmyra fruit. For one who habitually retains urine, as the urine accumulates, the natural steadiness and gentle flow are disturbed, and agitation arises. This leads to difficulty in urination, swelling of the scrotum and testicles, and aggravation of wind, especially when the person bathes in cold water. Retaining feces and urine, or irregular movements of the limbs, disturb and deplete the vital energies within the body. The wind, having become disordered, drives the blood downward, and at the joint, it produces swelling resembling a knot. Thus, the sages described the origins and signs of these diseases, so that the wise may recognize and treat them with compassion and skill.