As the imbalance within the body grows excessive, the abdomen becomes hard, cold to the touch, heavy, and unyielding. This state aggravates all three doṣas—vāta, pitta, and kapha—and the impurities arising from their disturbance further taint the body. These corrupted impurities, mingled with blood and all sorts of toxins, gather within and, upon reaching the abdomen, begin to transform. This leads to wasting of the body, spells of fainting, and bouts of dizziness. From these disturbances, three types of severe abdominal diseases manifest, maturing rapidly and growing especially intense when exposed to cold or wind. Overeating, agitation, improper foods and drinks, unsuitable beverages, and the strain from vomiting or other illnesses contribute to this condition. The spleen, which rests on the left side of the body, becomes enlarged and swells from its place—especially when increased by blood or other bodily fluids—causing pain. The spleen hardens like stone, becomes excessively firm, and rises up like the back of a tortoise. Gradually, it enlarges and spreads across the abdomen. This is accompanied by shortness of breath, cough, thirst, a foul taste in the mouth, bloating, fever, pallor, fainting, vomiting, burning sensations, and confusion. The area takes on a reddish or variegated appearance, tinged with blue and yellow. The patient experiences upward movement of wind, nausea, fainting, intense thirst, and persistent fever. Heaviness, loss of appetite, hardness, obstruction, and dizziness may even cause the spleen to shift from the left side to the right. When the liver is affected and feces are retained in the rectum, distressing symptoms with difficult names arise, along with other painful upward movements. If the downward wind (apāna) in the abdomen is aggravated, it binds together the stool, bile, and phlegm, resulting in fever and pain. Symptoms such as cough, breathlessness, chest pain, headache, pain in the navel and sides, constipation, loss of appetite, and vomiting are brought on by this abdominal wind. The abdomen becomes marked with firm blue and red veins, and above the navel, a shape resembling a cow’s tail often appears. When the abdomen is pierced by bone fragments or other foreign bodies, the liver and other organs begin to decay, and fluid seeps out through these openings. If there is rawness or burning in the rectum, the fecal matter becomes scanty, foul-smelling, slimy, yellow, and bloody. The remaining matter fills the abdomen, causing severe distress, increasing below the navel, and quickly taking on a watery nature. When the doṣas are greatly increased and spread throughout the body, accompanied by breathlessness, thirst, and dizziness, this condition is called "perforated abdomen"—others refer to it as "leakage." In those who suddenly indulge in unwholesome foods after consuming oily substances, who drink excessive water, have weak digestion, or are emaciated and thin, the disturbance is even greater. When the passage of wind is obstructed and phlegm is thickened by water, the excess water accumulates, forming a drop that gathers within. This disturbance gives rise to abdominal swelling, accompanied by thirst, the flow of mucus, pain, cough, breathlessness, loss of appetite, and the appearance of veins of various colors spreading across the abdomen. When the abdomen is filled with water, soft to the touch, trembling, and shivering as if agitated, a stable and unctuous condition called "Bakodara" arises, blocking the channels. When all the healthy elements are neglected and disturbed, even the digested and undigested fluids begin to liquefy the joints and openings of the channels. When sweat is also obstructed and the internal fluids thicken, this fluid fills the abdomen and causes abdominal disease. The heavy abdomen is stable, rounded, injured, and does not produce sound; it is weak, severe, and throbs when touched at the channel. The disappearance of veins in the abdomen is said to be a sign common to all types of abdominal diseases—whether caused by wind, bile, phlegm, spleen, a combination of factors, or water. When water is present from birth due to the influence of the parents, and symptoms of obstruction appear, all such congenital abdominal diseases are considered extremely difficult to treat. Dhanvantari then spoke: "Now hear the origin of pallor and swelling. I will explain it to you, O attentive one. When the humors dominated by bile are provoked by the causes I have described, and if not driven out by strong wind, but remain in place and reach the ten vessels, they spread throughout the entire body. They corrupt the skin, blood, phlegm, and flesh, and reside in the very essence, producing various colors in the skin and flesh. This disease itself is yellow like turmeric, and when it strikes severely, there is excessive yellowness in those parts, bringing heaviness. The tissues lose their firmness to the touch, and because of undigested matter, the body is left with little blood, fat, or bone, and the senses are weakened. The limbs feel as if decaying, the heart melts with sorrow, the mouth is dry and parched, and there is stiffness with drooling. The patient experiences little thirst, dislikes cold, lacks desire, suffers from impaired digestion, is weak, feverish, short of breath, has ear pain, and dizziness. This disease is fivefold, caused by separate humors or all together, and sometimes by eating clay. Its early signs are palpitations of the heart and dryness of the skin. There is loss of appetite, yellow urine, absence of sweat, and scanty urination. When fat is affected by wind, the body becomes very dry, rough, yet moist. The eyes, veins, nails, and urine turn black; there is swelling, aversion to smells and tastes, dryness of stool, and fainting in the sides. When bile predominates, the fever appears yellowish-green in the head and other parts; there is thirst, dryness, fainting, foul smell, desire for cold, bitterness, and a crooked taste. Diarrhea, sourness, burning sensation, and moistness of the heart appear due to phlegm, along with drowsiness, a salty and crooked taste, horripilation, and loss of voice. There is cough and vomiting, and in some cases, the symptoms disappear entirely and are extremely difficult to endure; when bile and wind are greatly aggravated, the phlegm is either bitter or sweet. After corrupting the fats and similar tissues, due to dryness, bloodletting is advised; the channels are depleted, and, as before, the symptoms persist." Thus, the sages described the many forms and progressions of abdominal disorders, their signs, and the suffering they bring, so that the attentive may recognize and address them with wisdom.