Hear now the vivid account of the origins and course of abdominal diseases, pallor, and swelling, as spoken by the wise Dhanvantari. When the downward-moving wind called apāna within the abdomen becomes disturbed, it binds together the stool, bile, and phlegm, resulting in fever and pain. This aggravated wind gives rise to cough, breathlessness, pain in the chest, headache, discomfort in the navel and flanks, constipation, loss of appetite, and vomiting—all manifestations of its disturbance. As the condition progresses, the abdomen becomes marked with firm, blue, and red veins, and above the navel, one may observe a shape resembling a cow’s tail. If 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. When there is burning or rawness in the rectum, the fecal matter becomes scanty, foul-smelling, slimy, yellow, and tinged with blood. The remaining waste accumulates in the abdomen, causing severe distress, especially below the navel, where it quickly takes on a watery nature. When the doṣas—vital bodily humors—are greatly disturbed and spread throughout the body, accompanied by breathlessness, thirst, and dizziness, this condition is known as “perforated abdomen” or, by others, “leakage.” This affliction often arises in those who, after consuming oily foods, suddenly indulge in unwholesome substances, drink excessive water, possess weak digestion, or are emaciated and very thin. When the wind is blocked from its natural path and phlegm is thickened by water, this water increases and, from its essence, a drop forms and accumulates. This disturbance leads to abdominal swelling marked by thirst, the flow of mucus, pain, cough, breathlessness, loss of appetite, and the appearance of veins of various colors. When the abdomen is filled with water, it becomes soft to the touch, trembles, and shivers as if agitated. This stable and unctuous swelling is called “Bakodara,” which blocks the body’s channels. If the healthy elements are neglected and disturbed, both digested and undigested fluids begin to liquefy even the joints and openings of the channels. When sweat is also obstructed and internal fluids thicken, this fluid fills the abdomen and causes abdominal disease. The abdomen, now heavy, remains stable and rounded, yet injured and silent—no sound emerges from it. It is weak and severe, and when touched at the channels, it throbs. The disappearance of veins in the abdomen is said to be a sign of all types of abdominal diseases: those caused by wind, bile, phlegm, spleen, combinations, or water. Sometimes, water accumulates in the abdomen from birth due to the influence of the parents. These congenital abdominal diseases, marked by obstruction, are considered extremely difficult to treat. Now, listen to the origin of pallor and swelling. When humors dominated by bile are provoked by the causes previously described, and if not driven away by strong wind but allowed to settle in the body, they reach the ten vessels and spread throughout. Corrupting the skin, blood, phlegm, and flesh, and residing in the very essence, they produce a variety of colors in the skin and flesh. This disease appears yellow like turmeric, with excessive yellowness in the affected parts, and brings a sense of heaviness. There is looseness in the tissues, loss of natural qualities due to undigested matter, and a depletion of blood, fat, and bone, along with weakened senses. The limbs feel as if decaying, the heart melts with distress, the mouth is dry and parched, and there is stiffness with drooling. The afflicted person experiences little thirst, dislikes cold, lacks desire, has impaired digestion, is weak, feverish, short of breath, and suffers from ear pain and dizziness. This disease is fivefold, caused by individual humors or all together, and even by the consumption of clay. Its early signs include palpitations of the heart and dryness of the skin. There is loss of appetite, yellow urine, absence of sweat, scanty urination; when fat is affected by wind, the body becomes very dry, rough, and yet moist. The eyes, veins, nails, and urine become black; swelling occurs, there is aversion to smells and tastes, dryness of stool, and fainting in the sides. When bile predominates, fever appears yellowish-green in the head and other parts; there is thirst, dryness, fainting, foul smell, a desire for cold, bitterness, and a crooked taste. Diarrhea, sourness, and burning sensations arise, and due to phlegm, moistness of the heart, drowsiness, a salty and crooked taste, horripilation, and loss of voice also occur. Cough and vomiting may be present, and at times, the symptoms disappear entirely, making the disease extremely difficult to endure. When bile and wind are greatly aggravated, phlegm may taste bitter or sweet. As these humors corrupt the fats and similar tissues, dryness prevails, and bloodletting is indicated. The channels are depleted, and the symptoms persist as before. In diseases of anemia and consumption, the navel, feet, mouth, and urinary tract are affected, and the stool is passed in pieces, mixed with mucus, resembling that of worms. If a person afflicted with bile consumes substances that further increase bile, jaundice arises. The bile, having entered the intestines, burns and draws out blood and flesh. The urine and eyes turn yellow, the mouth and stool become red, and the person suffers from burning, abnormal digestion, thirst, a frog-like appearance, and weakened senses. Swelling associated with bile may occur in one suffering from anemia, and due to neglect, further swellings and related conditions arise, which are difficult to treat, such as dropsy and severe jaundice. When anemia is accompanied by greenish or dark bile, and when wind and bile are involved, there is dizziness, thirst, sexual excitement in women, and mild fever. If there is drowsiness or loss of digestive fire, it is called halīmaka, with excessive laziness as an early complication. Swelling is described as the main disorder here. When bile, blood, phlegm, and wind are corrupted, they carry these impurities into the external veins. Having brought them there, they obstruct the flow, causing the swelling to settle in the skin and flesh. This compact, raised swelling is called accumulation by some. From all these causes, with various forms and natures, and provoked by all the different humors, as well as from injury or poison, such swellings arise. When this affliction spreads throughout the body, it manifests as kāmajaundice, marked by broad, raised, and knotted features, known in three types. Thus, the complex interplay of the humors, the channels, and the elements within the body gives rise to these grievous diseases—each with its own signs, symptoms, and challenges—requiring wisdom and discernment for their understanding and treatment.