The ancient sage described the many forms and signs of leprosy with great care and detail. He explained that the disease may first reveal itself through changes in the skin—sometimes becoming excessively smooth or rough, sometimes sweating or dry, with discoloration, a burning sensation, itching, numbness, pricking pain, swelling, and even a darkened appearance. The sores that appear can be intensely painful, arising quickly and persisting for a long time; even when they seem to heal, the skin remains rough, and with only a slight provocation, the disease can flare up again with severity. In the early stages, one may notice goosebumps and darkening of the blood. If the lesions are black, red, dry, rough, and thin like the surface of a skull, and if they are spread out and scattered, with corrupted hairs, this is known as Kāpāla leprosy—a type marked by much pricking pain and considered irregular in its presentation. Another form, Audumbara, resembles the fruit of the Udumbara tree. Its lesions are round, with thickened edges, and are accompanied by intense burning and pain. These sores are exposed, do not spread much, but may become infested with worms, much like the Udumbara fruit itself. They are firm, heavy, oily, either white or red in color, and often ooze impurities. There is also Maṇḍala leprosy, characterized by lesions with tails that seem to connect to one another, causing much itching, discharge, and the presence of worms. The patches appear smooth and yellowish. Vicarcikā, on the other hand, is dark and moist, with itching and pimples; the skin is rough, red inside, dark within, and raised above the surface. A type called 'carmākhya' is recognized by its resemblance to a deer's tongue, with many worms, and is rough to the touch like elephant skin. Another, 'kiṭima', does not sweat and looks like fish scales; it is dry, fiery in color, unpleasant to touch, itchy, rough, and grayish-black. There are cases where the skin is dry inside but oily outside, shedding dust when rubbed. These patches are smooth, thin, oily, clear, and shine like the blossom of sweat. Another form, 'vipādikā', is marked by emaciation that moves upward, clusters of intense itching, and red, thread-like lines on the hands and feet. Some lesions are filled with red pimples, cause severe pain and intense itching, and spread widely, taking on the color of dūrvā grass or the atasi flower. The raised, circular lesion known as 'dadru' is especially itchy, with a thick base, constant burning pain, red discharge, and many sores. It is often accompanied by burning, moisture, and recurring pain, returning even in each new birth. These lesions are pale, circular, tinged with red, and always bring itching, burning, and pain. The 'puṇḍarīka' type is raised and red, like a lotus leaf with water, and features blisters that are white and reddish. The condition called 'pāmā' is marked by blisters and pimples, with itching, moisture, and pain; the sores are fine, dark-reddish, dry, and mostly found on the buttocks, hands, and elbows. 'Kākaṇa' presents as painful, blistered patches with itching, redness, and intense burning—a red patch or lesion with severe pain. This type often begins red, then turns black, resembling the triphalā fruit, and may display all the dark features, each arising from its own cause. To determine the nature of these diseases, one must observe the signs and actions as prescribed for each humor—vāta, pitta, and kapha. If leprosy arises from a combination of all three humors, it is best to abandon its treatment, for it is most difficult to cure. The sage further explained that the location of the disease affects its severity. Leprosy that resides in the bone, marrow, or semen is very difficult to cure. If it is found in the fat, it can be managed; if in the skin, flesh, or bone, it tends to be chronic. However, when caused by kapha and vāta and limited to the skin, it is less severe and characterized by discoloration and dryness. When the disease affects the blood and flesh, there is sweating, heat, and swelling, and blisters may appear on the hands and feet, especially at the joints. When the humors frequently combine, they destroy the fat, but there are no clear signs in the marrow, bone, eyes, or voice. In severe cases, wounds may develop, worms may be found in the semen, or one's wife and children may also become afflicted. All previous signs may then appear even in animals. Vitiligo (śvitra) is another dreadful condition, especially when it arises from contact with certain woods and involves all three humors. If caused by wind, the lesion is dry and reddish; if by bile, it is coppery, like a lotus petal, always burning and destroying hair; if by phlegm, it is white, dense, and heavy. With itching, the lesion gradually becomes red, affecting flesh and fat, and as its color changes, its severity increases. Leukoderma is considered curable if it is not white, has abundant hair, is not attached, is new, and has not been burned by fire. Otherwise, it should be avoided. If it appears recently in the genital area, palm, or lips, it is especially to be avoided by those seeking success. Diseases such as these generally arise through contact, sharing food, and other intimate interactions, as well as by sharing beds, seats, clothes, garlands, and ointments. Then Dhanvantari, the divine physician, spoke about worms, explaining that they are of two kinds—external and internal. Externally, there are four kinds, arising from dirt, phlegm, blood, and feces. These external worms are of twenty kinds; those from dirt are the size and shape of sesame seeds and dwell in hair and clothing. They are many-legged and subtle, known as lice and nits, and are of two types, both of which live on the body and cause itching and swelling. The sole cause of leprosy, however, is internal worms. These arise from phlegm externally and from the consumption of sweet foods, molasses, milk, curd, fish, and fresh rice. Born in the stomach from phlegm, they grow and spread throughout the body. Some look like broad threads, others like swelling lumps, some like sprouted grains—thin, long, and small—white or coppery in appearance, and are of seven kinds by name. Some worms arise from the intestines and encircle the abdomen; others come from the heart or the anus, and when expelled, they resemble grass flowers and are even fragrant, but they cause many effects. They bring nausea, mouth discharge, indigestion, loss of appetite, fainting, vomiting, fever, abdominal swelling, emaciation, sneezing, and nasal congestion. Those worms born in the blood vessels are minute, without legs, round and coppery, and because of their subtlety, some cannot be seen at all. Thus, the sage revealed the many forms, signs, and causes of leprosy and related diseases, and the subtle beings that dwell within and without, ever urging careful observation and understanding for those who seek health and wisdom.