Diseases, Dhanvantari explained, arise most often from our interactions with others and the things we share—through contact, eating together, and even by using the same beds, seats, clothing, garlands, or ointments. Each of these exchanges can become a pathway for illness to enter the body. Dhanvantari then spoke further, saying, “Worms are of two main kinds: external and internal. The external worms are of four types, arising from dirt, phlegm, blood, and feces. In total, there are twenty kinds of these external worms. Of these, those born from dirt are as small and shaped like sesame seeds, and they dwell in the hair and clothing. These are the many-legged, subtle creatures known as lice and nits. They are of two varieties, living upon the body and causing itching and swelling. But it is the internal worms that are the sole cause of leprosy. These arise from phlegm externally, and within, they are born from the consumption of sweet foods, molasses, milk, curd, fish, and freshly cooked rice. Nurtured in the stomach from phlegm, they grow and travel throughout the body. Some of these worms look like broad threads, while others appear as swelling lumps. There are some shaped like sprouted grains—thin, long, and tiny; they may be white or coppery, and are known to be of seven kinds. Certain worms originate in the intestines and wrap around the abdomen, while others come from the heart or the anus. When expelled, they resemble grass flowers, and some even carry a fragrance; all of them cause various effects in the body. Their presence leads to nausea, discharge from the mouth, indigestion, loss of appetite, fainting, vomiting, fever, abdominal swelling, emaciation, sneezing, and congestion of the nose. Some worms are born in the blood vessels—tiny, legless, round, and coppery in color. Because of their minuteness, some cannot even be seen. There are also those that arise from the hair, destroying it and forming bald patches like islands, resembling figs. These six types, together with the Sausura and Samatara, are the sole cause of leprosy. Worms born in the large intestine from feces can also spread. As they grow, they move toward the stomach, causing foul breath, wheezing, and the odor of feces. These worms are broad, round, thick, and may be dark, yellow, white, or black. They are known by five names: Kakeruka, Makeruka, Sausura, Sashula, and Lelihā, and they produce their own offspring. Their effects include splitting of speech, piercing pain, stiffness, emaciation, roughness, pallor, horripilation, burning sensation in the rectum, itching of the anus, and abnormal passage of stool. Turning to another cause of disease, Dhanvantari addressed Suśruta: “O Suśruta, now hear from me the origins of diseases caused by wind. In every case of misfortune, it is obstruction that lies at the root. The wind, unseen and corrupted, sweeps indiscriminately through the body. This wind is the universal creator, the very soul of all, the one who takes the form of the universe, the lord of all creatures. He is the creator, sustainer, pervader—Viṣṇu himself—the destroyer, death, and the end. Thus, whatever is spoken must be pursued with diligence. Knowing the faults described, one should discern between what is natural and what is altered, and carefully consider the varieties of faults, both in summary and detail. The wind, as an agent, acts in five altered forms, and its divisions, causes, and features are explained thus: When the wind is provoked by substances that deplete the body’s elements and is not properly tended, it fills the four bodily channels even more. When these channels are filled with faults and their openings are blocked, the provoked wind produces colic, obstructions, and rumbling in the intestines. This leads to retention of waste, loss of voice, stiffness of vision, back, and hips, and other severe afflictions in the body. Diseases may arise from the stomach, such as vomiting, breathlessness, cough, and cholera, as well as obstruction, itching, heat, and other ailments above the navel. The wind afflicts the sense organs like the ears, causes eruptions and roughness of the skin, intense pain, breathlessness, fever, and discoloration. It can cause obstruction within the intestines, loss of appetite, emaciation, dizziness, nodules in muscle and fat, and hardness in the skin and elsewhere. When heaviness arises in the limbs, as if struck by a staff or fist, the wind situated in the bones produces severe pain in the hip joints and bones. When wind is in the marrow, it causes instability in the bones, sleeplessness, and pain; in semen, it quickly causes abnormal emission or distortion. When wind is in the embryo or semen, it causes swelling and emptiness in the head; when it remains in its place and is provoked, it produces severe swelling. When wind is in the joints, it causes a sensation of fullness, dryness, and a touch like water; as it spreads throughout the body, it brings pain, splitting, twitching, and a feeling of breaking apart. It causes stiffness, convulsions, disturbed sleep, and trembling of the joints. When it repeatedly attacks all the arteries, it seizes the limbs—this is known as a convulsive disorder. If the wind is obstructed below and moves upward, it presses upon the heart, causing pain in the head and temples. The afflicted person may toss his body about, clench his jaw, struggle to breathe out, and close both eyes. Sometimes he may coo like a pigeon, his limbs become loose, and when the wind settles at the root of the nose, it finds its way to the heart. At such times, the person may alternate between comfort and discomfort; this condition, arising from injury, is considered most difficult to treat. There may be stiffness of sweat, and as the wind, having lost its proper form, pervades the whole body, there is a further decline. The force of wind within causes stiffness in the eyes, yawning, slackness of the teeth, and loss of effort. There is external pain in the sides, stiffness of the jaw, back, and head, and the body may stretch outward, with pain in the back, heart, and head. The chest may rise, or the shoulder may bend; the teeth and mouth lose their color, and there is an absence of sweat. Outward extension and stiffness of the jaw are symptoms of wind disorder; and when the wind moves together with feces and urine, it produces these effects. Thus, Dhanvantari revealed the many ways in which disease may arise within the body—through worms, through wind, and through the disruptions of the natural order—so that one may recognize, understand, and strive to restore balance and health.