From the roots of hair, certain creatures arise—six distinct types, together with Sausura and Samatara, that dwell within and are the sole cause of leprosy. They destroy hair, forming islands upon the scalp and skin, resembling figs in their appearance. Some of these worms are born in the large intestine, emerging from feces and spreading further; as they grow, they move toward the stomach. Their presence brings about foul breath, wheezing, and a persistent odor of excrement. Broad, round, and thick, these worms may appear dark, yellow, white, or black. They are known by five names: Kakeruka, Makeruka, Sausura, Sashula, and Lelihā, and they propagate, giving rise to their own offspring. Those afflicted by these parasites suffer a host of symptoms: their speech becomes split, they endure piercing pain, stiffness, emaciation, roughness, and pallor. Horripilation—the raising of hair on the skin—occurs, along with a sensation of heat in the rectum, itching of the anus, and abnormal passage of stool. Then Dhanvantari, the divine healer, spoke to Suśruta: “Let me explain to you the origin of diseases caused by wind. Listen well, for in every account of misfortune, obstruction is the root cause. The unseen, corrupted wind affects the body indiscriminately. He is the universal creator, the soul of all, the form of the universe, the lord of creatures—he is Viṣṇu, the sustainer, pervader, destroyer, death, and the end. What is spoken must always be pursued with effort. Upon recognizing the faults described, one must discern natural and altered actions, and, in both summary and detail, ascertain the varieties of faults. Each fault, in five ways, acts here in altered forms; its divisions, along with causes and characteristics, are explained. When wind is provoked by substances that deplete the bodily elements and is not properly attended to, it fills the four channels in the body even more. From these channels, filled with faults, the wind—once provoked—blocks the openings and produces colic, obstruction, and rumbling in the intestines. It causes retention of waste, loss of voice, stiffness of vision, back, and hips; again, throughout the body, it produces other severe afflictions. Diseases arising from the stomach, such as vomiting, breathlessness, cough, cholera, obstruction, itching, heat, and other ailments above the navel, are caused by this wind. It afflicts the sense organs like the ears, produces eruptions and roughness of the skin, intense pain, breathlessness, fever, and discoloration. It causes 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 touch like water; when it spreads throughout the body, it produces pain, splitting, twitching, and breaking. It causes stiffness, convulsions, disturbed sleep, breaking and trembling of the joints. When it repeatedly attacks all the arteries, it seizes the limbs—this disease is known as convulsive disorder. When wind is obstructed below and then moves upward, it presses upon the heart and causes pain in the head and temples. The afflicted may toss their body about, bend their jaw, or breathe out with great difficulty, and may close both eyes. Sometimes, they coo like a pigeon, without restraint, with looseness of the limbs; and when the wind is situated at the root of the nose, it settles in the heart. They repeatedly attain comfort, only to become uncomfortable again; this condition, arising from injury, is considered most difficult to treat. At such times, there is stiffness of sweat; when the wind, having lost its form, pervades the whole body, decline follows once more. The force, having entered within, causes stiffness in the eyes, produces yawning, slackness of the teeth, and loss of effort. External pain arises in the sides, stiffness of the jaw, back, and head, and outward extension of the body, with pain in the back, heart, and head. The chest may be raised up, or the shoulder bent; the teeth and mouth become discolored, and there is absence of sweat on the body. Outward extension and stiffness of the jaw are said to be symptoms of wind disorder; when wind moves together with feces and urine, it produces these effects. These disorders spread throughout the body, from head to toe; in one who remains pale, swelling of wounds increases greatly. When there is a rush of movement in the limbs, health returns by means such as licking the tongue, eating hot food, and excessive pride. When the wind, aggravated and situated at the root of the jaw, causes stiffness, it produces either an open mouth or a closed mouth. Thus, there is stiffness of the jaw, making chewing and speaking difficult; when the wind stiffens the veins of speech, it paralyzes the tongue. This results in inability to eat, drink, or speak, often caused by bearing heavy loads on the head, excessive laughter, or talking. Using an uneven pillow or chewing hard substances increases the wind; and in those afflicted, it rises upwards. It makes the face crooked, causes loud laughter and staring, then produces weakness of speech and stiffness of the eyes. There is chattering of teeth, loss of voice, hearing loss, impairment of vision, loss of smell, destruction of memory, fear, and difficulty in breathing. There is spitting, pain in the sides, closing of one eye, severe pain above the collarbone, or even paralysis of half the body. Some call this hemiplegia, others call it monoplegia; when the veins, depending on blood, are affected, they cause the veins of the head to be afflicted. Thus, the origins and manifestations of disease—whether from parasites or the wind—are revealed in their many forms, bringing suffering to those who do not heed the causes or pursue the remedies with effort and discernment.