When vāta, the wind principle, becomes disturbed within the body, it reveals itself through a variety of discomforts: the blood vessels and finger joints contract, the limbs grow stiff and crooked, and there arises an aversion to cold, with relief only in warmth. The body may shiver, grow rigid, and sometimes even become numb. If, however, blood predominates in the disturbance, swelling occurs, the skin flushes red and tingles, and neither oily nor dry treatments bring relief. Instead, there is persistent itching and a moistness that pervades the affected areas. When pitta, the fiery principle, is at the root, the sufferer feels burning sensations, may faint, and tastes bitterness. There is loss of consciousness, intoxication, unquenchable thirst, and even the lightest touch cannot be tolerated due to severe pain. Dryness, suppuration, and intense heat follow. When kapha, the watery and earthy principle, is predominant, it brings stiffness, heaviness, and sleepiness. The skin becomes oily and cold, there is mild itching and dull pain. But when all three doṣas—vāta, pitta, and kapha—are disturbed together, their symptoms appear in a confusing, overwhelming mixture. If only one doṣa is involved, it can be managed with skill; if two are disturbed, the condition is still controllable. But when all three are afflicted, the disease quickly becomes destructive, causing the severe condition known as raktapitta. Vāta rapidly attacks the blood in the limbs, especially at the joints. It blocks the subtle channels, inflicting pain and, if unchecked, can even claim one’s life. The fivefold vital airs (prāṇas) become disturbed by dryness, restlessness, excessive jumping, overeating, injury, and rapid movements, further aggravating the condition. When these airs are agitated, they harm the eyes and other senses. The person may suffer nasal congestion, burning, thirst, cough, and breathlessness. The throat may feel obstructed, mucus is lost, vomiting and loss of appetite may occur, and various nasal disorders arise. Swelling may develop in the throat, jaw, and upper regions. Vyāna, one of the vital airs, is corrupted by excessive movement, bathing, playful activities, indulging in pleasures, and by exposure to incompatible, dry, frightening, exciting, or depressing influences. This leads to loss of virility, enthusiasm, and strength, as well as sorrow, mental agitation, fever, various pains, goosebumps, and even deep sleep. Further, it brings about skin diseases, spreading eruptions, and other ailments that sap the body’s strength. Samāna, another vital air, is disturbed by irregular digestion and the consumption of cold, mixed foods. This results in disorders from improper sleep and wakefulness, including colic, abdominal tumors, seizures, and diseases rooted in unfulfilled desires. Apāna, the downward-moving air, is disturbed by dry, heavy foods, suppression of natural urges, excessive riding, frequent travel, and overindulgence in movement. When agitated, it produces diseases in the lower abdomen, such as disorders of urine and semen, piles, prolapse of the rectum, and many other complaints. A general malaise then spreads throughout the body, with drowsiness, heaviness, and sluggishness. Because of unctuousness and delayed awakening, coldness, swelling, and loss of digestive fire may occur. Relief is found by alleviating itching, dryness, and destructive symptoms through proper remedies; otherwise, drowsiness and related disorders persist. The obstruction of vāyu (wind) takes many forms. When it is covered by pitta symptoms, burning, thirst, pain, dizziness, and darkness afflict the person. Pungent, hot, sour, and salty foods bring burning and a desire for cold. Coldness, heaviness, pain, loss of digestive fire, bitterness, and excessive intake of ghee and milk may also result. Fasting, exertion, dryness, heat, and a desire for warmth occur when vāyu is covered by kapha. Then, there is body ache, heart fatigue, heaviness, and loss of appetite. When blood covers vāyu, constant burning, intense pain rooted in the skin and flesh, redness, swelling, and the formation of patches are seen. Swelling may become hard, accompanied by fleshly growths, heart fatigue, and boils. There is a sensation like ants crawling, and the swelling is soft, cold, and appears on the limbs. This condition is akin to āḍhya-vāta, which is difficult and arises from fat; the sense of touch is concealed, and the swelling may be hot or cold when not covered. When covered by marrow, there is irregular yawning and constriction. Pain and swelling arise, yet these may be relieved by the touch of the hands. When semen covers vāyu, swelling occurs but there is no excessive urge. After eating, abdominal pain may arise, and when digestion is impaired, a cutting sensation is certain. If urine is obstructed, swelling manifests in the bladder. When there is obstruction due to a perforation, constriction occurs and the proper location is severed. The person quickly falls, afflicted by fever and experiences fainting. When semen is pressed by another, it is expelled after a long time in a corrupted state. When wind is obstructed in all tissues, pain arises in the hips, groin, and back. If the wind moves in the opposite direction, the heart is afflicted. When breath is obstructed by bile, there is dizziness, fainting, pain, and burning. Pain, drowsiness, loss of voice, and burning occur throughout the body when vyāna is affected. Movement is disturbed, actions are interrupted, heat and pain accompany these changes. When samāna is afflicted, warmth is lost, sweating ceases, and there is intense thirst and burning. If apāna is affected, the excreta become yellow. Menstrual flow increases, heat intensifies, and urine is retained. When breath is obstructed by phlegm, there is sound, snoring, and blockage. Spitting, sweating, difficulty in breathing, and accumulation of breath result. If udāna is affected, there is heaviness of the limbs, loss of appetite, and hoarseness of voice. Strength and color are lost, accumulation occurs in the joints and bones, heaviness pervades all limbs, and pronounced corpulence appears. When samāna is affected, there is ignorance of proper actions, absence of sweating, and weak digestive fire. When apāna is affected, there is complete expulsion of urine and feces. Thus, the disorder known as vātarakta is understood to manifest in twenty-two types, as the vital breaths and other elements are afflicted by one another in succession. One should also know the twenty types of obstruction, which bring palpitations, suppression of breath, cold, and headache. When prāṇa is obstructed by apāna, heart disease and dryness of the mouth occur. If prāṇa is obstructed by udāna, there is loss of strength. The wise physician should examine and distinguish all obstructions, considering the locations of the winds, their increase and decrease, and their actions. Obstruction of pitta occurs mutually among the five vital airs, and the residence of pitta and others is mixed with those elements. With mixtures of pitta and others, similarly, mixed disorders arise in many ways. The attentive physician should recognize them according to their characteristic manifestations.