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The causes of acquired hemorrhoids :  
 
The causes of acquired hemorrhoids :  
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In a person whose power of digestion is afflicted, mala (waste products) gets accumulated in excess due to the following reasons:
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In a person whose power of digestion is afflicted, ''mala'' (waste products) gets accumulated in excess due to the following reasons:
#Intake of heavy, sweet, cold, abhishyandi (food that causes obstruction in the channels of circulation), vidahi (that causes burning sensation) and viruddha ( mutually contradictory ) food; intake of food before the previous meal is digested; intake of a small quantity of food; and intake of unwholesome food;
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#Intake of heavy, sweet, cold, ''abhishyandi'' (food that causes obstruction in the channels of circulation), ''vidahi'' (that causes burning sensation) and ''viruddha'' ( mutually contradictory ) food; intake of food before the previous meal is digested; intake of a small quantity of food; and intake of unwholesome food;
 
#Excessive intake of the meats of cattle, fish, pig, buffalo, goat and sheep;  
 
#Excessive intake of the meats of cattle, fish, pig, buffalo, goat and sheep;  
 
#Meat of emaciated animals, dried meat and putrefied meat.
 
#Meat of emaciated animals, dried meat and putrefied meat.
#Excessive intake of pastries, paramanna (preparation of milk, rice and sugar), milk, dadhimanda (whey), preparations of sesame seed and jaggery-products;
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#Excessive intake of pastries, ''paramanna'' (preparation of milk, rice and sugar), milk, ''dadhimanda'' (whey), preparations of sesame seed and jaggery-based products;
#Excessive intake of masha, sugarcane juice, oil cake, pindaluka, dry vegetables, vinegar, garlic, kilat (cream of milk) takra-pindaka (cream of curd), bisa (thick lotus stalk ), naktamala (thin lotus stalk) shaluka, kraunchodana, kasheruka, shringataka, tarut, germinated corns and pulses, freshly harvested corns and cereals and tender radish;
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#Excessive intake of ''masha'', sugarcane juice, oil cake, ''pindaluka'', dry vegetables, vinegar, garlic, ''kilat'' (cream of milk) ''takra-pindaka'' (cream of curd), ''bisa'' (thick lotus stalk ), ''naktamala'' (thin lotus stalk) ''shaluka, kraunchodana, kasheruka, shringataka, tarut,'' germinated corns and pulses, freshly harvested corns and cereals and tender radish;
#Intake of heavy fruits, vegetables, pickles, hantaka (uncooked vegetables), mardaka, vasa (muscle fat), meat of head and legs of animals, stale, putrid  and sankeerna anna (food prepared by the mixture of different items, like rice and meat).
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#Intake of heavy fruits, vegetables, pickles, ''hantaka'' (uncooked vegetables), ''mardaka, vasa'' (muscle fat), meat of head and legs of animals, stale, putrid  and ''sankeerna anna'' (food prepared by the mixture of different items, like rice and meat).
#Intake of mandaka (immature curds) and wrongly (excess) fermented wines.
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#Intake of ''mandaka'' (immature curds) and wrongly (excess) fermented wines.
#Drinking of polluted and heavy water, excess intake of sneha (oleation therapy), non-use of panchakarma (elimination therapies), improper basti karma (enema therapy)
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#Drinking of polluted and heavy water, excess intake of ''sneha'' (oleation therapy), non-use of [[Panchakarma]] (elimination therapies), improper ''basti karma'' (enema therapy)
#Lack of exercise, avayaya (lack of sexual activity) or adhivayaya (excess sexual activity), sleep during day time; and habits to pleasant beds, seats and location.
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#Lack of exercise, ''avayaya'' (lack of sexual activity) or ''adhivayaya'' (excess sexual activity), sleep during day time; and habits to pleasant beds, seats and location.
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Similarly, the following factors are responsible for the aggravation of apana vayu.
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Similarly, the following factors are responsible for the aggravation of ''apana vayu'':
1. Use of rough, irregular and hard seats
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2. Use of vehicles carried by improperly trained animals or vehicles carried by camels  
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#Use of rough, irregular and hard seats
3. Excessive indulgence in sexual act;
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#Use of vehicles carried by improperly trained animals or vehicles carried by camels  
4. Improper insertion of enema nozzle and frequent injury in the anal region.
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#Excessive indulgence in sexual act;
5. Frequent application of cold water.
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#Improper insertion of enema nozzle and frequent injury in the anal region.
6. Use of rags, clods of grass, etc. for rubbing the anus
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#Frequent application of cold water.
7. Continued and excessive strain
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#Use of rags, clods of grass, etc. for rubbing the anus
8. Forcible attempts for passing flatus, urine and stool
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#Continued and excessive strain
9. Suppression of natural urges
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#Forcible attempts for passing flatus, urine and stool
10. Miscarriage, pressure of the pregnant uterus and abnormal delivery in the case of women.
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#Suppression of natural urges
The apana vayu aggravated by the above mentioned factors, brings down the accumulated waste products and so afflicts the anal sphincters and leads to acquired type of hemorrhoids. [9]
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#Miscarriage, pressure of the pregnant uterus and abnormal delivery in the case of women.
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The ''apana vayu'' aggravated by the above mentioned factors, brings down the accumulated waste products and so afflicts the anal sphincters and leads to acquired type of hemorrhoids. [9]
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==== Shapes of the ''arsha'' (hemorrhoids) ====
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Shapes of the arsha (hemorrhoids):
   
सर्षप मसूर माष मुद्गमकुष्ठ कयव कलाय पिण्डिटिण्टिकेर केबुक तिन्दुक कर्कन्धु काकणन्तिका बिम्बी बदर करीरोदुम्बर- खर्जूर जाम्बव गोस्तनाङ्गुष्ठ कशेरु शृङ्गाटक शृङ्गीदक्ष शिखि शुकतुण्ड जिह्वा पद्ममुकुलकर्णिका संस्थानानि सामान्याद्वात पित्त कफ प्रबलानि||१०||
 
सर्षप मसूर माष मुद्गमकुष्ठ कयव कलाय पिण्डिटिण्टिकेर केबुक तिन्दुक कर्कन्धु काकणन्तिका बिम्बी बदर करीरोदुम्बर- खर्जूर जाम्बव गोस्तनाङ्गुष्ठ कशेरु शृङ्गाटक शृङ्गीदक्ष शिखि शुकतुण्ड जिह्वा पद्ममुकुलकर्णिका संस्थानानि सामान्याद्वात पित्त कफ प्रबलानि||१०||
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sarṣapa masūra māṣa mudgamakuṣṭha kayava kalāya piṇḍiṭiṇṭikera kebuka tinduka karkandhu kākaṇantikā bimbī badara karīrodumbara- kharjūra jāmbava gostanāṅguṣṭha kaśeru śṛṅgāṭaka śṛṅgīdakṣa śikhi śukatuṇḍa jihvā padmamukulakarṇikā saṃsthānāni sāmānyādvāta pitta kapha prabalāni||10||
 
sarṣapa masūra māṣa mudgamakuṣṭha kayava kalāya piṇḍiṭiṇṭikera kebuka tinduka karkandhu kākaṇantikā bimbī badara karīrodumbara- kharjūra jāmbava gostanāṅguṣṭha kaśeru śṛṅgāṭaka śṛṅgīdakṣa śikhi śukatuṇḍa jihvā padmamukulakarṇikā saṃsthānāni sāmānyādvāta pitta kapha prabalāni||10||
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sarShapamasUramAShamudgamakuShThakayavakalAyapiNDiTiNTikerakebukatindukakarkandhukAkaNantikAbimbIbadarakarIrodumbara-kharjUrajAmbavagostanA~gguShThakasherushRu~ggATakashRu~ggIdakShashikhishukatuNDajihvApadmamukulakarNikAsaMsthAnAnisAmAnyAdvAtapittakaphaprabalAni||10||
 
sarShapamasUramAShamudgamakuShThakayavakalAyapiNDiTiNTikerakebukatindukakarkandhukAkaNantikAbimbIbadarakarIrodumbara-kharjUrajAmbavagostanA~gguShThakasherushRu~ggATakashRu~ggIdakShashikhishukatuNDajihvApadmamukulakarNikAsaMsthAnAnisAmAnyAdvAtapittakaphaprabalAni||10||
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Hemorrhoids have different shapes and resemble mustard, masura, masha, mudga, kushtaka (Saussurea lappa CB. Clarke), yava (barley), kalaya (green pea), pindi, tundikeri (fruit of karira), kebuka, tinduka, karkandhu, kakanantika, bimbi badara, karira, udumbara (Ficus racemosa Linn), kharjura (Phoenix dactylifera) jambu (Syzygium cuminii (Linn.)), gostana (cow's breast), thumb, kasheruka, shringataka, shringi, beaks or tongues of a fowl, a peacock or a parrot, and buds of lotus or karyika.
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Hemorrhoids have different shapes and resemble mustard, ''masura, masha, mudga, kushtaka'' (Saussurea lappa CB. Clarke), ''yava'' (barley), ''kalaya'' (green pea), ''pindi, tundikeri'' (fruit of karira), ''kebuka, tinduka, karkandhu, kakanantika, bimbi badara, karira, udumbara'' (Ficus racemosa Linn), ''kharjura'' (Phoenix dactylifera), ''jambu'' (Syzygium cuminii (Linn.)), ''gostana'' (cow's udders), thumb, ''kasheruka, shringataka, shringi,'' beaks or tongues of a fowl, a peacock or a parrot, and buds of lotus or ''karyika''.
All above mentioned shapes are in general the characteristic shapes of hemorrhoids caused by excessive aggravation of vayu, pitta and kapha, [10]
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All above mentioned shapes are in general the characteristic shapes of hemorrhoids caused by excessive aggravation of ''vayu, pitta'' and ''kapha'' [10]
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==== Signs and symptoms of ''vataja arsha''  ====
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Signs and symptoms of vataja arsha 
   
तेषामयं विशेषः- शुष्कम्लान कठिन परुष रूक्ष श्यावानि, तीक्ष्णाग्राणि, वक्राणि, स्फुटित मुखानि, विषम विसृतानि, शूलाक्षेपतोदस्फुरण चिमिचिमासंहर्ष परीतानि, स्निग्धोष्णोपशयानि, प्रवाहिका ध्मान शिश्न वृषण बस्ति वङ्क्षण हृद्ग्रहाङ्गमर्द हृदय द्रव प्रबलानि, प्रतत विबद्ध वात मूत्र वर्चांसि, ऊरु कटी पृष्ठ त्रिक पार्श्व कुक्षि बस्ति शूल शिरोऽभिताप क्षवथूद्गार प्रतिश्याय कासोदावर्तायाम शोष शोथ- मूर्च्छारोचक मुखवैरस्य तैमिर्य कण्डू नासा कर्ण शङ्ख शूल स्वरोपघातकराणि, श्यावारुण परुष नख नयन वदन त्वङ्मूत्र पुरीषस्य वातोल्बणान्यर्शांसीति विद्यात्||११||
 
तेषामयं विशेषः- शुष्कम्लान कठिन परुष रूक्ष श्यावानि, तीक्ष्णाग्राणि, वक्राणि, स्फुटित मुखानि, विषम विसृतानि, शूलाक्षेपतोदस्फुरण चिमिचिमासंहर्ष परीतानि, स्निग्धोष्णोपशयानि, प्रवाहिका ध्मान शिश्न वृषण बस्ति वङ्क्षण हृद्ग्रहाङ्गमर्द हृदय द्रव प्रबलानि, प्रतत विबद्ध वात मूत्र वर्चांसि, ऊरु कटी पृष्ठ त्रिक पार्श्व कुक्षि बस्ति शूल शिरोऽभिताप क्षवथूद्गार प्रतिश्याय कासोदावर्तायाम शोष शोथ- मूर्च्छारोचक मुखवैरस्य तैमिर्य कण्डू नासा कर्ण शङ्ख शूल स्वरोपघातकराणि, श्यावारुण परुष नख नयन वदन त्वङ्मूत्र पुरीषस्य वातोल्बणान्यर्शांसीति विद्यात्||११||
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teṣāmayaṃ viśeṣaḥ- śuṣkamlāna kaṭhina paruṣa rūkṣa śyāvāni, tīkṣṇāgrāṇi, vakrāṇi, sphuṭita mukhāni, viṣama visṛtāni, śūlākṣepatodasphuraṇa cimicimāsaṃharṣaparītāni, snigdhoṣṇopaśayāni, pravāhikā dhmāna śiśna vṛṣaṇa basti vaṅkṣaṇa hṛdgrahāṅgamarda hṛdaya drava prabalāni, pratata vibaddha vāta mūtra varcāṃsi, ūru kaṭī pṛṣṭha trika pārśva kukṣi basti śūla śiro’bhitāpa kṣavathūdgāra pratiśyāya kāsodāvartāyāma śoṣa śotha- mūrcchārocaka mukhavairasya taimirya kaṇḍū nāsā karṇa śaṅkha śūla svaropaghātakarāṇi, śyāvāruṇa paruṣa nakha nayana vadana tvaṅmūtra purīṣasya vātolbaṇānyarśāṃsīti vidyāt||11||
 
teṣāmayaṃ viśeṣaḥ- śuṣkamlāna kaṭhina paruṣa rūkṣa śyāvāni, tīkṣṇāgrāṇi, vakrāṇi, sphuṭita mukhāni, viṣama visṛtāni, śūlākṣepatodasphuraṇa cimicimāsaṃharṣaparītāni, snigdhoṣṇopaśayāni, pravāhikā dhmāna śiśna vṛṣaṇa basti vaṅkṣaṇa hṛdgrahāṅgamarda hṛdaya drava prabalāni, pratata vibaddha vāta mūtra varcāṃsi, ūru kaṭī pṛṣṭha trika pārśva kukṣi basti śūla śiro’bhitāpa kṣavathūdgāra pratiśyāya kāsodāvartāyāma śoṣa śotha- mūrcchārocaka mukhavairasya taimirya kaṇḍū nāsā karṇa śaṅkha śūla svaropaghātakarāṇi, śyāvāruṇa paruṣa nakha nayana vadana tvaṅmūtra purīṣasya vātolbaṇānyarśāṃsīti vidyāt||11||
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teShAmayaM visheShaH- shuShkamlAnakaThinaparuSharUkShashyAvAni, tIkShNAgrANi, vakrANi, sphuTitamukhAni,viShamavisRutAni, shUlAkShepatodasphuraNacimicimAsaMharShaparItAni, snigdhoShNopashayAni,pravAhikAdhmAnashishnavRuShaNabastiva~gkShaNahRudgrahA~ggamardahRudayadravaprabalAni,pratatavibaddhavAtamUtravarcAMsi,UrukaTIpRuShThatrikapArshvakukShibastishUlashiro~abhitApakShavathUdgArapratishyAyakAsodAvartAyAmashoShashotha-mUrcchArocakamukhavairasyataimiryakaNDUnAsAkarNasha~gkhashUlasvaropaghAtakarANi,shyAvAruNaparuShanakhanayanavadanatva~gmUtrapurIShasya vAtolbaNAnyarshAMsIti vidyAt||11||  
 
teShAmayaM visheShaH- shuShkamlAnakaThinaparuSharUkShashyAvAni, tIkShNAgrANi, vakrANi, sphuTitamukhAni,viShamavisRutAni, shUlAkShepatodasphuraNacimicimAsaMharShaparItAni, snigdhoShNopashayAni,pravAhikAdhmAnashishnavRuShaNabastiva~gkShaNahRudgrahA~ggamardahRudayadravaprabalAni,pratatavibaddhavAtamUtravarcAMsi,UrukaTIpRuShThatrikapArshvakukShibastishUlashiro~abhitApakShavathUdgArapratishyAyakAsodAvartAyAmashoShashotha-mUrcchArocakamukhavairasyataimiryakaNDUnAsAkarNasha~gkhashUlasvaropaghAtakarANi,shyAvAruNaparuShanakhanayanavadanatva~gmUtrapurIShasya vAtolbaNAnyarshAMsIti vidyAt||11||  
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Hemorrhoids caused by the predominance of aggravated vata:  
 
Hemorrhoids caused by the predominance of aggravated vata:  
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1. The mass of hemorrhoids is dry, wrinkled, hard, rough, ununctuous and greyish in color; these masses have sharp tips; these are curved and with cracks on the surface; and these are spread irregularly.
 
1. The mass of hemorrhoids is dry, wrinkled, hard, rough, ununctuous and greyish in color; these masses have sharp tips; these are curved and with cracks on the surface; and these are spread irregularly.
 
2. The mass of hemorrhoids is associated with pain, cramps toda (piercing pain), itching, numbness and tingling sensa¬tion in excess.
 
2. The mass of hemorrhoids is associated with pain, cramps toda (piercing pain), itching, numbness and tingling sensa¬tion in excess.