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#He has persistent giddiness and is extremely lazy.
 
#He has persistent giddiness and is extremely lazy.
 
#Right from the birth, his apana vayu gets obstructed by the hemorrhoid-mass and moves upwards leading to aggravation of samana vayu, vyana vayu, prana vayu,  udana vayu, pitta and kapha. When all these five types of vayu, pitta and kapha get aggravated the individual suffers from above mentioned morbidities of congenital hemorrhoids.[8]
 
#Right from the birth, his apana vayu gets obstructed by the hemorrhoid-mass and moves upwards leading to aggravation of samana vayu, vyana vayu, prana vayu,  udana vayu, pitta and kapha. When all these five types of vayu, pitta and kapha get aggravated the individual suffers from above mentioned morbidities of congenital hemorrhoids.[8]
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====Etiology and pathogenesis of acquired arsha (hemorrhoids)====
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अत ऊर्ध्वं जातस्योत्तरकालजानि व्याख्यास्यामः- गुरु मधुर शीताभिष्यन्दि विदाहि विरुद्धाजीर्ण प्रमिताशना सात्म्य भोजनाद्गव्य मात्स्य वाराह माहिषा जाविक पिशित भक्षणात् कृश शुष्क पूतिमांस पैष्टिक परमान्न क्षीर दधि मण्ड तिलगुड विकृति सेवनान्माषयूषेक्षुरस पिण्याक पिण्डालुक शुष्क शाक- शुक्तल शुन किलाट तक्र पिण्डक बिस मृणाल शालूक क्रौञ्चादन कशेरुक शृङ्गाटकतरूट विरूढ नव शूक शमी- धान्याममूलकोपयोगाद्गुरु फल शाक राग हरितक मर्दक वसा शिरस्पद पर्युषित पूति शीत सङ्कीर्णान्नाभ्यवहारान्मन्द- कातिक्रान्त मद्यपानाद्व्यापन्न गुरु सलिलपानादति स्नेहपानादसंशोधनाद्बस्तिकर्म विभ्रमाद व्यायामाद व्यवायाद्दिवास्वप्नात् सुख शयनासन स्थान सेवनाच्चोपहताग्नेर्मलोपचयो भवत्यतिमात्रं, तथोत्कटक विषम कठिनासनसेवनादुद्भ्रान्तयानोष्ट्रयानादति व्यवायाद्बस्तिनेत्रा सम्यक्प्रणिधानाद्गुदक्षणनाद भीक्ष्णं शीताम्बु संस्पर्शाच्चेललोष्ट तृणादि घर्षणात् प्रतताति निर्वाहणाद्वातमूत्रपुरीषवेगोदीरणात् समुदीर्ण वेग विनिग्रहात् स्त्रीणां चामगर्भभ्रंशाद्गर्भोत्पीडनाद्विषमप्रसूतिभिश्च प्रकुपितो वायुरपानस्तं मलमुपचितमधोगमासाद्य गुदवलिष्वाधत्ते, ततस्तास्वर्शांसि प्रादुर्भवन्ति||९||
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ata ūrdhvaṃ jātasyottarakālajāni vyākhyāsyāmaḥ- guru madhura śītābhiṣyandi vidāhi viruddhājīrṇa pramitāśanāsātmyabhojanādgavyamātsya vārāha māhiṣājāvika piśita bhakṣaṇāt kṛśa śuṣka pūtimāṃsa paiṣṭika paramānna kṣīra dadhi maṇḍa tilaguḍa vikṛti sevanānmāṣayūṣekṣurasa piṇyāka piṇḍāluka śuṣka śāka- śuktalaśunakilāṭa takra piṇḍaka bisa mṛṇāla śālūka krauñcādana kaśeruka śṛṅgāṭakatarūṭa virūḍha navaśūkaśamī- dhānyāmamūlakopayogādguruphalaśāka rāga haritakamardakavasāśiraspadaparyuṣitapūtiśītasaṅkīrṇānnābhyavahārānmanda- kātikrāntamadyapānādvyāpannagurusalilapānādatisnehapānādasaṃśodhanādbastikarmavibhramādavyāyāmādavyavāyāddivāsvapnāt sukhaśayanāsanasthānasevanāccopahatāgnermalopacayo bhavatyatimātraṃ, tathotkaṭakaviṣamakaṭhināsanasevanādudbhrāntayānoṣṭrayānādati vyavāyādbastinetrā samyakpraṇidhānādgudakṣaṇanādabhīkṣṇaṃ śītāmbu saṃsparśāccelaloṣṭa tṛṇādi gharṣaṇāt pratatāti nirvāhaṇādvātamūtrapurīṣavegodīraṇāt samudīrṇavegavinigrahāt strīṇāṃ cāmagarbhabhraṃśādgarbhotpīḍanādviṣamaprasūtibhiśca prakupito vāyurapānastaṃ malamupacitamadhogamāsādya gudavaliṣvādhatte, tatastāsvarśāṃsi prādurbhavanti||9||
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ata UrdhvaM jAtasyottarakAlajAni vyAkhyAsyAmaH-gurumadhurashItAbhiShyandividAhiviruddhAjIrNapramitAshanAsAtmyabhojanAdgavyamAtsyavArAhamAhiShAjAvikapishitabhakShaNAtkRushashuShkapUtimAMsapaiShTikaparamAnnakShIradadhimaNDatilaguDavikRutisevanAnmAShayUShekShurasapiNyAkapiNDAlukashuShkashAka-shuktalashunakilATatakrapiNDakabisamRuNAlashAlUkakrau~jcAdanakasherukashRu~ggATakatarUTavirUDhanavashUkashamI-dhAnyAmamUlakopayogAdguruphalashAkarAgaharitakamardakavasAshiraspadaparyuShitapUtishItasa~gkIrNAnnAbhyavahArAnmanda-kAtikrAntamadyapAnAdvyApannagurusalilapAnAdatisnehapAnAdasaMshodhanAdbastikarmavibhramAdavyAyAmAdavyavAyAddivAsvapnAtsukhashayanAsanasthAnasevanAccopahatAgnermalopacayo bhavatyatimAtraM,tathotkaTakaviShamakaThinAsanasevanAdudbhrAntayAnoShTrayAnAdativyavAyAdbastinetrAsamyakpraNidhAnAdgudakShaNanAdabhIkShNaMshItAmbusaMsparshAccelaloShTatRuNAdigharShaNAt pratatAtinirvAhaNAdvAtamUtrapurIShavegodIraNAt samudIrNavegavinigrahAt strINAMcAmagarbhabhraMshAdgarbhotpIDanAdviShamaprasUtibhishca prakupito vAyurapAnastaM malamupacitamadhogamAsAdya gudavaliShvAdhatte,tatastAsvarshAMsi prAdurbhavanti||9||
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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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#Intake of heavy, sweet, cold, abhishyandi (food that causes obstruction in the channels of circulation), vidahi (that causes burning sensation) and viruddha ( mutually contra¬dictory ) 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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#Excessive intake of the meats of cattle, fish, pig, buffalo, goat and sheep;
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#Meat of emaciated animals, dried meat and putrefied meat.
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#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 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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#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 mandaka (immature curds) and wrongly (excess) fermented wines.
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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)
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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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#Use of rough, irregular and hard seats
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#Use of vehicles carried by improperly trained animals or vehicles carried by camels
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#Excessive indulgence in sexual act;
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#Improper insertion of enema nozzle and frequent injury in the anal region.
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#Frequent application of cold water.
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#Use of rags, clods of grass, etc. for rubbing the anus
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#Continued and excessive strain
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#Forcible attempts for passing flatus, urine and stool
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#Suppression of natural urges
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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]
    
=== ''Tattva Vimarsha'' ===
 
=== ''Tattva Vimarsha'' ===