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तत्र सहजान्यर्शांसि कानिचिदणूनि, कानिचिन्महान्ति, कानिचिद्दीर्घाणि, कानिचिद्ध्रस्वानि, कानिचिद्वृत्तानि, कानिचिद्विषमविसृतानि, कानिचिदन्तःकुटिलानि, कानिचिद्बहिःकुटिलानि, कानिचिज्जटिलानि, कानिचिदन्तर्मुखानि, यथास्वं दोषानुबन्धवर्णानि||७||
 
तत्र सहजान्यर्शांसि कानिचिदणूनि, कानिचिन्महान्ति, कानिचिद्दीर्घाणि, कानिचिद्ध्रस्वानि, कानिचिद्वृत्तानि, कानिचिद्विषमविसृतानि, कानिचिदन्तःकुटिलानि, कानिचिद्बहिःकुटिलानि, कानिचिज्जटिलानि, कानिचिदन्तर्मुखानि, यथास्वं दोषानुबन्धवर्णानि||७||
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tatra sahajānyarśāṃsi kānicidaṇūni, kānicinmahānti, kāniciddīrghāṇi, kāniciddhrasvāni, kānicidvṛttāni, kānicidviṣamavisṛtāni, kānicidantaḥkuṭilāni, kānicidbahiḥkuṭilāni, kānicijjaṭilāni, kānicidantarmukhāni, yathāsvaṃ doṣānubandhavarṇāni||7||
 
tatra sahajānyarśāṃsi kānicidaṇūni, kānicinmahānti, kāniciddīrghāṇi, kāniciddhrasvāni, kānicidvṛttāni, kānicidviṣamavisṛtāni, kānicidantaḥkuṭilāni, kānicidbahiḥkuṭilāni, kānicijjaṭilāni, kānicidantarmukhāni, yathāsvaṃ doṣānubandhavarṇāni||7||
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tatra sahajAnyarshAMsi kAnicidaNUni, kAnicinmahAnti, kAniciddIrghANi, kAniciddhrasvAni, kAnicidvRuttAni,kAnicidviShamavisRutAni, kAnicidantaHkuTilAni, kAnicidbahiHkuTilAni, kAnicijjaTilAni,kAnicidantarmukhAni, yathAsvaM doShAnubandhavarNAni||7||
 
tatra sahajAnyarshAMsi kAnicidaNUni, kAnicinmahAnti, kAniciddIrghANi, kAniciddhrasvAni, kAnicidvRuttAni,kAnicidviShamavisRutAni, kAnicidantaHkuTilAni, kAnicidbahiHkuTilAni, kAnicijjaTilAni,kAnicidantarmukhAni, yathAsvaM doShAnubandhavarNAni||7||
    
Among the congenital hemorrhoids, some are small, some are large, some are long, some are short, some are round, some are irregularly spread, some are curved internally, some are curved externally, some are matted together, and some are introverted. Their characteristic or forms of hemorrhoids are as per the doshas involved in their formation. [7]
 
Among the congenital hemorrhoids, some are small, some are large, some are long, some are short, some are round, some are irregularly spread, some are curved internally, some are curved externally, some are matted together, and some are introverted. Their characteristic or forms of hemorrhoids are as per the doshas involved in their formation. [7]
Signs and symptoms of congenital hemorrhoids:
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==== Signs and symptoms of congenital hemorrhoids ====
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तैरुपहतो जन्म प्रभृति भवत्यतिकृशो विवर्णः क्षामो दीनः प्रचुर विबद्ध वात मूत्र पुरीषः शर्कराश्मरीमान्, तथाऽनियतविबद्धमुक्तपक्वामशुष्कभिन्नवर्चा अन्तराऽन्तरा श्वेत पाण्डु हरित पीत रक्तारुण तनु सान्द्र पिच्छिल कुणपगन्ध्याम पुरीषोपवेशी, नाभि बस्ति वङ्क्षणोद्देशे प्रचुर परिकर्तिकान्वितः, सगुदशूल प्रवाहिका परिहर्ष प्रमेह प्रसक्त विष्टम्भान्त्रकूजोदावर्त हृदयेन्द्रियोपलेपः प्रचुर विबद्ध तिक्ताम्लोद्गारः, सुदुर्बलः, सुदुर्बलाग्निः, अल्पशुक्रः, क्रोधनो, दुःखोपचारशीलः, कास श्वास तमक तृष्णा हृल्लास च्छर्द्यरोचका विपाक पीनस क्षवथु परीतः, तैमिरिकः, शिरःशूली, क्षामभिन्नसन्नसक्तजर्जरस्वरः, कर्णरोगी, शून पाणिपाद वदनाक्षिकूटः, सज्वरः, साङ्गमर्दः, सर्व पर्वास्थि शूली च, अन्तराऽन्तरा पार्श्व कुक्षि बस्ति हृदय पृष्ठ त्रिकग्रहोपतप्तः, प्रध्यानपरः, परमालसश्चेति; जन्म प्रभृत्यस्य गुदजैरावृतो मार्गोपरोधाद्वायुरपानः प्रत्यारोहन् समानव्यानप्राणोदानान् पित्तश्लेष्माणौ च प्रकोपयति, एते सर्व एव प्रकुपिताः पञ्च वायवः पित्तश्लेष्माणौ चार्शसमभिद्रवन्त एतान् विकारानुपजनयन्ति; इत्युक्तानि सहजान्यर्शांसि||८||
 
तैरुपहतो जन्म प्रभृति भवत्यतिकृशो विवर्णः क्षामो दीनः प्रचुर विबद्ध वात मूत्र पुरीषः शर्कराश्मरीमान्, तथाऽनियतविबद्धमुक्तपक्वामशुष्कभिन्नवर्चा अन्तराऽन्तरा श्वेत पाण्डु हरित पीत रक्तारुण तनु सान्द्र पिच्छिल कुणपगन्ध्याम पुरीषोपवेशी, नाभि बस्ति वङ्क्षणोद्देशे प्रचुर परिकर्तिकान्वितः, सगुदशूल प्रवाहिका परिहर्ष प्रमेह प्रसक्त विष्टम्भान्त्रकूजोदावर्त हृदयेन्द्रियोपलेपः प्रचुर विबद्ध तिक्ताम्लोद्गारः, सुदुर्बलः, सुदुर्बलाग्निः, अल्पशुक्रः, क्रोधनो, दुःखोपचारशीलः, कास श्वास तमक तृष्णा हृल्लास च्छर्द्यरोचका विपाक पीनस क्षवथु परीतः, तैमिरिकः, शिरःशूली, क्षामभिन्नसन्नसक्तजर्जरस्वरः, कर्णरोगी, शून पाणिपाद वदनाक्षिकूटः, सज्वरः, साङ्गमर्दः, सर्व पर्वास्थि शूली च, अन्तराऽन्तरा पार्श्व कुक्षि बस्ति हृदय पृष्ठ त्रिकग्रहोपतप्तः, प्रध्यानपरः, परमालसश्चेति; जन्म प्रभृत्यस्य गुदजैरावृतो मार्गोपरोधाद्वायुरपानः प्रत्यारोहन् समानव्यानप्राणोदानान् पित्तश्लेष्माणौ च प्रकोपयति, एते सर्व एव प्रकुपिताः पञ्च वायवः पित्तश्लेष्माणौ चार्शसमभिद्रवन्त एतान् विकारानुपजनयन्ति; इत्युक्तानि सहजान्यर्शांसि||८||
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tairupahato janma prabhṛti bhavatyatikṛśo vivarṇaḥ kṣāmo dīnaḥ pracura vibaddha vāta mūtra purīṣaḥ śarkarāśmarīmān, tathā’niyatavibaddhamuktapakvāmaśuṣkabhinnavarcā antarā’ntarā śveta pāṇḍu harita pīta raktāruṇa tanu sāndra picchila kuṇapagandhyāma purīṣopaveśī, nābhi basti vaṅkṣaṇoddeśe pracura parikartikānvitaḥ, sagudaśūla pravāhikā pariharṣa prameha prasakta viṣṭambhāntrakūjodāvarta hṛdayendriyopalepaḥ pracura vibaddha tiktāmlodgāraḥ, sudurbalaḥ, sudurbalāgniḥ, alpaśukraḥ, krodhano, duḥkhopacāraśīlaḥ, kāsa śvāsa tamaka tṛṣṇā hṛllāsa cchardyarocakā vipāka pīnasa kṣavathu parītaḥ, taimirikaḥ, śiraḥśūlī, kṣāmabhinnasannasaktajarjarasvaraḥ, karṇarogī, śūna pāṇipāda vadanākṣikūṭaḥ, sajvaraḥ, sāṅgamardaḥ, sarva parvāsthi śūlī ca, antarā’ntarā pārśva kukṣi basti hṛdaya pṛṣṭha trikagrahopataptaḥ, pradhyānaparaḥ, paramālasaśceti; janma prabhṛtyasya gudajairāvṛto mārgoparodhādvāyurapānaḥ pratyārohan samānavyānaprāṇodānān pittaśleṣmāṇau ca prakopayati, ete sarva eva prakupitāḥ pañca vāyavaḥ pittaśleṣmāṇau cārśasamabhidravanta etān vikārānupajanayanti; ityuktāni sahajānyarśāṃsi||8||
 
tairupahato janma prabhṛti bhavatyatikṛśo vivarṇaḥ kṣāmo dīnaḥ pracura vibaddha vāta mūtra purīṣaḥ śarkarāśmarīmān, tathā’niyatavibaddhamuktapakvāmaśuṣkabhinnavarcā antarā’ntarā śveta pāṇḍu harita pīta raktāruṇa tanu sāndra picchila kuṇapagandhyāma purīṣopaveśī, nābhi basti vaṅkṣaṇoddeśe pracura parikartikānvitaḥ, sagudaśūla pravāhikā pariharṣa prameha prasakta viṣṭambhāntrakūjodāvarta hṛdayendriyopalepaḥ pracura vibaddha tiktāmlodgāraḥ, sudurbalaḥ, sudurbalāgniḥ, alpaśukraḥ, krodhano, duḥkhopacāraśīlaḥ, kāsa śvāsa tamaka tṛṣṇā hṛllāsa cchardyarocakā vipāka pīnasa kṣavathu parītaḥ, taimirikaḥ, śiraḥśūlī, kṣāmabhinnasannasaktajarjarasvaraḥ, karṇarogī, śūna pāṇipāda vadanākṣikūṭaḥ, sajvaraḥ, sāṅgamardaḥ, sarva parvāsthi śūlī ca, antarā’ntarā pārśva kukṣi basti hṛdaya pṛṣṭha trikagrahopataptaḥ, pradhyānaparaḥ, paramālasaśceti; janma prabhṛtyasya gudajairāvṛto mārgoparodhādvāyurapānaḥ pratyārohan samānavyānaprāṇodānān pittaśleṣmāṇau ca prakopayati, ete sarva eva prakupitāḥ pañca vāyavaḥ pittaśleṣmāṇau cārśasamabhidravanta etān vikārānupajanayanti; ityuktāni sahajānyarśāṃsi||8||
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tairupahato janmaprabhRuti bhavatyatikRusho vivarNaH kShAmo dInaHpracuravibaddhavAtamUtrapurIShaH sharkarAshmarImAn,tathA~aniyatavibaddhamuktapakvAmashuShkabhinnavarcA antarA~antarAshvetapANDuharitapItaraktAruNatanusAndrapicchilakuNapagandhyAmapurIShopaveshI,nAbhibastiva~gkShaNoddeshe pracuraparikartikAnvitaH,sagudashUlapravAhikApariharShapramehaprasaktaviShTambhAntrakUjodAvartahRudayendriyopalepaHpracuravibaddhatiktAmlodgAraH, sudurbalaH, sudurbalAgniH, alpashukraH, krodhano,duHkhopacArashIlaH,kAsashvAsatamakatRuShNAhRullAsacchardyarocakAvipAkapInasakShavathuparItaH, taimirikaH,shiraHshUlI, kShAmabhinnasannasaktajarjarasvaraH, karNarogI, shUnapANipAdavadanAkShikUTaH,sajvaraH, sA~ggamardaH, sarvaparvAsthishUlI ca, antarA~antarApArshvakukShibastihRudayapRuShThatrikagrahopataptaH, pradhyAnaparaH, paramAlasashceti;janmaprabhRutyasya gudajairAvRuto mArgoparodhAdvAyurapAnaH [1] pratyArohansamAnavyAnaprANodAnAn pittashleShmANau ca prakopayati, ete sarva eva prakupitAH pa~jca vAyavaHpittashleShmANau cArshasamabhidravanta etAn vikArAnupajanayanti; ityuktAni sahajAnyarshAMsi||8||
 
tairupahato janmaprabhRuti bhavatyatikRusho vivarNaH kShAmo dInaHpracuravibaddhavAtamUtrapurIShaH sharkarAshmarImAn,tathA~aniyatavibaddhamuktapakvAmashuShkabhinnavarcA antarA~antarAshvetapANDuharitapItaraktAruNatanusAndrapicchilakuNapagandhyAmapurIShopaveshI,nAbhibastiva~gkShaNoddeshe pracuraparikartikAnvitaH,sagudashUlapravAhikApariharShapramehaprasaktaviShTambhAntrakUjodAvartahRudayendriyopalepaHpracuravibaddhatiktAmlodgAraH, sudurbalaH, sudurbalAgniH, alpashukraH, krodhano,duHkhopacArashIlaH,kAsashvAsatamakatRuShNAhRullAsacchardyarocakAvipAkapInasakShavathuparItaH, taimirikaH,shiraHshUlI, kShAmabhinnasannasaktajarjarasvaraH, karNarogI, shUnapANipAdavadanAkShikUTaH,sajvaraH, sA~ggamardaH, sarvaparvAsthishUlI ca, antarA~antarApArshvakukShibastihRudayapRuShThatrikagrahopataptaH, pradhyAnaparaH, paramAlasashceti;janmaprabhRutyasya gudajairAvRuto mArgoparodhAdvAyurapAnaH [1] pratyArohansamAnavyAnaprANodAnAn pittashleShmANau ca prakopayati, ete sarva eva prakupitAH pa~jca vAyavaHpittashleShmANau cArshasamabhidravanta etAn vikArAnupajanayanti; ityuktAni sahajAnyarshAMsi||8||
    
The person suffering with congenital hemorrhoids has the following signs and symptoms:
 
The person suffering with congenital hemorrhoids has the following signs and symptoms:
1. Right from the birth he is lean and thin, pale, emaciated, weak, excessive or obstructed flatus, urine and stool. He has gravels and stone in the urinary system.  
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#Right from the birth he is lean and thin, pale, emaciated, weak, excessive or obstructed flatus, urine and stool. He has gravels and stone in the urinary system.  
2. Irregular bowel habit- sometimes constipation and sometimes normal; sometimes stool is pakva (free from ama) and sometimes it is associated with ama (mucus or products of improper digestion); sometimes stool is dry and sometimes it is liquid.
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#Irregular bowel habit- sometimes constipation and sometimes normal; sometimes stool is ''pakva'' (free from ''ama'') and sometimes it is associated with ''ama'' (mucus or products of improper digestion); sometimes stool is dry and sometimes it is liquid.
3. The stool color differs, having white, pale yellow, green, yellow, red, thin, dense, slimy, having bad odor like dead tissue and associated with ama.
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#The stool color differs, having white, pale yellow, green, yellow, red, thin, dense, slimy, having bad odor like dead tissue and associated with ''ama''.
4. The patient suffers from severe colicky pain in umbilicus, region of urinary bladder, pelvic region and anus.
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#The patient suffers from severe colicky pain in umbilicus, region of urinary bladder, pelvic region and anus.
5. Patient suffers from dysentery, horripilation, prameha (obstinate urinary disorders including diabetes), constipation, gurgling sound in the intestine, abdominal distension and a feeling of covering on the heart and the sense organs.  
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#Patient suffers from dysentery, horripilation, ''prameha'' (obstinate urinary disorders including diabetes), constipation, gurgling sound in the intestine, abdominal distension and a feeling of covering on the heart and the sense organs.  
6. Patient gets excessive eructation associated with bitter and sour taste, extreme weakness, weak digestive power; he has very little semen; he is irritable and is difficult to treat.
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#Patient gets excessive eructation associated with bitter and sour taste, extreme weakness, weak digestive power; he has very little semen; he is irritable and is difficult to treat.
7. He has frequent cough, dyspnea, bronchial asthma, morbid thirst, nausea, vomiting, anorexia, indigestion, chronic rhinitis and sneezing.
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#He has frequent cough, dyspnea, bronchial asthma, morbid thirst, nausea, vomiting, anorexia, indigestion, chronic rhinitis and sneezing.
8. He gets fits of fainting and headache; his voice is weak, broken, of low pitch, impeded and has hoarseness.  
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#He gets fits of fainting and headache; his voice is weak, broken, of low pitch, impeded and has hoarseness.  
9. He may suffer from ear diseases, gets swelling around the eyes, suffers from fever, malaise and pain in all the joints and bones.
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#He may suffer from ear diseases, gets swelling around the eyes, suffers from fever, malaise and pain in all the joints and bones.
10. Patient gets stiffness in chest, abdomen, region of urinary bladder, cardiac region, back and lumber region.
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#Patient gets stiffness in chest, abdomen, region of urinary bladder, cardiac region, back and lumber region.
11. He has persistent giddiness and is extremely lazy.
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#He has persistent giddiness and is extremely lazy.
12. 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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#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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Etiology and pathogenesis of acquired arsha (hemorrhoids):
   
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||
 
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||
 
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||
 
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 :  
 
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:
 
In a person whose power of digestion is afflicted, mala (waste products) gets accumulated in excess due to the following reasons:
1. 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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#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;
2. Excessive intake of the meats of cattle, fish, pig, buffalo, goat and sheep;  
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#Excessive intake of the meats of cattle, fish, pig, buffalo, goat and sheep;  
3. Meat of emaciated animals, dried meat and putrefied meat.
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#Meat of emaciated animals, dried meat and putrefied meat.
4. 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-products;
5. 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;
6. 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).
7. Intake of mandaka (immature curds) and wrongly (excess) fermented wines.
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#Intake of mandaka (immature curds) and wrongly (excess) fermented wines.
8. 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)
9. 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.
 
Similarly, the following factors are responsible for the aggravation of apana vayu.
 
1. Use of rough, irregular and hard seats
 
1. Use of rough, irregular and hard seats

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