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तत्र हेतुः सहोत्थानां वलीबीजोपतप्तता । अर्शसां बीजतप्तिस्तु मातापित्रपचारतः ॥ ६ ॥
Sahaja Arshas (congenital piles) : The cause of Sahaja Arsas (congenital piles) is the abnormalities of Valibija (seed/genes which are responsible for the formation of the rectal folds), abnormalities of the seed are (due to) improper activities of the parents and Daiva (providence);
english translation
दैवाच्च ताभ्यां कोपो हि सन्निपातस्य तान्यतः । असाध्यान्येवमाख्याताः सर्वे रोगाः कुलोद्भवाः ॥ ७ ॥
their (of these two) aggravation is the cause for Sannipata (increase of all the Doshas together). Hence this kind (of Arsas) is described as incurable; similarly, are all the diseases which are Kulodbhava (familial/hereditary).
english translation
सहजानि विशेषेण रूक्षदुर्दर्शनानि च । अन्तर्मुखानि पाण्डूनि दारुणोपद्रवाणि च ॥ ८ ॥
Sahaja Arshas (congenital piles): Sahaja Arsas (congenital piles) are especially dry, ugly to look at, facing inward, yellowish-white and accompanied with grave complications (secondary diseases).
english translation
षोढान्यानि पृथग्दोषसंसर्गनिचयास्रतः । शुष्काणि वातश्लेष्मभ्यामार्द्राणि त्वस्रपित्ततः ॥ ९ ॥
Janmottaraja Arshas (piles occurring after birth): The other kind is of six varieties; one from each Dosha separately, one from the combination of all and one from Asra (blood). Janmottaraja Arshas (piles occurring after birth): Shushka (dry, non-exudative) are caused by Vata and Slesma (Kapha) and the Ardra (moist, exudative) by Asra (blood) and Pitta.
english translation
दोषप्रकोपहेतुस्तु प्रागुक्तस्तेन सादिते । अग्नौ मलेऽतिनिचिते पुनश्चातिव्यवायतः ॥ १० ॥
Nidana (causes): The causes of aggravation of the Doshas have been enumerated previously (chapter 1 of this section); they cause weakness of the fire (digestive activity) and accumulation of wastes, the feces (which lead to the production of piles). Further, indulging too much in copulation,
english translation