हस्त्यश्वपृष्ठगमनकठिनोत्कटकासनैः । अर्शोनिदानाभिहितैरपरैश्च निषेवितैः ॥ १ ॥
Riding on elephant, horse etc. for long periods, sitting on hard seats, one’s own heels (and such other troublesome postures) and indulging in unsuitable activities enumerated as the causes of Arshas (piles / haemorrhoids),
अनिष्टादृष्टपाकेन सद्यो वा साधुगर्हणैः । प्रायेण पिटिकापूर्वो योऽङ्गुले द्व्यङ्गुलेऽपि वा ॥ २ ॥
maturing of sinful acts of previous lives or current life, of abusing ascetics; by these causes the blood and muscle tissue in the rectum become vitiated, give rise to the formation of a vrana (ulcer), probably preceded by a pitaka (eruption); one angula or two angula (deep),
भगन्दरः स सर्वांश्च दारयत्यक्रियावतः । भगबस्तिगुदांस्तेषु दीर्यमाणेषु भूरिभिः ॥ ४ ॥
this disease is called Bhagandara. Because it causes tearing of all parts (mentioned below), in a person who does not follow proper diet (or has done sins) due to severe tearing in the pelvis, urinary bladder, rectum etc.
there is gradual elimination of air, urine, faecal matter and semen though its small orifices. It is of eight types, from each dosha separately, in their combinations of two and all the three and from agantu (external agent) the eighth.