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विष्टम्भोऽन्नस्य दौर्बल्यं कुक्षेराटोप एव च। कार्श्यमुद्गारबाहुल्यं सक्थिसादोऽल्पविट्कता॥२१॥
[Purvaroopa (premonitory) signs and symptoms of hemorrhoids] Delayed digestion of the food, weakness, gurgling sound in the lower abdomen, emaciation, frequent eructation;
english translation
ग्रहणीदोषपाण्ड्वर्तेराशङ्का चोदरस्य च। पूर्वरूपाणि निर्दिष्टान्यर्शसामभिवृद्धये॥२२॥
pain in thighs, voiding less stool, anemia, apprehension of the manifestation of udararoga (obstinate abdominal disorders including ascites)-these are the premonitory signs and symptoms in the development of hemorrhoids.
english translation
अर्शांसि खलु जायन्ते नासन्निपतितैस्त्रिभिः। दोषैर्दोषविशेषात्तु विशेषः कल्प्यतेऽर्शसाम्॥२३॥
[Involvement of three doshas] Hemorrhoids never manifest without the aggravation of all the three doshas. It is evident that the predominance of one or all the doshas determine the type of hemorrhoids. The nomenclature of doshaja arsha is given according to the predominance of dosha e.g. if vata dosha is predominat then that hemorrhoid is said to be vataja arsha.
english translation
पञ्चात्मा मारुतः पित्तं कफो गुदवलित्रयम्। सर्व एव प्रकुप्यन्ति गुदजानां समुद्भवे॥२४॥
[Aggravation of tridosha in arsha] Five types of vata (prana, apana, vyana, udana and samana), pitta and kapha - all these morbid factors in their aggravated state afflict the three anal sphincters at ano-rectum and lead to hemorrhoids.
english translation
तस्मादर्शांसि दुःखानि बहुव्याधिकराणि च। सर्वदेहोपतापीनि प्रायः कृच्छ्रतमानि च॥२५॥
These hemorrhoids are painful and are usually associated with several complications. These hemorrhoids affect the whole body and so they are difficult to cure with conservative measures.
english translation