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हस्ते पादे मुखे नाभ्यां गुदे वृषणयोस्तथा। शोथो हृत्पार्श्वशूलं च यस्यासाध्योऽर्शसो हि सः॥२६॥
[Symptoms of incurable arsha] If the patient of hemorrhoids develops edema in upper and lower extremities, face, umbilicus, anus and scrotum, and if he suffers from pain in the cardiac region and lateral parts of chest, then such types of patients became incurable.
english translation
हृत्पार्श्वशूलं सम्मोहश्छर्दिरङ्गस्य रुग् ज्वरः। तृष्णा गुदस्य पाकश्च निहन्यर्गुदजातुरम्॥२७॥
Pain in the cardiac region and lateral parts of the chest, fainting, vomiting, pain in the limbs, fever, thirst and perianal swelling - these complications lead to the death of the patient suffering from hemorrhoids.
english translation
सहजानि त्रिदोषाणि यानि चाभ्यन्तरां वलिम्। जायन्तेऽर्शांसि संश्रित्य तान्यसाध्यानि निर्दिशेत्॥२८॥
Congenital/hereditary hemorrhoids caused by aggravation of three doshas and hemorrhoids located in the internal sphincter of the anus are also considered as incurable.
english translation
शेषत्वादायुषस्तानि चतुष्पादसमन्विते। याप्यन्ते दीप्तकायाग्नेः प्रत्याख्येयान्यतोऽन्यथा॥२९॥
In the presence of above incurable symptoms, if all four aspects of treatments like physician, drugs, attendant and patient are in the state of their excellence and if the patient has strong kayagni (power of digestion and metabolism) the disease may become yapya (palliative). Otherwise the disease became incurable.
english translation
द्वन्द्वजानि द्वितीयायां वलौ यान्याश्रितानि च। कृच्छ्रसाध्यानि तान्याहुः परिसंवत्सराणि च॥३०॥
If the hemorrhoids are caused by vitiation of two doshas, and are located in the second anal- sphincter and if these are more than one year old, then these are difficult of cure.
english translation