The Compendium of Bheḷa 6.16

From vāta, pitta, kapha, and likewise from sannipāta, / congenital, and from blood—thus are the six types of hemorrhoids of embodied beings.

I shall state their etiology and treatment in due order, / both what has been spoken of the invisible and the visible, in proper sequence.

From the consumption of burning, heavy, and dry things, [animals] of marshy and aquatic [habitats], / and in those eating curd, milk, jaggery and the like, and meats;

from the use of spoiled barley and waters; / and in those constantly eating while suffering from indigestion, and from the suppression of natural urges;

from excessive straining, excessive indulgence in sexual intercourse, / addiction to unwholesome drinks, and pressure on the back from hard [seats];

from excessive use of non-unctuous enemata, from improper administration of enemata, / from disordered unctuous drinks, wine disorders, fatigue, and wasting—

aggravated by these, the three doṣas—vāta, pitta, and kapha— / singly, all together, in pairs, or along with blood,

lodged in the anus, quickly produce channel-blocking of the anus itself; / pile-masses sprout there resembling minute mustard seeds,

resembling barley, mung beans, niṣpāva, wild jujube, and jujube fruit, / or the size of the thumb of the body, copper-colored, resembling a cow's teat.

Grown in the anus, those pile-masses obstruct the anus severely, / or, having distended the anus, they block the root of the channels.

From the obstruction of those channels, the doṣas, having risen upwards / and vitiating the receptacles one by one, produce diseases:

splitting of stools, discoloration, colic, dysenteric tenesmus, / ulceration, thirst, burning sensation, fat in the anal and dorsal region, fever,

loss of appetite, indigestion, wasting of limbs and loss of strength, / paleness, cracking of the joints, and swelling around the eye-sockets,

exhaustion, loss of sexual potency, prolapse of the rectum, and anal spasm. / The general characteristics of hemorrhoids [have been stated]; the differentiation among them will be told.

The stool becomes black, dry, somewhat frothy; / he has constantly hard stool, and repeatedly loose feces;

stiffness of the thighs, back, and hips, constantly distended and very weak; / cracking of the joints, earache, thirst, and dizziness arise.

Indeed, wind enlarges hemorrhoids, liver, or the abdomen; / and colics arise in him, along with repeated distension;

his digestive seat is vitiated, and discoloration arises, / along with pain in the heart, flanks, and abdomen in wind-born hemorrhoids.

With fever, eruptions, thirst, sharp urge, along with blood, / hot, fluid, and burning—[such stool] is passed in pitta-hemorrhoids.

And he becomes pale in color and appears yellowish; / the anus burns exceedingly, and suppuration of the anus occurs.

In kapha-born hemorrhoids also, slimy, covered with white, / stool with kapha passes little by little, accompanied by pain.

Having sat down, he sits for a long time, and evacuates without sound; / the penis, scrotum, bladder, and anus swell.

There is loss of appetite, indigestion, and what is digested is not purged; / and swelling attacks him, especially around the eye-sockets.

This is called the symptom of hemorrhoids arising from kapha; / one should recognize that arising from sannipāta by all the symptoms.

Clotted or foul-smelling blood, or loose, or mixed with pitta; / his straining takes a long time, or is continuous at times.

Discharging [hemorrhoids] release blood in bleeding hemorrhoids; / they discharge blood in a stream, just like a punctured vein.

Like a menstruating young woman, they discharge blood repeatedly. / [One should take] excessively […] wine, dantī, kakubha, along with apāmārga,

and one should employ the urines of cows and buffaloes; / having reduced them to ash, one should administer that alkali properly with wine to drink.

It pacifies kapha-hemorrhoids, swelling, and paleness. / But whatever treatment has been stated for hemorrhoids born of vāta,

just that should one apply for those born of phlegm, but without unctuous substances. / In hemorrhoids born of blood as well, goat's milk is praised.

One should drink it for a season, or a half-year, or even a month. / Balā, young fruits of bilva, triphalā, hastipippalī,

karañja, madhūka, palāśa, madhuka, utpala, and tinduka— / with pastes of these, equal to an akṣa each, one should cook a prastha of ghee

in ten times as much goat's milk; when it is prepared, one should drink it in proper measure. / This [ghee] which arises from blood and those which are born of pitta,

destroys hemorrhoids quickly, like wind scatters torn clouds. / Lodhra, dāruharidrā, and likewise bibhītaka pulp,

drunk with rice water and honey, destroy hemorrhoids. / Lac, haridrā, mañjiṣṭhā, madhuka, blue lotus,

drunk with goat's milk, destroy those born of blood. / Siris flower, the flower of kuṭaja, and of kakubha,

dārvī, haridrā, lodhra, dhātakī, kaṭphala, and vṛṣa— / one should properly administer pastes of these with rice water to drink;

accompanied by honey, it pacifies hemorrhoids born of blood and pitta. / Madhuka, badara, drākṣā, and the roots of kuśa and kāśa,

drunk with rice water and honey, destroy hemorrhoids. / From nyagrodha, udumbara, aśvattha, badarī, plakṣa, and vetasa,

one should collect fresh sprouts, two palas each separately. / Eight palas of avākpuṣpī, and likewise eight of dārvī,

one should throw in two palas each of śāliparṇī and pṛśniparṇī; / two palas of rālaśāka—one should throw in all of this,

which is to be boiled in two droṇas of water, reduced to an eighth part. / And an āḍhaka of ghee is to be boiled with the decoction and lukewarm water,

along with the fresh juice produced from cāṅgerī and amlikā, equal to the unctuous substance. / Devadāru, abhayā, mustā, citraka, bilva pulp,

kaṭphala, ginger, pippalī, and sandalwood, / Sauvīra-collyrium, pippalī root, tiktarohiṇī,

treacle, priyaṅgu flower, the so-called exudate of śālmalī, / seeds of vatsaka, and likewise ativiṣā, vacā—

having added these portions equal to an akṣa each separately, one should cook it. / This prepared ghee, properly used, destroys hemorrhoids of blood,

pitta-gulma, diarrhea, colic, fever, loss of taste, / severe menorrhagia of women, bleeding disease, dysentery,

jaundice, poison, cough, and eliminates worms. / It is the destroyer of those born of phlegm and an excellent kindler of the bodily fire.

It brings about conception for barren women, and is like ambrosia for those afflicted with wasting. / This well-known Cāṅgerī-ghṛta destroys hemorrhoids,

promotes strength and complexion, and also removes blood-gulma. / It is beneficial in hemorrhoids born of pitta as well as in those born of blood,

and is praised in all those arising from combined doṣas. / But for innate hemorrhoids, one should proceed according to constitution,

having determined the treatment oneself by intellect according to strength. / Three palas of ginger, a fourth of marica,

half a kuḍava of pippalī, and a pala of cavya, / a pala of tālīsapatra, and half a pala of filament,

two palas of pippalī root, likewise a pala of citraka, / likewise karṣas of tvak and patra, and a karṣa of fine cardamom—

one should process these powders in thirty palas of purified jaggery; / from that, pills measuring an akṣa, celebrated as 'prāṇadā',

are also proclaimed as the Tālīsapatra pills. / One should consume them according to strength, either before or after a meal,

and make them take their meal with wines, meat broths, vegetable soups, and milks. / Through this, it destroys hemorrhoids born of kapha and innate ones,

those arising from vāta and pitta, those born of blood, and the others; / in alcohol intoxication, dysuria, urinary disorders, cardiac spasm,

toxic fever, flank pain, for one who is injured, emaciated, or purged; / for those with dull digestion or irregular digestion, and likewise those with worms in the gut;

for those seized by colic and gulma, and also for those with vomiting and diarrhea; / for heart patients, jaundice patients, those with wasting, and those with upward-moving vāta;

and these auspicious pills should be taken by those afflicted with cough and dyspnea. / Innate [hemorrhoids] in this world mostly wear down an embodied being;

therefore, one should perform his treatment by the regimen for wasting. / Hemorrhoids are rightly declared the highest of the entire host of diseases;

therefore, the physician should treat hemorrhoids in detail. / Excision of them with an instrument, and burning with alkali—

a surgeon of seen practice should apply these treatments. / But whatever treatment is to be applied by one who knows Ayurveda,

the rule of ointments, inunction, and sudation therapy—hear that: / having anointed the navel, belly, bladder, testicles, and anus,

one should sprinkle them with lukewarm sour liquids, milks, and urines. / With young steamed radishes, and also with carrots,

one should properly sweat them with lukewarm [substances], or with oil-cake or cow dung. / Rāṭha, castor root, madhūka, and devadāru,

mixed with barley flour, having stirred them with milk, one should administer them to drink; / one should make a poultice with it and sweat them again and again.

The hemorrhoids subside, and the pain ceases. / With leaf decoctions of vṛṣa, arka, and naktamāla, and also of kāśmarya and ādaṇḍa,

one should sweat [the patient], and sit him right there. / Mahānimba, ginger, kuṣṭha, and iron sulphate,

rock salt, citraka, dantī, karavīra, arsenic stone, / pūtika, varuṇa bark, vidārī, the one called lāṅgalī,

viḍaṅga, hemadugdhā, and yellow orpiment—one should grind them. / With this paste-substance, one should cook oil in four times as much urine,

and here there should be a kuḍava each of snuhī milk and arka milk. / This ointment, properly applied, is the supreme pacifier of hemorrhoids.

For this performs the work of an alkali and does not corrupt the rectum. / Kulīraśṛṅgī, elephant bone, balā, and lāṅgalikī,

asafoetida, kuṣṭha, blue vitriol, bilva, and marking nuts— / the plastering of the hemorrhoids with that [is to be done] again and again for seven nights.

Siris seeds, the two alkalis, lāṅgalī, and rock salt, / ground with snuhī latex, one should steep with cow's bile.

One should smear the hemorrhoids with that again and again for seven nights. / Hemorrhoids smeared with this are destroyed, there is no doubt.

Moringa […] / Having gathered everything together, one should grind it with latex of snuhī.

Karavīra, anavadya, mālatī, and golden jasmine— / this decoction for washing is declared beneficial for hemorrhoids.

Butter with honey, however, is a wound-healing plaster. / It burns away [the piles] in seven nights, and virility is not destroyed.

[…] / […] three pungents one should grind with latex of snuhī.

This supreme plaster destroys hemorrhoids. / Svarṇakṣīrī, however, […]

And chicken dung one should grind with latex of snuhī. / This is an excellent plaster for hemorrhoids, equal to alkali.

The hemorrhoids are burnt away in a week, and virility is not destroyed. / Barley, white mustard seeds, marking nut, and fat—

sandalwood, kuṣṭha, and the heartwood of śiṃśapā for fumigation, / and cow dung, boar's [dung], or leaves of ariṣṭa and moringa,

mixed with ghee, they praise as the best fumigation for hemorrhoids. / In those arising from blood and pitta, milk enemas are praised;

sharp ones in those arising from kapha, and unctuous enema in vāta types. / Those from the combination of all three doṣas are incurable, as are those of long standing here; / those born of blood and congenital ones are palliatable, and the other three are also curable. / Thus said the venerable Ātreya. / Thus the sixteenth chapter in Bheḷa. / Seventeenth chapter. / Now we shall explain the treatment of swelling, so said the venerable Ātreya: