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Garudapurana 1.156

English (machine translation) 1.156

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1.156.1

The glorious Garuḍa Mahāpurāṇa — 156.
Dhanvantari said: / Now I shall explain the etiology of piles (arśas), O Suśruta! / The pegs that constantly arise in the flesh of living beings,

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are called piles (arśas) because they obstruct the anal passage. / The doṣas, vitiating the skin, flesh, and fat, produce diverse forms of

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fleshy sprouts in the anus and other parts; they call these piles. / Briefly, their division is twofold: congenital and arising in later life.

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The varieties are dry and exuding, residing in the region of the rectum. / It measures four and a half finger-breadths; in it are three [folds], each situated at one and a half finger-breadths.

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Among them, the inner is pravāhiṇī, in the middle of the bowel is visarjinī, / and the outer is saṃvaraṇī, at the anus, extending outward by a finger-breadth;

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at a measure of one and a half finger-breadths further on are the hairs. / The cause of the congenital ones is the affliction of the seed in childhood;

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the creation of the seed of piles is from the misconduct of mother and father, / from the wrath of deities, or from the combination of doṣas in another manner.

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All hereditary diseases are declared to be incurable. / The congenital ones, in particular, are rough and unsightly,

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turned inward, pale, and accompanied by severe complications. / They are also to be classified individually from the single doṣas, their combination, and their gathering.

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The dry ones are from vāta and kapha, while the moist ones are from blood and pitta. / The cause of the aggravation of the doṣas is as stated before in [the chapter on] wasting and other diseases:

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when the digestive fire is impaired and wastes are excessively accumulated; also from excessive sexual intercourse; / from agitation caused by drinking, and eating irregular, hard, or meager food;

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from trauma caused by the enema nozzle, ulceration of the throat or lips, and splitting of the palms or soles; / from contact with extremely cold water, and constant excessive straining;

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from suppressing or forcefully expelling the urges of passing urine and feces; / disgust, diarrhea, and grahaṇī are also complications of it;

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from emaciation, irregular exertion, and the like; in women, furthermore, / from miscarriage of an immature fetus, and pressure from the growth of the fetus.

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By these and other such causes, the apāna vāyu, aggravated in the fecal matter / and in the folds of the anus, having moisture and circular shape, swelling into full forms,

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piles are born. Their premonitory symptoms are: weakness of the digestive fire, / flatulence, debility of the bones, cramps in the calves, and dizziness;

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thick swelling arising in the eyes, looseness or retention of stool, / wind moving downward confounded, usually wandering below the navel;

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with blood, cutting pain, contracting with difficulty while panting, / rumbling in the intestines, abdominal distension, and abundant sour or caustic belching;

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abundant urine, scanty stool, lack of appetite, a smoky sensation in the gut, / pain in the head, back, and chest, laziness, and loose feces;

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longing for sensory objects, anger from slight provocation, / suspicion, grahaṇī, swelling, anemia, abdominal tumors, and dropsy.

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These very symptoms increase when [the piles] are formed under their specific names; / for the wind, turning back due to the obstruction of the downward path caused by them,

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agitates the other winds going to all the sense organs and the body, / and the wind, drying up urine, feces, pitta, and kapha,

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steals the digestive fire; then all [kinds of] piles generally develop. / The patient becomes exceedingly emaciated, dispirited, dejected, weak, and lusterless,

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destitute of strength, bereft of complexion, like a tree consumed by pests; / seized by painful and severe complications, and torment of the vital parts as described in consumption;

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likewise with cough, thirst, bad taste in the mouth, asthma, chronic rhinitis, / fatigue, aching of the limbs, vomiting, sneezing, swelling, and fevers;

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afflicted with impotence, deafness, numbness, and urinary gravel, / emaciated, with a broken voice, brooding, spitting repeatedly, and lacking all relish.

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suffering from sharp pain in all joints, bones, heart, navel, anus, and groins; / through the rectum dripping bile resembling a heron's belly,

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dried up, discharged at the tip, alternately cooked and raw, / pale yellow, smeared with turmeric, and slimy is evacuated.

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Anal polyps having an excess of wind are dry, tingling, / reddish-brown like glowing coals, rigid, irregular, and rough in shape;

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dissimilar to each other, crooked, sharp, with cracked mouths, / resembling beans, dates, wild jujubes, or cotton fruits;

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some resemble kadamba flowers, some are like mustard seeds; / causing severe distress in the head, flanks, shoulders, calves, thighs, groins, and elsewhere;

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causing sneezing, eructation, constipation, cardiac distress, and anorexia, / bringing on cough, dyspnoea, irregular digestive fire, ringing in the ears, and dizziness.

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Afflicted by them, a person passes knotty, scanty, noisy stool with tenesmus, / accompanied by pain, froth, and slime, [passed] with obstruction.

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His skin, eyes, and mouth become black, and urine and stool are obstructed; / moreover, abdominal tumours, spleen disorders, and stone-like swellings arise in him.

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Those dominated by bile have blue tips, with red, yellow, and black lustres; / their discharges flow from slender tips, they smell like raw meat, and are thin, soft, and flaccid;

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resembling parrot tongues, pieces of liver, or leech mouths; / causing burning, emaciation, fever, perspiration, thirst, fainting, anorexia, and confusion;

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they are accompanied by heat; the faeces are liquid, blue, hot, yellow, red, and undigested; / they are barley-shaped in the middle, and the skin, nails, and other parts become green, yellow, and turmeric-coloured.

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Those dominated by phlegm have deep roots, are dense, cause dull pain, and are white; / elevated, fleshy, unctuous, rigid, round, heavy, and firm;

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slimy, motionless, smooth, very itchy, pleasant to the touch; / resembling karīra sprouts, jackfruit seeds, or cow udders;

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causing fullness in the groins, cutting pain in the anus, bladder, and navel; / accompanied by cough, dyspnoea, nausea, excessive salivation, anorexia, and chronic catarrh;

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causing great dysuria, heaviness in the head, chilliness, and alkaline discharges; / producing impotence, dullness of digestion, vomiting, diarrhoea, and other disorders;

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accompanied by tenesmus and copious stool mixed with fat-like matter, phlegm, and blood; / they do not bleed or burst; the skin and other parts are pale and oily.

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From combinations [of two doshas] arise combined symptoms; from all three combined, all signs are present. / Blood-dominated piles in the rectum have the shape of bile-type piles,

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resemble banyan sprouts, and look like guñjā berries or corals. / Afflicted by tight constipation, they suddenly bleed

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excessive, vitiated, and hot blood; and from its excessive flow, / looking like a peacock, he is afflicted by miseries arising from blood loss;

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diminished in complexion, strength, and enthusiasm, his vitality destroyed, his senses clouded. / By mung beans, kodo millet, citron, karīra, chickpeas, and the like,

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which are dry and astringent, wind is aggravated in the seat of stool and becomes strong; / blocking the downward-moving channels and drying up below,

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it produces severe retention of wind, stool, and urine; / thereby, intense pain arises in the abdomen, back, heart, and flanks;

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distension in the abdomen, retained faeces, nausea, cutting pain, / especially severe colic in the bladder, and swelling of the cheeks occur.

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Because wind moves upward, there arise vomiting, anorexia, fever, / heart disease, disorders of the duodenum, urinary retention, and tenesmus;

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deafness, severe head pain, dyspnoea, headache, cough, and chronic catarrh; / mental disturbance, thirst, breathlessness, bilious abdominal tumours, and other disorders.

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These highly dreadful diseases caused by wind arise; / udāvarta is the most grave complication, an enemy of longevity, [caused by] piles.

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In those whose bellies are overwhelmed by wind, it arises even without them. / But those piles that are congenital, and those situated on the innermost fold,

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are incurable; they are palliated by digestive strength and the like. / Those born of two doshas, and those situated on the second fold,

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are said to be curable with difficulty, as are those lasting over a full year; / but those arisen on the outer fold, aggravated by only a single dosha,

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are easily curable piles, if not of long standing. / They will also be described on the penis and other parts according to their characteristics; but those born at the navel

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have the form of earthworms, slimy and soft. / Vyāna wind, seizing phlegm, produces piles on the exterior of the skin,

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peg-like, firm, and rough; they know it as a cutaneous wart. / By wind there is piercing pain and roughness; from bile there is a blackish tip;

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from phlegm there is unctuousness, knottiness, and same colour as the skin. / An intelligent person should quickly make an effort for the relief of piles; / for, quickly causing disease, they may cause intestinal obstruction.

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Thus in the glorious Garuḍa Mahāpurāṇa, in the first section called the first part, in the section on Conduct, the one hundred and fifty-sixth chapter, named “Diagnosis of Piles”.

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