Haemorrhoids may be divided into six classes viz - (i) Vataja (due to the action of the deranged Váyu), (ii) Pittaja (due to the action of deranged Pittam), (iii) Kaphaja (due to the action of deranged Kapham), (iv)
Raktaja (due to the action of the vitiated blood), (v) Samipátaja (due to the concerted action of the deranged Vayu, Pittam and Kapham and (vi) Sahaja (congenil enraged by their specific aggravating causes, or by such acts or conduct as partaking of food composed of incompatible substances eating before the previous meal. has been digested,inordinate sexual intercourse, sitting on the haunches, excessive riding, and the voluntary suppression of any natural urging of the body, either severally or in combination of two or three Doshas, or vitiating the blood of a person, who observes no moderation in food and drink etc. become dislodged from their natural seats in the body [according to the law of Prasáranam (expansion and change of place by a deranged organic principle)] and are carried down through the large intestine (Pradhána Dhamani) into the descending colon and getting lodged therein, give rise to growths of polypi or fleshy condylomata., which are known as piles. These growths chiefly appear in persons suffering from impaired digestion (Agni). and gain in size through friction with the wearing apparel, weeds, wood, lumps of clay or stone, or by contact with cold water. 3.
The lower end of the large intestine., which passes into the flexure of the rectum and measures four and a half fingers in length, is called the Gudam (lit - the channel of fecal matter,), the interior of which is provided with three spiral grooves. Each of these grooves or ring-like muscles lie a finger and a half apart, and arc respectively known as Pravahini, Visarjani and Samvarani, or the grooves of out-flow, defecation and arc of the anus (sphincter ani), covering a space of four fingers and having laterally an elevation of one finger's width. 4
These grooves arc like the involuted indentures of a conch shell, situated one above the other, coloured like the palate of an elephant. A part of the channel, half a finger's width in length as it is usually measured from the outer hairy orifice of the rectum, is called the anus (Gudoushtha). 5 - 6
The first of the aforesaid grooves or rings lies about a finger's width apart from the orifice of the anus.
A non-relish for food, a tardy and difficult digestion of food (brought into the stomach), acid eructations a sense of weakness in the thighs, a rumbling sound in the intestines, emaciation of the body, frequent eructations, swellings around the eyes, a croaking sound in the intestines, cutting-pain in the rectum (Guda), apparent indications of an attack of phthisis, jaundice, dysentery cough, dyspnoea, vertigo, somnolence, excessive sleep weakness of the organs (Indriya), are indications which predict the advent of this disease, and which become more marked with its progress. 7.
Piles, due to the action of the aggravated Váyu, are non-exuding, rose-coloured, and uneven in their surface. They resemble the Kadamba flowers in structure and are either tubular or sharp-pointed like a needle, sometimes assuming the shape of the wild Tundikeri flower. The stool of a hemorrhoid patient of this type becomes excessively hard, and can be evacuated only in a sitting posture, with the greatest pain and difficulty. An excruciating pain is experienced in the regions of the waist, back, sides, anus, umbilicus and the genitals. Symptoms peculiar to Gulma, Ashthilá, enlarged spleen and abdominal dropsy add to the distress of the patient, whose skin, nails, eyes, teeth, face, urine and stool also assume a dark black colour. 8.
Piles, brought on through the action of the deranged Pittam, are slender, blue-topped, shifting in their nature, yellowish in their hue, or are coloured like shreds of liver, resembling in shape the tongue of the Suka bird. They are thick at middle, like barley grains, or resemble the mouth of leeches and secrete a sort of slimy exudation. The stool is marked with blood, and the patient complains of a painful, burning sensation (in the rectum) at the time of defecation. Fever, with a burning sensation and thirst, and epileptic fits, supervene. The skin, nails, eyes, face, teeth, stool, and urine of the patient assume a yellow hue. 9.
Piles, due to the action of the deranged Kapham, become white, are sunk about their roots, and are hard, round and glossy. They assume a greyish hue and resemble the teats of a cow or the stones of the Karira, or of a Panasa fruit. These piles do not burst, nor do they exude any sort of secretion. The patient feels an irresistible tendency to scratch the excrescences. The stools become copious in quantity and are charged with mucous (Sleshmá), resembling the washings of meat. Indigestion, fever with shivering (Sita-jvara), and heaviness of the head and cedema with a non-relish for food are the symptoms which become manifest with the progress of the disease. The skin, finger nails, eyes, teeth, face, stool and urine of the patient also assume a white colour, 10.
Piles (haemorrhoids), having their origin in the vitiated condition of the blood resemble the sprouts of the Vata tree in shape and are of the colour of red coral, or the seeds (dark red) of Gunja berry. They exhibit all the symptoms, which are peculiar to the Pittaja type of this disease. Pressed hard by the constricted faeces in their passage through the anus, they suddenly give rise to a haemorrhage of vitiated (venous) blood, and symptoms characteristic of excessive bleeding are found to supervene. 11.