Hemorrhoids (Arßhas)
Causes: Simultaneous vitiation of all three doßhas
weakens the skin, muscles, and fat, obstructing the
veins in the muscles of the rectum. The predominating
doßha will determine the main cause and symptoms.
Varieties: Two types of hemorrhoids exist: those
that are congenital or those acquired occurring during
one’s life. Their symptoms are either dry or bleeding.
Congenital (Sahaja): Due to improper or
unhealthy activities of the parents or fate. This
produces tridoßhic hemorrhoids that can be checked,
but not healed (as with all hereditary diseases). They
are dry, face inward or outward; some are round,
irregularly spread or matted together, yellowish-white,
usually small, and accompanied by secondary
After Birth (Janmotta-raja): Five types of this
disease can occur: Váyu, Pitta, Kapha, Tridoßhic, and
blood-induced. Váyu and Kapha cause dry (¤hußhka)
piles, while Pitta and blood cause bleeding
Congenital Symptoms: Apána Váyu, being
obstructed from birth, moves the air upwards,
aggravating the other 4 Váyu sub-doßhas, Pitta, and
Kapha. This develops the following conditions.
Persons are born thin, lean, emaciated, and weak, with
excessive gas, urine, and feces that may be obstructed.
Other symptoms include poor complexion, urinary
tract stones, and gravel. Feces can vary, from
constipation or dryness to diarrhea, or may be normal.
Sometimes feces have toxins and mucus. They can
be white, pale, green, yellow, reddish, thin, dense,
and slimy.
Severe pain may develop in the navel, urinary
bladder, and pelvis areas. Other symptoms include
dysentery, hair standing on end, urinary disorders,
diabetes, intestinal gurgling, distention, a sensation
of stickiness in the heart and sensory organs. Persons
may experience excessive bitter and sour belching,
poor digestion, irritability, weakness, and small
amounts of seamen. Additional symptoms include
frequent coughs, difficult breathing, bronchial asthma,
thirst, nausea, vomiting, anorexia, indigestion, chronic
rhinitis, sneezing, fainting, and headaches. Persons
may develop low, weak, hoarse, and broken voices;
ear diseases, fevers, joint and bone pain associated
with general weakness. Stiffness in the side of the
chest and abdomen, urinary bladder, heart area, back
and lumbar regions can occur. Mentally, one is very
thoughtful, giddy, or lazy.
Acquired Hemorrhoids
General: Hemorrhoids are caused by excess
aggravation of the doßhas through improper diet and
lifestyle that weaken the digestive fire. They may be
caused by excess sex, riding, straining, sitting for long
periods on uneven or hard seats, or on one’s heels.
Other causes include enema nozzles, rough surfaces,
washing with very cold water, straining during
defecation, and suppression or early release of gas,
urine, or feces. Emaciation caused by fever,
abdominal tumors, diarrhea, excess áma, duodenal
disorders, edema, anemia, and overexertion can also
cause this disease. For women this disorder can be
caused by abortion, miscarriage, and abnormal fetus
development. This leads to an accumulation of
undigested food (toxin waste or áma). Feces become
lodged in the folds of the rectum, hardening and
causing friction, thus developing hemorrhoids.
Premonitory Symptoms: Weak digestion, weak
thighs, twisting pain in calves, dizziness,
enfeeblement of parts of the body, swelling of eyes,
diarrhea or constipation, gas with lower abdominal
pain, cutting pain in the anus; feces are difficult to
eliminate with accompanying noise. Other symptoms
include intestinal gurgling, abdominal distention,
emaciation, excess belching, excess urine, and insufficient
feces, not feeling the need to defecate, hot
fumes, acidity, pain in the head, back, and chest, exhaustion,
skin discoloration, stupor, weakened sense
organs, anger, and unhappiness.
General: Downward moving air (Apána Váyu)
moves upward because of obstructions of the rectum.
This aggravates the other four forms of Váyu (Práò,
Udán, Vyán, Samán) in the body, as well as the urine,
feces, Pitta, Kapha, the tissues (dhátus), and their sites.
Thus, digestion is weakened, and áma and feces
accumulate and sit in the folds of the rectum.
Poor digestion, accumulation of sweat, urine, and
feces can develop by eating too many heavy, sweet,
cold foods and liquids that block the channels of
circulation and cause burning sensations. Also, eating
mutually contradictory foods, eating before the last
meal is digested, eating too small portions, junk food
or stale food, animal products or excessive amounts
of pastries can cause trouble. Other causes include
dry or raw vegetables, vinegar, garlic, pickles, heavy
fruits, fermented wines, polluted water. External
causes include excessive oleation therapy, not
eliminating toxins, wrong use of enema therapy, lack
of exercise, excessive sexual acts, and day naps.
When Apána Váyu is excessive, it pushes feces to
the anal sphincter and aggravates it, developing
hemorrhoids. Apána Váyu is deranged from sitting
on rough, hard, or uneven seats, bumpy rides,
excessive sexual intercourse, enema nozzles
improperly inserted, too much cold water, and
scratching the anus. Other causes include straining
in life and in passing feces, suppressing the natural
urges, miscarriage, pressure of the uterus during
pregnancy, and abnormal delivery.
Váyu: Eating astringent, pungent, bitter, dry, cold,
and light food, eating too little food or fasting,
drinking sharp alcohol, sex, living in too cold an
environment, hard exercise, grief, and exposure to
the wind.
Pitta: Eating pungent, hot, salty, burning, and sharp
foods (e.g., onions, garlic, cayenne), straining
exercise, exposure to the sun and fire, living in very
hot places, drinking alcohol, envy, anger, and
Kapha: Eating sweet, oily, cold, salty, sour, and
heavy foods, eastern winds, living in cold climates,
mental lethargy.
Tridoßhic: Caused by combinations of foods and
life-styles mentioned above.
General: Severe emaciation, lack of enthusiasm,
helplessness, a weakened, broken voice, pale
complexion, weakened tissues, and pain in the vital
organs. Further symptoms include cough, thirst, bad
taste in the mouth, difficult breathing, nasal mucus,
exhaustion, faint body pains, vomiting, excessive
sneezing, edema, fever, impotence, deafness, and
blindness. Persons may develop urinary gravel or
stones, worry, spitting, loss of appetite, pains in all
the bones, joints, heart, navel, anus, and groin. Other
symptoms include oozing from the rectum,
hemorrhoids (either dry or bleeding—yellow, green,
red, or slimy) may occur.
Váyu: Dry, tingling, shriveled, bluish-red, uneven,
coarse and hard, sharp, cracked, associated with pain,
cramps and excessive itchiness, numbness, and
tingling sensations. Other symptoms include severe
pain in the head, ribs, shoulders, waist, thighs and
groin, sneezing, and belching. Further disorders
include food not moving through the digestive tract,
sudden heart pain, loss of taste or appetite, cough or
difficult breathing. Irregular digestion, ringing in the
ears, dizziness, blackened skin, nails, feces, urine,
eyes, and face may occur. Feces disorders include
small quantity with noises and straining, or dysentery
followed by painful release of frothy, slimy fluid. If
this is not healed, it will lead to abdominal tumors,
enlargement of the spleen, abdomen, and prostate.
Oily and hot things relieve this condition.
Pitta: Thin, soft, flabby hemorrhoids are blue, red,
yellow, blue, or black in complexion, exuding thin
blood with a foul smell and burning sensation in the
body. Other symptoms include asthma, ulceration,
fever, perspiration, excessive sweating and discharge,
thirst, fainting, and loss of taste and appetite. Further
disorders are delusion, heavy stool, brown, green,
yellow or deep yellow complexion, eyes, and nails.
The stool becomes yellow or red, and bloody, burning,
and itching. Colic or pricking pain, yellow or green
loose stools or diarrhea develops. Copious, yellow
and malodorous urine and stool develop. Cold things
bring relief.
Kapha: Hemorrhoids are deeply rooted, large,
swollen, thick, hard, round, white, and bulging. They
may be oily, greasy, smooth, with dull pain (but
painless to the touch), stiff, and rigid. Other symptoms
include severe itching, cutting pain in the anus, urinary
bladder, and navel region. Further developments
include cough, difficult breathing, nausea, salivation,
anorexia with mucus, and urinary disorders (e.g.,
dysuria, diabetes, stones, gravel). Persons may
experience vomiting, excessive spitting, cough, cold,
impotence, dull head pain, and fever with shivering.
Feces symptoms include straining to eliminate,
containing mucus and excess elimination. The stool
can be reddish, white and sometimes with slimy
discharge. The urine and stool are heavy, slimy, and
white. Complexion becomes yellowish-white and
greasy; there is constant edema, and the organs feel
as though covered with sticky material. The mouth
has a sweet taste. Tuberculosis and poor digestion
associated with acute diseases caused by áma
(undigested food toxins) can develop. This is a chronic
condition. Dry and hot things bring relief.
Tridoßha: Symptoms of all three doßhas will
appear simultaneously.
Blood: Hemorrhoids caused by blood aggravation
have symptoms similar to Pitta and have the look of
Váyu. Feces are hard, and hemorrhoids may bleed
suddenly. This bleeding can lead to a greenish or pale
complexion and to other diseases associated with loss
of blood, strength, enthusiasm, and sensory abilities.
The most serious secondary complication to arise
along with hemorrhoids is constipation.
The most serious forms of hemorrhoids occur with
cardiac and/or rib pain, limb pain, fainting, vomiting,
thirst, and inflammation of the anus. Almost as serious
are symptoms of hand, leg, face, navel, anal, or testicle
edema. In these cases, hemorrhoids can only be
controlled, but they cannot healed. Also in this
category are hereditary symptoms due to tridoßhic
causes, when found in the internal anal sphincter.
If persons are strong and have good digestion, their
hemorrhoids can be healed. Hemorrhoids may last
for a long time when they are caused by the
simultaneous imbalance of two doßhas, when they
are congenital, when they are tridoßhic, or when they
are found in the innermost folds of the rectum.
However, they can be controlled if the digestive fire
is adequately strengthened. Those hemorrhoids
caused by two doßhas found in the second rectal fold
or those that have existed more than one year (chronic)
are difficult to heal. Those caused by only one doßha,
found in the outer folds and that are non-chronic, are
easily healed. Some suggest surgery or cauterization
with alkalis.
There are 3 additional places where piles may
occur: in the male organ (discussed later), at the navel
(being slippery and soft), and on the skin as warts.
General: Herbs of neem, triphalá, guæúchí,
licorice, chitrak, viæa´ga, and pittapapra are most
Hemorrhoids are classified into 2 main categories,
dry and wet. Those caused by Váyu and Kapha fall
into the former category, those caused by Pitta and
blood aggravation fall into the latter. Here blood is
considered wet, and although Kapha hemorrhoids are
oily, greasy, slimy, etc., they are considered dry.

Dry Symptoms and Therapies: With numbness,
edema, and painful lumps, the mass is first smeared
with triphalá, bilwa, or chitrak medicated oils. Afterwards,
warm or oily compresses (fomentation) of
barley, or sesame seed powder, lukewarm compresses
of vachá powder, corn flour with sesame oil or ghee,
dry radish pulp are applied.
Next, herbal water made from herbs of bilwa,
vásák, arka, and castor oil may be sprinkled on the
areas of the navel and anus. Persons may take sitz
baths with water decoctions made from triphalá,
bilwa, yogurt-water, whey, or radish leaves. One
prepares for the sitz bath by smearing warm triphalá
oil or ghee on the hemorrhoids.
Aromatherapy includes burning and inhaling arka
root, viæa´ga, barley, a¤hwagandhá, or Pippalí mixed
with ghee. Ointments are also used, mixing sesame
oil, ghee, or warm water with herbs until the mixture
becomes a paste. The paste is smeared on the masses.
Herbs used include pippalí, chitrak, turmeric,
triphalá, and cane sugar. Ointments are specifically
useful when there is edema, stiffness, itching, and
Herbs that reduce the various doßha-caused
hemorrhoids are also used in the above therapies (i.e.,
cold, bitter herbs for Pitta; warm, oily herbs for Váyu;
bitter and warm herbs for Kapha). Bloodletting is
administered (by qualified practitioners) when the
above therapies do not work.
Herbal powder mixtures (chúròas) are also
ingested; the mixture depends on the prevailing doßha
causing the hemorrhoids. Triphalá is a good general
chúròa. Hot spices like ginger, pippalí, and black
pepper (t^ikatu) are used for Váyu and Kapha
conditions. These also help improve the digestive
power, improve appetite, stimulate the downward
movement of air (Apána Váyu), reduce swelling,
itching and pain, promote strength and complexion.
Barley, turmeric, triphalá, and viæa´ga are useful for
Pitta conditions.
When the patient suffers from both hemorrhoids
and constipation, recipes include triphalá decoction,
triphalá with yogurt-water (lassi), or just harítakí with
lassi. Lassi (buttermilk) is considered the best
medicine for healing hemorrhoids caused by Váyu
and Kapha (a teaspoon of ghee or sesame oil may be
added for Váyu conditions). Depending upon the
person’s strength and the season, they may take
buttermilk (lassi) from 1 week to 1 month, gradually
increasing and decreasing the number of glasses per
day. [1 month example: 1 lassi—first day. 2 lassis—
second day...adding 1 lassi per day until 15 lassis on
the 15th day. On the 16th day—14 lassis, the 17th
day—13 lassis...reducing the amount by 1 each day
until 1 lassi on the 30th day.
If the person is weak, then lassi is given mornings
and evenings. When persons are strong, they may
mix fried barley flour with lassi for evening drinks.
Rock salt (saindav namak), found in any Indian
grocery store, may be added to the drink. Meals are
eaten using foods that balance the person’s doßha.
After meals lassi with ghee or oil, mixed with basmati
rice is taken.
There are 3 types of lassi: (one for each doßha),
Váyu’s lassi is made with whole milk. Pitta’s lassi is
made with skim milk. Kapha’s lassi is made with
fat-free milk. Lassi cleanses the circulatory channels,
enabling the plasma (rasa) to reach and nourish all 7
tissue layers (dhátus). It is said that hemorrhoids
healed with lassi will not develop again.
Other useful foods and drinks:
1) Thin gruel (peyá)—rice flour, pippalí, chitrak,
bilwa, lassi, fried in ghee or oil for Váyu hemorrhoids.
A peyá mix is 50 gms. (1.76 oz) basmati rice cooked
with 8 times as much water.
2) Thick gruel (yavágú)—Basmati rice with
pippalí, lassi, black pepper for Váyu and Kapha. A
yavágú mix is 50 gms. basmati rice cooked with 2 to
4 times as much water.
3) Vegetable soup—boiled and dry paßhana
bedha, dried radish, bilwa, lassi, any astringent herbs
(e.g., raspberry) for Pitta.
4) For hemorrhoids with constipation—drinks
consisting of cane sugar, ghee, barley, gokßhura, and
lassi are for all doßhas.
Cane sugar, barley flour, pomegranate juice,
boiled water, and black salt for Váyu.

Barley, honey, pippalí, dry ginger, black pepper,
rock salt, and lassi for Kapha and Váyu.
5) Green leafy vegetables are especially good for
6) Fresh white unsalted butter with sugar and
sesame seeds also heals this disease if taken for a
long time.
1) For gastritis (upward moving air [Upána
Váyu]—chitrak, pippalí, bilwa, licorice decoction).
This is an anuvásana enema.
2) Medicated enema for Váyu—milk, decoction
of da¤hmúl, castor oil, and black salt. This is a nirúha
Bleeding Hemorrhoid Therapy: Two types of this
therapy exist: when Pitta is predominant, and when
Kapha or Váyu are secondarily aggravated.
Signs of Váyu as a secondary cause—grayish
color, hard and dry stool, not releasing gas through
the anus, blood from hemorrhoids is thin, reddish,
and foamy, pain in lumbar, thighs, and anus, great
weakness. This is caused by drying foods and lifestyles.
[Váyu predominance—develops even in Pitta
and Kapha excesses if bleeding is excessive.]
Therapies include oily and cold foods and lifestyles.
Signs of Kapha as a secondary cause—stool is
loose, yellow, white, dry, heavy and cold; blood from
hemorrhoids is dense, thready, pale yellow, and slimy.
There is sliminess and numbness in the region of the
anus. This is caused by heavy and dry foods and lifestyles.
Therapies include dry and warm foods and lifestyles.
First, detoxifying or elimination therapies (e.g.,
fasting, purgation, emesis) are recommended, then
herbs are taken.
Hemostatic Therapies (stopping bleeding): When
toxic blood is exuded, continued bleeding is necessary
to release the toxins. Should bleeding be stopped too
soon, it can lead to various other diseases of Rakta
Pitta. Examples include bleeding from other parts of
the body, fever, morbid thirst, weakening digestion,
anorexia and, jaundice. Other disorders include
edema, colic pain in the anus and pelvic areas, skin
diseases in the lumbar region and thighs, anemia,
retention of gas, urine, and stool, headache, and
Bitter drugs stimulate the digestion, metabolism,
and stoppage of bleeding. If Váyu is predominant even
after the toxins are eliminated, then oily liquids,
massage, and anuvásana enemas are suggested. If
Pitta is the only cause of the illness, and bleeding
occurs in the summer, then hemostatic therapies are
immediately given to stop the bleeding.
Hemostatic herbal decoctions: Kuþaj, ginger
(coagulates blood), sandalwood, neem, musta, bilwa,
nágkehar, pittapapra, red lotus, white lotus, balá, and
Recipes: Fried barley flour with any of the above
herbs, onions taken alone or with barley and sugar
(or with lassi, butter, and sesame seeds).
Sprinkling water, sitz baths, and ointments made
from the above herbs also help stop bleeding. Water
decoctions include licorice, arjuna, neem, and vásák.
Bath herbs include sandalwood and licorice.
Ointments include ghee with sandalwood and neem
If rectum prolapse (determined by feeling a Pitta/
Váyu pulse) or burning or stickiness in the anus
occurs, then it is rubbed with sesame oil or ghee and
mañjißhþhá, licorice, sandalwood and neem, honey,
and ghee, red and white sandalwood.
Continuous Bleeding Therapy: Forehead paste and
soup made of dúrba (the best blood coagulative),
sandalwood, and ghee. Also, anuvásana enemas with
the luke-warm upper portion of ghee, dúrba, and
Summary: Váyu uses oily, sour and sweet
therapies, Pitta uses bitter, dry and cool therapies,
Kapha uses hot therapies.
Either hemorrhoids, diarrhea, and sprue (grahaní—
malabsorption, anemia, and gastrointestinal disorders)

can cause the development of the other 2 diseases.
They develop from poor digestion and are healed by
strengthening the digestive power. Generally
hemorrhoids are healed by eating fried vegetables,
thick barley gruel, vegetable/ghee soup, milk, and
Due to Hemorrhoids (Udávarta)
Causes: Váyu is aggravated in the colon by eating
air-increasing foods and drinks, i.e., foods that are
bitter, astringent, and dry (e.g., broccoli, barley, apples,
most beans, and dry cereals).
Developmental Symptoms: The accumulated air
then becomes aggravated, blocking the downward
movement of Váyu (Apána). This dries the moisture
in these channels, obstructing the movement of feces,
gas, and urine.
Following this, severe pain develops in the lower
abdomen, ribs, back, and heart area, along with
gripping abdominal pain, nausea, cutting pain in the
rectum, severe and constant pain in the urinary
bladder; cheeks may swell. Váyu moves upward.
The next stage of symptoms includes vomiting,
anorexia, fever, other Váyu diseases of the heart,
duodenum, and urine suppression. Other disorders
include dysentery, deafness, blindness, difficult
breathing, headache, cough, nasal mucus, mental
anxiety, worry or fear, thirst, bleeding, abdominal
tumors, and enlarged abdomen. Being secondary
complications, these diseases—when associated with
hemorrhoids—are difficult to heal. Therefore,
constipation is the main complication to heal before
these other symptoms appear.
Castor oil—Pitta, Pitta/Váyu—2 teaspoons in
a cup of hot water before bed.
Rhubarb—for stronger measures Senna—the
strongest therapy.
Therapies include oil massage (oleation) followed
by sudation (sweating). Afterwards, oleation and
sudation herbal suppositories are given, made of
pippalí, madanphal, charcoal ash, mustard, and
jaggery. In difficult cases castor oil purgation and
nirúha basti (enema) (mainly using castor oil) are used.

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