What symptoms arise when the four great elements are out of balance?

When the four great elements are in discord, a hundred illnesses arise; all diseases of the material body are caused by the disharmony of the four great elements. The causes of this disharmony are twofold: one is the working of karmic obstructions, and the other is the environment one encounters later in life. When the four great elements fall out of harmony, the composition of the four great seeds has changed, and the body must undergo corresponding changes, giving rise to various illnesses. The disharmony of a single great element alone can bring about the diseases corresponding to it. For example, when the water element is in discord, the water in the body is either too much or too little, and whether the water content is excessive or deficient, it will cause illness—such as edema, dry skin, kidney disease, eczema, dermatitis, thickened blood, cardiovascular and cerebrovascular diseases, and other water-related ailments. Disharmony of the wind element can cause wind-related diseases, such as respiratory illnesses, urticaria, rheumatism, and so on. Disharmony of the fire element can cause fire-related diseases, such as disorders of bodily heat and cold, chills, high fever, low fever, and the like. Disharmony of the earth element can cause diseases related to the hardness and supportive function of earth, such as calcium deficiency, weakness of the limbs, physical frailty, hunched back, aching all over the body, and so forth. When one element is in discord, a hundred illnesses spring up—how much more so when all four elements are in discord, when the obstructions of disease become layer upon layer. In sum, these are all karmic retributions invoked by sentient beings' karma created over beginningless kalpas; only in rare cases are they temporarily caused by the body's occasional maladjustment to changes in the external environment, while most are illnesses of karmic obstruction. Whether it is an illness of karmic obstruction or one triggered by occasional environmental maladjustment, the change is brought about by the tathāgatagarbha: the four great seeds are transmitted from the tathāgatagarbha, and when their proportions and composition change, the material body undergoes corresponding changes. The change in the composition of the four great seeds is decided by the tathāgatagarbha as the master. Upon what does the tathāgatagarbha base its decision to alter the output of the four great seeds? One is the karmic seeds: the tathāgatagarbha can discern karmic seeds, and its operation must proceed in accordance with them. The other is the environment contacted by the body, for the tathāgatagarbha can discern the body faculty and the environment of the material world; relying on these, it must constantly adapt to the environment and the body faculty, altering the structure of the four great seeds. In this way the body is perpetually undergoing all kinds of changes. The material body of every sentient being changes moment by moment in just this way—there is none that does not change—and all of it is brought about by one's own tathāgatagarbha.