मर्मोपतापात् सम्मोहादयनानां विघट्टनात् । तृष्णातियोगाद्वेगानां विषमं च प्रवर्तनात् ॥ ४६ ॥
It arises from the affliction or disease of vital organs (marmas like the heart, head, or bladder), loss of consciousness, severe injury or blockage of the channels and sense organs, profound thirst, and the improper or forced elimination of natural bodily urges.
english translation
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